To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.annemergmed.2008.03.022 Byline: Bruria Adini (a)(b), Avishay Goldberg (b)(c), Robert Cohen (d), Yaron Bar-Dayan (b)(e) Abstract: Standard operating procedures are the basis of a consistent response to varied threats. The aim of this study is to investigate the relationship between the quality of standard operating procedures developed by hospitals for the management of a pandemic influenza outbreak and the level of performance in a H5N1 flu drill. Author Affiliation: (a) Emergency and Disaster Management Division, Ministry of Health, Tel-Aviv, Israel (b) Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel (c) Department of Health Systems Management, Leon and Mathilda Recanati School for Community Health Professions, Ben Gurion University of the Negev, Beer-Sheva, Israel (d) Center for Medical Education, Hebrew University, Jerusalem, Israel (e) IDF Home Front Command, Ramle, Israel Article History: Received 21 May 2007; Revised 29 June 2007; Revised 7 November 2007; Revised 10 January 2008; Revised 13 March 2008; Accepted 21 March 2008 Article Note: (footnote) Supervising editor: Jonathan L. Burstein, MD Author contributions: BA participated in determining the aim of the study, conducted most of the research, and processed the data. BA and YB-D reviewed the literature. BA and RC wrote the article. BA, AG, and RC participated in planning the research and in article revisions. AG participated in literature review. RC conducted the statistical analysis. YB-D led the research group, decided the aim of the study, and led the planning of the research. YB-D takes responsibility for the paper as a whole. Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. The article is part of Bruria Adini studying for PhD in the Faculty for Health Sciences, Ben-Gurion University of the Negev. Publication dates: Available online May 12, 2008.