This past week, we experienced two major natural events that affected a large part of our nation. First, the rapid trajectory of our sun and moon across our continent created, for many, a once-in-a-lifetime opportunity to see a full solar eclipse. But then, the slow and lumbering trajectory of Hurricane Harvey across the Texas Gulf Coast brought mass flooding, destruction, and emergency response from our local and national support agencies, including our healthcare systems.
Although a few emergency departments and urgent care centers received patients with eye issues from staring a little too long at the solar eclipse, it was a relatively pleasant diversion. However, the arrival of Harvey initiated a call to action for dozens of healthcare facilities that will need to manage a variety of issues, including loss of utilities, medical gases, flooded grounds and roads, and patient/family evacuations.
How well prepared are we for public emergencies and unexpected local and regional disasters? Do we remember our last disaster training session, or better yet, did we learn lessons from the last real disaster?
Healthcare technology management (HTM) professionals are essential to ensuring disaster preparedness. For our colleagues who are—right now—hip deep in evacuation plans, emergency repairs, relocations, and asset utilization: We are hoping only for your success and the safety and well-being of your patients and staff. In the comments section below, I would be honored to hear your success stories after you’ve had a chance to recover.
All healthcare facilities are required to adopt emergency operations plans (EOPs) that will direct them to respond to and recover from a variety of natural and man-made disasters. These must include the six critical areas of emergency response, as described by The Joint Commission (EM.02.02.01 to EM.02.02.09): 1) communication, 2) resources and assets, 3) safety and security, 4) staff responsibilities, 5) utilities management, and 6) patient clinical and support activities.
Each healthcare facility uses a hazard vulnerability assessment (HVA) tool to determine the probability of significant events, such as earthquakes, flooding, droughts, outages, industrial accidents, and terrorist or criminal activity, that could affect a community and its healthcare system. The HVA is assessed annually by the Disaster Response Committee at our facilities. Doubtlessly, our friends in the Gulf states have flooding and weather events among the top vulnerabilities that can impact patient care and a variety of other areas. The HVA will identify and allow the correct resource planning for preparedness, training, funding, and internal and/or external responses.
An EOP will be most successful by understanding and preparing for the reality that all resources may not be available during a disaster. In 2003, President George W. Bush created the National Incident Management System (NIMS) to manage and standardize our disaster preparedness process. All members of the Disaster Preparedness Committee are required to receive NIMS training as part of our requirement to receive federal funding for disaster management.
As part of an incident action plan, a reporting structure is established at the onset of the disaster. The Hospital Incident Command System (HICS) was developed to assign and organize the reporting structure during all phases of the event, including recovery. Reporting to the incident commander, the core leadership groups will include the safety officer, public information officer, and various medical technical specialists, as assigned by the incident commander. In addition, various support sections report to the command team; these include the following:
- Operations section: medical care, staging, infrastructure (including medical devices), HAZMAT, security
- Planning section: resource and staffing, situation leader, documentation, demobilization
- Logistics section: service branch (e.g., telecom, information technology, staff comfort), support branch (e.g., labor pool, facilities, transportation)
- Financial/ administration section: procurement, cost analysis, compensation/claims
The roles of the groups assigned to the sections are well defined by job action sheets, which outline the responsibilities and timelines involved in the disaster: immediate, intermediate, and extended operational periods, as well as the demobilization/system recovery periods. For the medical device group, examples include distributing predesignated medical devices to affected areas, initiating emergency equipment orders from vendors, obtaining additional support from hospitals in our network, and documenting all medical devices events to the HICS. Of note, our medical center is now developing business continuity plans to outline the mission-critical services and recovery time objectives that the departments can provide during periods of emergent events.
We all are aware that when disaster strikes, we are most likely caught off guard and unprepared—at that moment. By having standard work processes that are recognized both locally and nationally (i.e., NIMS) and a way to rapidly organize and begin managing our emergency (i.e., HICS), we can react and anticipate the needs of our patients, community, and facilities.
I would like to encourage and engage all HTM professionals to take a little time in the coming weeks to engage and catch up on your disaster preparedness processes. And if you’re not already, ask if you can get involved in your organization’s disaster-readiness program. Here are some resources to get you off and running:
- FEMA (Federal Emergency Management Agency): NIMS training
- California Emergency Medical Services: HICS homepage
- Centers for Medicare & Medicaid Services emergency preparedness rule
As we on the West Coast are a little drier, I must remind myself that earthquakes and seismic activity are crucial items for our HVA. All of us must be prepared for events as they occur. Be safe, be well, and be prepared.
David A. Stiles, CBET, is director of the Biomedical Engineering Department and Central Equipment Services at Long Beach Memorial Medical Center and Miller Children’s & Women’s Hospital in Long Beach, CA, and a member of the BI&T Editorial Board