Forming a Disaster Management Plan for Healthcare

For the United States, and really the whole world, this is a time when large-scale disasters are becoming more frequent, some of them linked to climate change and global warming. Whether in response to an event like the current COVID-19 pandemic, widespread wildfires, earthquake, or a hurricane, healthcare organizations can find their operations threatened and even overwhelmed by human need as well as catastrophic system failure. This blog looks at healthcare disaster impacts, serious vulnerabilities, preparation best practices, and the need for enhanced disaster recovery planning in healthcare organizations.

Emergency Preparedness for Healthcare Is Required

At this point, healthcare providers and their suppliers must be compliant with "national emergency preparedness requirements to ensure adequate planning for both natural and man-made disasters, and coordination with federal, state, tribal, regional and local emergency preparedness systems." These are published by CMS in the Federal Register, with regulations stating that "Each provider and supplier will have its own set of Emergency Preparedness regulations incorporated into its set of conditions or requirements for certification"… in order "to participate in the Medicare or Medicaid program." Given the pace of catastrophe, having a disaster management plan in healthcare is a necessity, not just for compliance, but for healthcare disaster preparedness.

Specific Disaster Considerations

According to CMS, here are some specific disasters and how they can affect providers and other healthcare-related entities:

Earthquakes – "May cause a variety of hazards, such as care-related emergencies, equipment and power failures, interruptions in communications and operations as well as loss of normal supply essentials or structure of the facility."

Hurricanes – "May cause a variety of hazards, such as care-related emergencies, equipment and power failures, interruptions in communications and operations as well as loss of normal supply essentials or structure of the facility."

Severe Weather – "Similar to other natural disaster which may cause a variety of hazards, such as care-related emergencies, equipment and power failures, and more; severe weather also has extended implications and may cause transportation challenges for some areas. Functional healthcare systems are therefore critical as hazardous conditions may lead to a variety of healthcare emergencies and mass surge influx of patients dependent on the duration of the severe weather. Additionally, residents may seek shelter in certain healthcare environments based on loss of power."

Fires – "Whether man-made or natural, can often have a massive impact on operations."

Disease Epidemics – "In 2014, the Ebola Virus Disease (EVD) manifested as a public health crisis internationally, and tested our national preparedness on disease control, such as related to virus outbreaks. Providers and suppliers faced a variety of challenges during the wake of the virus, which included basic care and treatment of patients with EVD; segregation; infection control; waste management; personal protective equipment (PPE) and more. Additionally, influenza such as the H1N1 pandemic, H3N2v in the United States, Zika Virus and others have reemphasized the need for disease control, prevention and preparedness, not to mention COVID-19! … In keeping with the all-hazards methodology, infectious diseases pose a threat to the community, healthcare workers as well as national response and recovery efforts."

Areas of Healthcare Most Vulnerable in Disasters

According to the New York Times, across the nation "hospitals and health care systems are trying to answer the central question of how to care for patients when climate change threatens their ability to keep hospitals open. Many of the changes to improve resilience are not sleek, tech-forward responses to crisis. Rather, they often represent common-sense solutions: moving technical equipment from basements where floodwater could damage it up to higher floors; organizing patient transfers in advance of catastrophes; improving energy efficiency; better air filters; and more backup systems and redundancies, just in case." The same article mentions that during fire season and extreme heat waves "power can go out or electric utilities may shut off power to avoid sparking fires or creating systemwide blackouts, both of which mean that hospitals have to run on their generators." In response, an important part of disaster planning in healthcare includes finding new ways to generate electricity, like through solar energy cells or cogeneration facilities, as a way to have backup power with generating problematic particulate exhaust from diesel generators.

Guidelines for Being Prepared in Healthcare

The University of St. Augustine offers the following advice for healthcare organizations' readiness for the next disaster or catastrophe:

Be Organized – "it is important that healthcare organizations have a disaster plan that is well documented and that they practice the steps they will take. The most important piece of disaster preparedness is making sure the patients are properly taken care of including their diagnosis, treatment, and follow up. For this to happen, healthcare organizations must have a method of entering the patient into their "system" so the procedures and care process can begin."

Act Collaboratively – "Healthcare organizations should provide additional advanced training to prepare personnel. Key staff members, usually directors or mid-high-level managers, should be assigned specific tasks during disaster situations.  Their primary responsibilities are to keep the process flowing as smoothly as possible, handle press requests, keep the patients and family members as calm as possible, and meet the needs of the customers.

"Prepare, Plan, Practice, Repeat – Advanced planning and practice is necessary so that when an emergency arises the healthcare staff is prepared for it… Walking through an emergency operations plan in advance of a real situation allows the personnel to encounter problems that could occur during a real disaster and allows for further refinement of the processes." Also, "Disaster planning should also include situations where the healthcare facility itself is the victim of a disaster rather than the place where the victims can come for treatment and refuge."

Since 2012, HealthStream has partnered with Yale New Haven Health System Center for Emergency Preparedness and Disaster Response (YNHHS-CEPDR) to provide courseware designed to help healthcare workers and leaders understand their respective roles in providing care for patients in the event of an emergency. Yale New Haven Health System Center for Emergency Preparedness and Disaster Response develops and disseminates programs and services in the areas of healthcare and public health emergency preparedness, response, recovery, and mitigation.

HealthStream's YNHHS-CEPDR library includes:

• Emergency Preparedness Special Topics for Clinicians Library
• Emergency Preparedness for Health Care with NIMS (Basic)
• Incident Command Systems for Healthcare with NIMS (Advanced)
• OSHA Library from YNHH-CEPDR
• OSHA Special Topics Library from YNHH-CEPDR
• Patient Safety Training Library from Yale New Haven Health System-CHS
• Planning and Response to Pandemic Influenza for Health Care Workers
• Preventing Central Line-Associated Bloodstream Infections (CLABSI)
• Small Victims, Big Challenges: Pediatric Triage, Treatment, and Recovery in Disasters