Coordinated Terror Attacks and Health Care Facilities: Future Considerations and Implications for Hospital Preparedness and Response-A Scoping Review.

OBJECTIVE: Coordinated Terror Attacks (CTAs) have evolved significantly, demonstrating increased complexity and deliberate strategies to maximize casualties. These attacks, typically unfolding across both space and time, often involve multiple targets and/or modalities and may target health care facilities directly or indirectly. This scoping review examines literature on CTAs that either directly targeted hospitals or significantly impacted responding hospitals, to identify gaps in preparedness and response and offer policy recommendations to enhance hospital readiness, protocols, and overall resilience. METHODS: Articles were retrieved from 6 databases and search engines using keywords relating to CTAs and hospitals. Data analysis focused on evaluating whether the event could be characterized as a CTA, whether it targeted or impacted a health care facility, and how they responded. RESULTS: Out of 1616 articles screened, 26 met the inclusion criteria. Characteristics of the attacks and themes in the literature were extracted, with a focus on hospital response measures and methods for enhancing hospital preparedness. CONCLUSIONS: The findings of this review highlight a significant gap in the literature that suggests opportunities for further research into the threats CTAs pose to health care facilities, enabling a better understanding of how to mitigate these risks to health care systems and prepare for future CTA events.