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The main factors that determine the success of a hospital disaster alert team are the ability to communicate, coordinate and work effectively as a team, ability to deliver commands quickly and effectively during catastrophic events using the unified command structure, maximizing coordination role with related agencies is the key to successful handling of any emergency condition This research aims to determine the communication and coordination system in hospital X during catastrophic events. A qualitative study uses a descriptive approach to the design of Phenyomology. Data obtained through in-depth interview, focused observation, document review, as many as 11 informants are determined by using purposive and Snowball Sampling, 9 informants from hospital are director, officer who served as disaster Commander, team member, public relations and 2 informants from (Badan Penanggulangan Bencana Daerah) BPBD and coordinator of Call Centre unit 112. Data processed with QSR NVivo 12 Plus. The communication system includes the command centre has not been determined, the placement of officers on communication systems in the ER planning does not exist, there has been no placement of radio operator officers, a Visitor control centre planning around the ER does not exist, communication plan with the media does not exist, a special telephone line planning (involving local ORARI) does not exist, the number of HT are still limited (4 pcs), while the coordination with MOU other agency/stakeholder with BPBD and Call Centre 112 already exists. Coordination meeting has been conducted in 2018. The management suggested making a Hospital Disaster Plan which contains integrated communication and coordination system planning for external and internal disasters and applies with disaster simulation immediately.