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If the 2017 hurricane season taught us anything, it was that you need to be prepared for anything when it comes to natural disasters. Procedures, protocols, and an emergency plan need to be prepared, evacuation plans finalized, incident command center plans put in place, and much, much more. Hospitals have shown remarkable resiliency in their ability to get back up and running after disasters, but it’s the hospitals that were properly prepared that are the most resilient.

Pre-planning for a hospital evacuation includes the development, communication, and internal coordination of your organization’s evacuation plan, but also includes external coordination of the plan.  What local emergency agencies do you need to coordinate with?  What is their emergency plan? What are other hospitals in the area doing?  Does FEMA or the local branch have procedures in place that must be considered? Understanding and incorporating local plans and protocols is vital for any evacuation. Agreements with other hospitals should be implemented for transfers and aid during an emergency.

When working to on your emergency plan for natural disasters, it’s important to consider some important questions:

What communication equipment will be available to us?
Depending on the type of disaster, communication within your organization and to the outside world could be difficult.  It’s important to thoroughly review your communication processes and establish back up plans well before a disaster.  Refer to our post How to Communicate when you Can’t Communicate for tips on preparing your organization for these types of communication issues.

Do we have a plan for an incident command center? Where is it?
Optimum Healthcare IT specializes in setting up command centers as part of our Best in KLAS Go-Live services. And while there’s pressure to come through for a go-live, there’s also plenty of time to plan, prepare, and adjust to extenuating circumstances.  In times of crisis, there is no time.  No time to plan and all preparations should be made in advance.  In times of crisis, your only option is to adjust to the situation you’re in and a well thought out command center will help everyone respond appropriately in the event of a disaster.

How often do we test emergency communications?
Emergency Communication and Uninterrupted Power Supplies (UPS) should be tested on a monthly basis to ensure that they are working properly and can respond to your needs in an emergency situation.  Some government agencies require this for healthcare facilities, depending on your location, but it’s a best practice and should be part of your readiness preparations.

Are our backup systems outside our area?
Where is your data center located? Where are your backup generators, servers, health records, and patient data?  What if a natural disaster destroys all of your local data and systems? You should have a plan in place for disaster recovery and business continuity.  In the event of a total system failure, how will your patients be cared for?  How will your business operate?  It’s important to have backup systems and operations centers that can support your organization and your patients, outside your immediate area.

How long will it take to get the backup systems up and running after a disaster?
Backup systems must be in place so that your organization can continue functioning.  It’s not enough to have a disaster recovery plan, the plan must be tested and retested to ensure that everything possible is being done to return to normal functionality as quickly as possible.  Time is of the essence, but accuracy is as well.  Don’t sacrifice good decisions and procedures because you’re in a hurry.  Mistakes in the face of crisis will be amplified and only make the situation worse.

Do you have an evacuation plan? Did you coordinate with city, town, county?
Your emergency plan must include to what extent you will need to evacuate and what criteria you will use to make that determination. Internal factors influencing the decision to evacuate, or shelter-in-place are unique to each hospital system and in some cases, each individual facility and the circumstances they face. Facilities in the same geography and facing the same emergency may make different emergency decisions based on internal factors, and both decisions may be valid.  But you must also coordinate with area leadership and first responders to ensure you’re complying with and taking advantage of their procedures.  Everyone must pull in the same direction to be effective.

How many days worth of supplies to have on hand?
And which supplies will you need? Prior to a major event, take the time to evaluate what supplies you will need in a time of crisis.  And lucky for you, clinicians are the best people to make these assessments. What medical supplies will be most vital?  What medications will be most needed?  Of course, there will be special cases and needs, but it’s important to plan for the worst and prepare to help as many people as possible. Also, what’s feasible for your organization for storage? Create an area or areas where extra, non-perishable, backup supplies can be stored for emergencies.

Unfortunately, hurricane season, natural disasters, and other emergencies are an ever-present risk throughout the healthcare world.  Hospitals must have their emergency plan up-to-date and always be ready to act in a time of crisis. Luckily, clinicians are usually prepared to answer the call.  It’s what they do.

Action under duress requires that a plan is implemented prior to the situation and responsible parties trained on the necessary steps to execute the plan. Emergencies don’t typically allow much time for contemplation.  Therefore, the plan must be in place, people at the ready, and a well-documented and communicated decision process must be adhered to in order to move patients, medical and non-medical staff, and equipment from an at-risk location to a safe space.

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