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The Critical Moments that Defined Tel Aviv-Sourasky University Medical Center (Ichilov) When Tel Aviv-Sourasky University Medical Center became a target of Iranian ballistic missile attacks, it’s team activated emergency protocols attracting the interest of leaders and professionals in healthcare management, worldwide | Interview with Dr. Daniel Trotzky , Medical Deputy Director | by Ayelet Lahav

During Operation ”Rising Lion” while Ichilov was operating from

a hospital. Behind the facility’s walls, medical infrastructure was installed and spaces were built to accommodate medical departments and units, and to transform within hours into a fully functioning hospital.” How do you fit an entire hospital into a parking garage? “We review patient load, expedite discharges, and expand home care and telemedicine. The challenge is to continue operating systems that must function uninterrupted, such as delivery rooms, blood banks, laboratories, and more. During Operation ‘Rising Lion,’ Ichilov reduced inpatient load by approximately 42% within 12 hours and transferred inpatients to protected areas within 4.5 hours. In an unprecedented step, all hospitalized patients and services across the medical center were relocated to protected spaces.” One of the common complaints about EDs is the long wait times; patients often wait long, frustrating hours to receive care. “I understand! A patient arriving in life-threatening condition will receive immediate care, even if they arrived later,” Trotzky explained. Although Ichilov already leads in ED wait times for physician evaluation, according to the Ministry of Health, it is taking this a step further with “Ichilov NOW,” a video assessment service with an emergency medicine specialist, before even leaving home.

its underground hospital, an alert was received about a missile strike on a residential building in central Israel. Within minutes, emergency teams mobilized for a potential mass-casualty event. “Emergency preparedness is tested the moment a major incident is reported,” said Dr. Daniel Trotzky, Ichilov’s Medical Deputy Director. How did the hospital transition from an institution dedicated to caring for the sick to an active warfront? “Since October 7th, the healthcare system in Israel has been coping with a new reality. At Ichilov, we not only received wounded patients from the North and South, we supported hostage releases, prepared for mass-casualty events, and operated a protected underground hospital." How do you prepare for such emergency events? "Emergency preparedness is a long-term process built over years; this time, we had to prepare for a scenario that had not previously been a focus: the possibility of a direct strike on the hospital itself." So what did you do? "Together with the Ministry of Health and the Home Front Command, we developed new operational concepts, protocols, and procedures, acquired equipment, and expanded rescue and communication abilities to ensure continuous functioning

Turning wartime lessons into shared knowledge for the global community. Dr. Daniel Trotzky

in all scenarios." How did you use the knowledge you acquired? “In response to a growing desire for hospital preparedness, we host delegations and share knowledge through conferences, research, and collaborations. In July, we held an Emergency Management and Preparedness Course (EMPC), for professionals from different countries covering a range of threats from terrorism to natural disasters.” Tell us about the underground hospital. “The protected hospital was established years ago within a parking facility and designed to be rapidly converted into