Hospital crisis preparedness plans put to the test in the former Yugoslav Republic of Macedonia

WHO/Margarita Spasenovska

Health authorities in the former Yugoslav Republic of Macedonia work closely with the WHO Country Office to strengthen their health system’s preparedness to respond in crisis situations. A simulation exercise to test the emergency preparedness of the General Hospital and emergency medical services (EMS) in Gostivar region took place on 22 October 2013, the fifth such event organized with WHO support.

The hospital in Gostivar is one of the key regional hospitals in the country. Located next to a highway, its EMS often respond to traffic accidents, sometimes involving large numbers of casualties. It is therefore important to test the functioning of the hospital’s preparedness plan and the EMS’ response in emergency situations.


Prior to the simulation exercise preparatory meetings were held to establish the parameters of the exercise, such as expected casualties, trigger indicators for activating the emergency response plan, triage and patient traffic flow as well as the responsibilities of hospital and emergency medical services staff.

Collaborative learning

The exercise demonstrated the strong, collaborative relationship between WHO and the health authorities in the former Yugoslav Republic of Macedonia. Other key stakeholders participating in the exercise were the Red Cross, fire-rescue units, the Ministry of the Interior and the Crisis Management Centre.

The simulation allowed the authorities to test general preparedness and coordination among the health and other relevant sectors. The exercise revealed the strengths in the current hospital crisis preparedness plan including strong command leadership, committed and qualified staff and effective management of incoming patients. It also revealed some potential gaps in the system and potential problems that can now be addressed.