Hospitals and the healthcare sector suffer from chronic work overload and personnel shortages in many nations. This poses strong incentives to rationalize all activities not directly related to care, such as the preparations for disasters and other hazards. One such rationalization is to turn from a rule-based to a risk-based approach. However, the risk landscape of hospitals and the relationship to the risk landscape of public authorities are ill-defined. Health Care Coalitions (HCCs) are in a good position to fill this gap and serve as an intermediary. We developed a scheme for defining the risk landscape of HCCs and its members and performed a prioritization process.

Objectives were to develop a knowledge platform of hospitals on risk assessment, promote integrated risk management by the HCC and its members, and determine the limiting (response) state for all relevant hazards.

We put maximum effort in limiting the time consumption for hospitals and align with the regular practices in hospitals for business continuity management. Strong points included the cooperation with the public authorities for safety and for health, a stepwise development of risk awareness and stepwise guidance for the assessment by hospitals, and formalization of the scenario-selection and choice of priorities by the HCC board.

A gross list of (>230) safety hazards was produced along with a netlist of (>80) hazards relevant to health care. In addition, an impact-scale for the continuity of care serving as a measurement stick for all health care sectors was developed. Risk diagrams were developed to present the results in a simple and clear format.

The HCC risk landscape served its purpose in improving the mutual understanding with the public authorities. The formal assessment provides a solid basis for operational planning, education, training, and future investments.