Perspectives of rural hospitals on bioterrorism preparedness planning.

Even the smallest, most isolated rural hospitals are now required to have bioterrorism preparedness plans. From the perspective of many rural hospitals, however, there is a disparity between Federal expectations and the realities of small hospitals operating in geographically isolated communities. As part of an effort to better understand how to close this gap, the Walsh Center for Rural Health Analysis convened a panel of representatives of rural hospitals who are responsible for bioterrorism preparedness in their hospitals. Perspectives of rural hospitals on various aspects of preparedness were discussed, in terms of workforce and training, physical capacity and supplies, communication, and coordination with other entities. All of the participants noted the tremendous progress that has been made in the past two years, but also the distance they each need to go. Some of the issues raised by the panelists included the dual benefit of efforts to increase capacity at rural hospitals, the inapplicability of many federal guidelines and directives for small hospitals because of size and less sophisticated infrastructure, the burden of geographic isolation relative to obtaining training and information, and the fragmentation of funding and directives at both the state and federal levels.