Readiness exercise guide

How hospitals can conduct an effective EHR downtime drill

Published July 30, 2026 · CodeDark Health editorial team

A downtime drill should test more than whether a policy exists. It should let the people who admit patients, provide care, dispense medication, manage specimens, clean rooms and reconcile records practise the decisions and handoffs they will make in a real interruption.

Choose a scenario that reveals dependencies

Pick one realistic condition: planned maintenance, loss of Wi-Fi, EHR vendor outage, data-centre failure or cyber containment. Define what is available and what is unavailable. A drill that is too vague lets everyone assume their usual tools still work.

Set specific objectives

Limit the exercise to a few things you can observe well. For example: time to activate the procedure, ability to identify an admitted patient, pharmacy communication, laboratory handoff, emergency intake, escalation of an exception, and reconciliation after restoration.

Run the exercise in five phases

Brief: Explain scenario boundaries, safety controls, observers and the stop condition.
Activate: Deliver the downtime alert using the actual escalation and communication path.
Operate: Ask participants to complete realistic departmental tasks using approved alternatives.
Restore: Announce return to normal systems and practise the transition plus reconciliation queue.
Review: Hold a structured debrief while observations are fresh, then assign improvements.

Use observers, not assumptions

Observers should capture actual delays, workarounds, missing information and unclear ownership without evaluating individual staff performance. The best findings are usually cross-departmental: a task seemed clear in one unit but the next unit did not know how to receive or act on it.

Measure useful signals

Use measures that are meaningful to your hospital: procedure activation time, number of unresolved handoffs, missing or ambiguous records, recovery queue age, training completion and action-item closure. Avoid using a drill only to produce a pass/fail result.

Include recovery: an exercise that stops at “the EHR is back” misses the part that creates the largest manual workload. Test ownership and review of downtime documentation as well.

Practice the workflows that matter to your departments.

Review a downtime-drill approach that starts with your hospital’s approved processes and operating requirements.

Explore the downtime-drill guide