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Objective: Malfunction in hospitals' complex internal systems, or extern threats, may result in a hospital evacuation. Factors contributing to such evacuation must be identified, analyzed and action plans should be prepared. Our aims in this study were 1) to evaluate the use of risk and vulnerability analysis as a basis for hospital evacuation plan, 2) to identify risks/hazards triggering an evacuation and evaluate the respond needed and 3) to propose a template with main key points for planning, performance and evaluation of such evacuation. Methods: A risk and vulnerability analysis at two county hospitals along with a systematic online literature search based on the following keywords; “evacuation/closure”, “hospitals/medical facilities” and “disaster/hazards” alone or with “planning”, was conducted. Results: We found that although all hospitals have a disaster plan, there is a lack of knowledge and appropriate instruments to plan, perform and evaluate a hospital evacuation. Risk and vulnerability analysis can be used to reveal threats leading to an evacuation (e.g. on-going climate changes and terror actions). These key points can later be used to plan, perform and evaluate such evacuation. Conclusion: There is a need for an elaborated evacuation planning for hospitals. An evacuation plan should continuously be drilled based on a risk and vulnerability analysis. A general guide can be used as foundation to plan, perform and evaluate such plan.