Imagine you’re halfway through a 12-hour shift. The ER is packed, you’re balancing a crashing patient and three new consults, when suddenly the call comes in: local power failure, and your hospital’s backup generator might not hold. You glance at your team—each person looks to you. At that crossroads, your medical training is muscle memory, but what about leadership under chaos? This is the difference between clinical care and clinical leadership.
Today, natural disasters, cyberattacks, and mass casualty events aren’t just far-off risks. They’re on the rise, and they’re real. Yet most clinicians—maybe you—still feel emergency preparedness is “some admin’s job.” It isn’t.
“You want to think about the safety and welfare of your patients right off the bat,” says Travis Kaufman, DMSc, Director At Large for the Colorado Academy of PAs. “But then you also have to think about your staff, your infrastructure, and your community during a crisis.”
Why does this matter right now? Because the next emergency won’t check if your unit had a meeting about it last week. It will just show up. And whether you’re still mostly bedside or already rounding with leadership, what you do in those moments will define your impact—maybe even your career.
Many assume “preparedness” is a checklist. Travis Kaufman’s military and healthcare leadership career will challenge that idea—and so should yours.
Kaufman’s journey took him from combat deployments in Iraq, to serving as a chief medical operations officer across 43 countries, to advising 32 NATO nations on disaster medicine. His advice? “Preparedness is not a binder on a shelf. It’s a culture you build, every day.”
After hurricanes Maria and Irma devastated Puerto Rico, Kaufman and his team landed to find the hospital’s ambulance entrance literally destroyed. No safe way in, patients and clinicians alike stranded. But, foresight paid off:
“They had worked with FEMA in advance. Tents were ready, bulldozers cleared a path, and we could bring in emergency vehicles. It wasn’t perfect—but it worked because leaders planned for the worst.”
Try This Today: Review your department’s most recent emergency drill. What’s one gap you could close this week?
What separates a merely “prepared” hospital from a resilient one? Leadership, not luck.
“It’s the leader who says, ‘This matters,’ but also models it—allocating resources, insisting on regular drills, and fostering true collaboration,” Kaufman notes.
Think of a level one trauma center, with its hallway stretchers and overburdened staff. Chaos is normal—but during a disaster, chaos turns lethal.
Kaufman’s tip:
“The first thing to go down in a crisis is communication. You can have the best equipment, the best plans, but if you can’t talk to your team, you’re in trouble.”
A simple 15-minute huddle, simulating radio failure or running a rapid triage setup in the parking lot, can mean the difference between order and mayhem.
Prioritize preparedness in every huddle. Tie it to real local threats—hurricanes in the Southeast, wildfires in the West, or mass casualty risk anywhere.
Make drills regular (quarterly, not yearly).
Empower feedback:
“If you don’t accept feedback after a drill, you won’t improve. My best leaders always listened, then actually changed the system.”
Try This Today: Ask your team what emergency scenario scares them most. Plan your next drill around it, and let a frontline clinician lead.
You know the tension: everyone’s “too busy” to plan for the rare event—until it’s not rare. How do effective leaders bridge the urgent with the important?
“Emergencies don’t happen every day, but that’s why they catch everyone off guard,” Kaufman says.
Here’s what smart organizations do differently:
During COVID, one of Kaufman’s units “had plenty of trauma bags—until we actually needed them. That’s when we realized half the contents were expired. The system broke because we didn’t assign clear responsibility.”
Assign an “Emergency Lead” per shift or department.
Create a training/inspection calendar—stick to it.
Resource allocation is strategic:
“If you have trauma bags or decon kits, check them. Cobwebs help no one.”
Integrate preparedness into everyday conversations. If you have a hurricane season, talk about it at shift change; if you’re urban, discuss mass decontamination logistics.
Try This Today: Audit one emergency supply—today, not tomorrow. Text your “emergency lead” to confirm inventory is up-to-date.
Let’s be blunt: there will be times when demand outstrips supply. Leadership means facing this—ethically and pragmatically.
“Everyone knows triage as a word. But in real mass casualty, it’s gut-wrenching. Sometimes you keep someone comfortable because survival isn’t possible,” Kaufman shares.
But here’s where preparedness expands beyond your walls:
“Collaboration with other hospitals, EMS, even local nonprofits—this is what keeps the system from breaking.”
Kaufman recalls running tactical combat casualty care (TCCC) training for local EMS and even firefighters in his community. The payoff?
“During a real disaster, those partners showed up ready. They knew the drill—literally.”
Know your community partners by name.
Regularly share training and protocols across organizations.
Build mutual trust before the crisis.
Try This Today: Set up a 15-minute call with a local EMS or fire contact. Compare your disaster protocols—where do you overlap or diverge?
Transitioning from clinician to leader is often painted as a “soft skills” journey. Kaufman disagrees—your diagnostic, pattern-matching, and empathy muscles are your greatest asset.
“As clinicians, our brains work differently. We gather history, see patterns, and problem-solve on the fly. That’s exactly what leadership needs—especially in uncertainty,” he says.
Imagine you’re a PA faced with a confused, hypotensive patient. You’re not just treating symptoms—you’re piecing together a complex story.
“The same skill applies when you’re listening to staff or building a strategic plan,” Kaufman notes. “And the human touch? That’s what keeps teams together under stress.”
Systems thinking: Seeing root causes, not just symptoms.
Empathy: Humanizing policy and operations.
Rapid prioritization: Essential for real emergencies.
Try This Today: Next time you solve a tough clinical case, reflect: how would you apply that logic to a leadership challenge you’re facing?
We live in an era where yesterday’s sci-fi is tomorrow’s standard. Kaufman, with global experience in disaster zones, insists technology isn’t just “nice to have”—it’s survival.
“The best innovation? Real-time communication. Radios, sure, but now also Starlink for internet after hurricanes. If you can’t communicate, you can’t lead,” Kaufman says.
Telemedicine: “I’ve called a surgeon for a second opinion during a life-or-death procedure, halfway around the world.”
Data analytics: Predict patient surges, allocate resources better, and analyze after-action reviews.
Mobile health apps: In Israel, motorcycle EMTs arrive first, stabilize, and handoff to ambulance crews—an idea U.S. systems could pilot in congested cities.
Drones: Already delivering blood on the battlefield in Ukraine—coming soon to U.S. disaster response.
Pandemics and infectious disease outbreaks.
Cybersecurity attacks—protect your EMRs and have a paper fallback.
Climate-related disasters (floods, wildfires, hurricanes).
Mass casualty/active shooter events.
Try This Today: Ask your IT or informatics contact how your clinical area would communicate if the EMR or phones went down. Make sure everyone knows Plan B.
Kaufman leaves us with a challenge, but also a reassurance:
“It’s about building a culture—every huddle, every drill, every feedback session.”
Emergencies don’t announce themselves, and perfect checklists won’t save you. Instead, you—and your team—need to be ready to flex, adapt, and lead under pressure.
So as you leave this post, ask yourself:
Where does your team stand on true preparedness—routine, or real?
How are you making time for practice, feedback, and continuous improvement?
Try This Today: Before your next shift, jot down the last time you personally participated in an emergency drill. If it’s been more than three months, ask your manager when the next one is scheduled—and volunteer to help lead.
Leadership in emergency preparedness isn’t just about handling “the big one.” It’s the everyday decisions—drills, huddles, feedback—that add up to resilience. Start now, however small. The next time the pager screams, you won’t just react. You’ll lead.
