Enhancing Quality of Disaster Preparedness and Response System in a Tertiary Care Hospital Sri Lanka: Lessons from a Mass Casualty Incident Review at District General Hospital Kegalle

This case study evaluates disaster preparedness and response at District General Hospital Kegalle, Sri Lanka, following a mass casualty incident. The study aims to assess hospital readiness, analyze gaps in existing protocols, and propose actionable improvements. Using a blend of post-event review meetings, key informant interviews, and document analysis, findings highlight prompt multidisciplinary engagement and director leadership as notable strengths. However, significant weaknesses were identified: low staff awareness of the Disaster Preparedness and Response Plan (DPRP), absence of job role cards, lack of regular drills, undefined disaster management responsibilities, and no formal allocation of these duties in medical officers’ job descriptions. Infrastructure and communication limitations further hampered optimal response. Recommendations emphasize the need for the Ministry of Health to designate responsible units, formally integrate disaster management roles into job descriptions, and institutionalize drills and ongoing training. This study concludes that bridging policy and practice through clear human resource frameworks and targeted capacity building is vital to enhancing hospital resilience and effective mass casualty response in Sri Lanka.