October 7 attacks exposed gaps in Israeli hospital disaster preparedness, study finds

Years of disaster preparedness drills at an Israeli hospital allowed staff to continue treating patients even under rocket fire during the October 7 attacks. However, the unprecedented reality of wartime conditions exposed significant gaps in communication, logistics, staffing, and casualty distribution, according to a new study.

“

The findings offer practical lessons that could help hospitals worldwide prepare for prolonged armed conflicts and other large-scale emergencies.

The research, published in the journal Disaster Medicine and Public Health Preparedness, focused on the Samson Assuta Ashdod University Medical Center. It offers one of the most detailed accounts of a civilian hospital's operations during a large-scale wartime emergency. The study's lead author, Maximilian Nerlander, a doctoral candidate at Linköping University, conducted in-depth interviews with 19 hospital staff members and the head of trauma and disaster management.

Unlike previous terrorist attacks in other cities, the October 7 assault unfolded over many hours across multiple communities, with surrounding regions remaining under active attack. This prolonged and widespread nature of the violence created immense challenges. Ambulances struggled to reach victims, communication systems failed, and hospital staff often lacked a clear understanding of the rapidly evolving situation, relying on fragmented information from patients, soldiers, and social media.

“

Years of frequent mass casualty drills meant doctors, nurses, and support staff instinctively understood their roles, allowing them to focus on solving unexpected problems.

Despite the overwhelming chaos, the hospital remained operational. The study identified years of frequent mass casualty drills as a key strength. This preparation meant that doctors, nurses, and support staff instinctively understood their roles, enabling them to focus on addressing unforeseen problems. The hospital's reinforced, missile-protected emergency department also played a crucial role, allowing continuous patient care without staff needing to seek shelter, which helped maintain workflow and morale.

“

The hospital’s reinforced, missile-protected emergency department also enabled teams to continue caring for patients without needing to seek shelter, preserving both workflow and morale.