Rajapaksha et al. BMC Emergency Medicine (2023) 23:6 https://doi.org/10.1186/s12873-023-00777-y RESEARCH © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Open Access BMC Emergency Medicine Incidence management system of the healthcare institutions for disaster management in Sri Lanka Nayani Umesha Rajapaksha 1* , Chrishantha Abeysena 2 , Aindralal Balasuriya 3 , Millawage Supun Dilara Wijesinghe 1 , Suranga Manilgama 1 and Yibeltal Assefa Alemu 4 Abstract Background Incident management systems and disaster planning processes facilitate maximal use of available resources. Evaluation of the Incident Command System (ICS) is one of the top five key areas of research priority in the field of surge. The study was aimed at assessing the disaster preparedness and ICS of the public healthcare institutions for the disaster management in a disaster-prone district of Sri Lanka. Methods A descriptive cross-sectional study was conducted among all public sector healthcare institutions (n = 74), including curative-healthcare institutions (n = 46) which have inward-care facilities for patient care and preventive healthcare institutions (n = 28) in Kurunegala district, Sri Lanka from May–September 2019 using a validated inter- viewer administered questionnaire which was based on ‘CO-S-TR Model’ for ICS assessment including ‘Clear need for increased capacity (≤25%), Basic level (26 – 50%), Moderate level (51 – 75%) and High level (>75%)’. Results Focal points for disaster management were nominated by the majority of the curative sector (n = 33; 76.7%) and preventive sector (n = 19; 73.1%) healthcare institutions. A written disaster preparedness and response plans were available in 72% (n= 31) curative sector and 76% (n= 19) preventive sector institutions. The higher proportion of the curative sector institutions had moderate level capacity in the area of providing treatment, and basic level capaci- ties were in the areas of ‘staff mobilization, coordination of activities, supplying of special needs, triage of cases and transportation’. There is a clear need for improvement in the areas of communication commanding, management of controlling the incidence and tracking of the cases in the curative sector. The majority of the preventive sector institu- tions had moderate level capacity in commanding, control, coordination and tracking of cases. The basic level capac- ity in the areas of staff mobilization, stuff management and triage of cases. There is a clear need for improvement in the areas of communication in preventive sector. Of the public sector healthcare institutions, the higher proportion of the preventive sector (n = 20; 76.9%) and curative sector (n = 29; 67.4%) had basic level overall surge capacity of ICS for disaster management. Conclusion Coordination, communication, commanding, management of controlling the incidence and tracking of cases following outbreaks need to be improved and capacity development programmes could implement to develop the preparedness for future disasters. *Correspondence: Nayani Umesha Rajapaksha drnayani2020@gmail.com; m28048@pgim.cmb.ac.lk; r.rajapaksha@ uq.edu.au Full list of author information is available at the end of the article