Planning for the inevitable: preparing for epidemic and pandemic respiratory illness in the shadow of H1N1 influenza.

The recent outbreak of novel H1N1 influenza has underscored the importance of hospital preparedness in responding toepidemic and pandemic respiratory illness. Comprehensive planning for the emergence of novel respiratory pathogens shouldbe based on an all-hazards approach, with the input of key stakeholders. A staged, scalable model allows for a flexibleresponse, and the addition of a medical control chief and a situational assessment chief to the incident command systemprovides the clinical and epidemiologic expertise essential for effective implementation. Strategies for coordinated and efficientcommunication both within and outside the institution should be clearly outlined. Furthermore, the outbreak of novel H1N1influenza demonstrated the necessity of (1) additional support roles within the hospital, (2) development of employeedatabases, and (3) incorporation of disease severity into staged planning. Careful consideration of these issues will allowinstitutions to better meet the challenges of treating epidemic and pandemic respiratory illness, both now and in the future.