The war and the ongoing challenges facing Israel’s healthcare system during emergencies have produced a series of lessons for hospitals. Now the Health Ministry is changing how medical centers will be required to prepare in case of deteriorating security conditions: The ministry published an update Monday to operational procedures for transitioning to orange alert status—limited operations—designed to create an intermediate stage on the way to the most severe emergency situation.
The update was developed by the Emergency and Operations Division and the Hospitalization and General Medicine Administration at the Health Ministry, in cooperation with the Home Front Command, as part of a process of drawing lessons and improving the healthcare system’s response to emergency scenarios. It’s important to emphasize that publishing the protocol does not constitute an instruction for hospitals to transition now to limited operations. It establishes how they will be required to operate if and when a decision is made to move to orange alert status.
1+Between Routine and Emergency: What Changes at Orange Alert?
Hospital operations during emergencies are divided into four alert levels: green—full operations; yellow—partial operations; orange—limited operations; and red—essential operations only. Until now, the guidelines for hospital operations at orange and red alert levels were identical. The new update creates an operational distinction between them, so that at orange alert, hospitals can scale down their operations gradually while simultaneously preparing for a rapid transition to red alert in case of deterioration. The goal is to give hospital administrators much greater flexibility: to maintain medical services to the public as much as possible, while simultaneously clearing beds and resources and preparing staff and protected spaces to receive emergency casualties.
Fewer Scheduled Surgeries, More Teams on Standby
Upon declaration of orange alert status, hospitals will be required to prepare for “thinning out” hospitalized patients—meaning discharging patients who can medically continue treatment outside the hospital—in order to clear beds for receiving casualties if needed. Simultaneously, sensitive units including premature infant wards, pediatric intensive care, and maternity departments will prepare to move to protected spaces. The decision to execute the move will be made according to the professional judgment of the medical center director. Hospitals will also be asked to implement a graduated reduction of elective surgeries and outpatient activity, with the goal of freeing up staff and resources for preparing for emergency events.
1+Key Personnel Required to Be Available Within 20 Minutes
According to the new guidelines, hospitals will be required to reinforce teams in emergency rooms, operating rooms, and recovery units and ensure rapid availability of on-call physicians and key personnel in operations and logistics—within 20 minutes of being called. Simultaneously, critical reserves essential for hospital functioning during emergencies will be checked, including oxygen, water, fuel, blood units, and medications, and essential equipment and resources will be deployed in protected spaces.
Red Alert Level Remains Unchanged
The guidelines for red alert status, when hospitals transition to essential operations, remain unchanged. The guidelines for green and yellow alert levels also continue to stand as is. The change is designed to create a clearer intermediate stage between partial operations and the most severe emergency situation. This way, hospitals can scale down services gradually, prepare for operations in protected spaces, and clear resources—while trying to maintain continuity of medical care to the public as much as possible.