It is paramount that all of those potentially involved in a mass casualty incident have a vested interest in practicing for the worst. Stressing teams to the point of failure during exercises will locate holes in the system that were previously undetectable. Inter-organizational relationships between hospitals as well as local, state and federal agencies should be continually developed to facilitate improved communication and prevent needless delays.
Societal changes now dictate that all healthcare facilities must be ready to deal with tragic events such as the Pulse nightclub shootings. They can and do happen anywhere. Hospitals, unfortunately, are also potential targets and must prepare for those type of situations, too. Engaging leadership on the medical staff, within the hospital, across the community and with all agencies involved will place organizations in the best possible position to deal with such tragedies.