One lesson learned from the 2015 Nepal earthquake was the need for a more coordinated effort between hospitals to improve disaster response. To improve the coordination, the concept of a hub and satellite system was introduced.

Describe the implementation of a hub and satellite system in the disaster management plan to improve coordination and communication between hospitals and the health system during a disaster.

A standard hospital disaster management plan was developed and validated with governmental and non-governmental agencies. Twenty-five hub hospitals within Nepal were identified. Smaller hospitals surrounding hub hospitals were identified as satellite hospitals. A plan was made to address communication and coordination between hub-satellite hospitals and ministry of health involving resource sharing, capacity analysis, and development of deployment teams in each hub. An output-based workshop was planned. Each hospital’s existing plans were evaluated before the workshop with a checklist containing essential components of disaster management. Each hospital was oriented and allowed to fill up a standardized template of a disaster management plan, after which their disaster management plan was reevaluated. The newly developed plan was then tested with a tabletop exercise function. The trainings were conducted from September 2017 to October 2018.

Disaster management plans were made in 110 hospitals, including nine hub hospitals and 101 satellite hospitals in three of seven provinces in Nepal. Evaluation of a pre-workshop score for the existing disaster plan was 18/32, and the score of the disaster plan post-workshop was 30/32 on average. The average score for hospitals for the tabletop exercise was 68.2% (53.8% to 84.6%).

A hub-satellite system-based disaster management plan has been developed and implemented in more than 100 hospitals in Nepal. Workshops for these hub and satellite hospitals improved their communication, coordination, and planning to improve disaster preparedness and future response.