Emergency Preparedness in Healthcare is Everyone's Business! Are You Part of the Team?
Print this Article | Send to Colleague
by Dick Bartlett, Kentucky Hospital Association
Last summer, over ten-thousand people across the globe participated in a disaster exercise that simulated an internet-driven attack on critical lifeline infrastructure in 32 different areas - including our healthcare institutions.
Hundreds of hospitals, long-term care facilities and major health organizations participated. This was unprecedented, and demonstrated a collective concern that we explore together how to become more resilient to one of the greatest threats to our modern way of life.
It was a real world cyber scenario, played-out over three phases, requiring facilities and their teams to develop situational awareness, recognize and deal with cross-sector impacts, explore local preparedness and requirements, and make some hard life-and-death decisions on how to manage or deliver services in a deteriorating situation.
Members of the healthcare community that played across the world had feedback comments like:
- “This exercise is a must do for all hospital and long term care facilities!!”
- “A big eye opener for something that could happen, but is not thought of until put right in front of you. This made us realized that this could be a real situation….”
- “The exercise was very life like it really made us examine our policies and figure out where we need to make adjustments”
By the time the exercise play slowed down after several hours of intense discussion and simulation it was clear that there were probably five key elements that drove how well healthcare facilities did: (1) The availability of power; (2) The availability of fuel to keep the emergency generators working; (3) The ability to communicate - internally and externally; (4) The availability for water, and critical supplies; (5) The ability to get in, and keep on the job; key staff members of all types. Each one of these presented significant challenges during the exercise.
There will always be those who will question the value of Emergency Preparedness, or downplay what Emergency Management in a healthcare program does. Of course your accreditation program requires Emergency Preparedness. The CMS Conditions of Participation in Medicare and Medicaid demand plans for seven types of healthcare facilities and services now. But some still will say they are too busy; or that they will look at it later. The staff takes the trainings and attends the meetings, but the managers and supervisors may be among the missing.
There are a number of factors at play in today's world that tell us that Emergency Preparedness can't wait. Media reports tell us that potential adversaries are targeting our critical infrastructure, to include out electrical grid. Regardless of your political ilk, we have seen the negative impact of severe weather in the last few years; and climatologists believe more is to come.
When Hurricane Michael hit the Florida Panhandle, and Hurricane Florence hit in the Carolinas this fall, hospitals had to evacuate hundreds of patients, and some were forced to lay off staff because of significant damage; or just closed their doors. Facilities ran on emergency power for an extended period of time, and some operated out of tents or mobile trailers. Some hospitals reportedly had to operate shelters for their employees and their families who had no home to go back to.
When is the last time your facility practiced for a patient evacuation? Do you know where your planned surge areas are? How quickly could you surge if called upon? If the facility became unusable, or there was a major disaster, could you set-up an alternate care site to take care of your hurting community in the convention center?
Over a year ago, a New York Times article said there was "Controlled Chaos at Las Vegas Hospital Trauma Center After Attack." Surge plans had to be put into action across the city as many hospitals were inundated with hundreds of patients - each! Non-trauma hospitals had to deal with life-threaten cases, ready or not. The Times article said that "For two or three hours, the patients came nonstop." This could happen in your town; at your Level-III Trauma Center, tomorrow! Remember this was an innocent music festival...
In our little three-hour cyber exercise we got to the point where healthcare facilities had to make decisions about things like "altered standards of care". How to do I provide care when I no longer have the medicines, supplies, or equipment I normally would?
- "If I have enough of something critical for five patients, but I have dozens who need it, who do I take care of?"
- "What do I do when I run out of disposable medical supplies?"
- "If it is summer time, and the temperature-humidity index is off the charts, and I have a modern hospital without windows that open and insufficient power to operate the AC, what do I do? Do we need to abandon the complex? Are their alternatives?"
The potential scenarios like this that come to mind go on and on. This is typical of what the Emergency Managers in your healthcare facility have to think about every day. They work with representatives of key departments and programs inside and outside your hospital. There is a co-dependency that exists between your community, and its Emergency Management program, and your organization.
The term Emergency "Manager" is probably a misnomer. I like to think of it as a Coordinator; a Facilitator; and Organizer; a Planner; a Team Leader. When you stop and think about it, the Emergency Manager - in your hospital or in the community - really has very few of his or her own assets to help fix a broken community - or healthcare facility. It is a Team Effort. Every department, every program; every agency in the community are all part of the Emergency Management "Team".
Think of the Emergency Manager as a "facilitator", leading orchestrated effort to prevent problems in the first place; and if not possible, to recognize the issues early and take appropriate actions to keep the problem from getting worse. To take defensive actions to save lives and protect property while the emergency is in-progress. To rapidly assess damage that may have occurred, and develop a plan to begin the recovery process. To expedite the return to "normal".
Emergency Management is a "Team Sport." Are you part of the Team?
Oh yea. One more thing. That big international emergency preparedness exercise that was done last summer.... They are going to do another version on August 21, 2019. Want to come play? Want to see if your Emergency Management plans are up to it?
More details to come!
Dick Bartlett works in Emergency Preparedness with the Kentucky Hospital Association, and serves as the state's Trauma Coordinator for the Kentucky Trauma Care System. He was the Emergency Manager for Louisville and Jefferson County, was Director of EMS for the City of Louisville, and a General Manager for Rural/Metro of Kentucky.
