The hurricane season is upon us and as you know, even in the midst of a storm, healthcare providers are responsible for ensuring medical services continue. The importance of having a solid emergency preparedness plan is vital for hospitals and other healthcare facilities, including nursing homes and long-term care facilities.
Failure to adequately plan for natural disasters can leave healthcare staff scrambling to provide adequate treatment. Lack of preparation can ultimately lead to poor patient outcomes and loss of life.
No matter the size of the organization, much of the preparedness checklist is the same: food, water, supplies, the reliability of power sources, phone and internet connections.
ACCESS TO HEALTH INFORMATION
HIM professionals face the unique challenge of not only preserving healthcare information systems infrastructure from threats of both natural disaster and cyber-attacks, but also with making such data easily accessible from remote locations, be it by caregivers on the front lines of disasters or other hospitals located beyond a disaster’s influence. The federal government’s push for electronic medical records (EHRs) was designed for improving access to health information, not only every day but especially during disasters.
WHEN THE STORM IS INEVITABLE
The first step is to make the decision early on whether the healthcare provider should remain open or evacuate. The media often generates a lot of hype when major storm systems hit, so it’s critical for providers to rely on solid data sources, such as the National Oceanic and Atmospheric Administration (NOAA).
ESSENTIAL ITEMS FOR EMERGENCY PREPAREDNESS CHECKLIST
Your emergency checklist should identify the following:
- A detailed description of the task(s) to be completed
- The status (not started, in progress, completed)
- The name or initials of the individual(s) handling each task
|Task||Not Started||In Progress||Completed|
|Fortify structure against damage (plywood for windows, sandbags, etc.)||initials||initials||initials|
|Power: generators, fuel, batteries…|
|Extra supplies of common medications|
DEVELOP SHELTER-IN-PLACE PLANS
Transporting vulnerable patients and residents is risky, so evacuation should only be attempted if sheltering-in-place poses even greater risks. To ensure your facility has an adequate plan for sheltering-in-place, do the following:
- Establish procedures to assess whether the facility is strong enough to withstand natural disasters like floods, earthquakes, and hurricane-force winds.
- Establish measures to fortify facility structures against damage from winds, water, etc.; supplies, including plywood for windows, sandbags for flooding, should be kept on hand.
- Identify the safest areas of the building for sheltering-in-place.
- Ensure sufficient resources are available shelter-in-place for at least 7 days, including:
- Emergency power, including backup generators, fuel supplies, and batteries
- Enough potable water to last at least 7 days-this will vary depending on the location and population
- An adequate supply of food and a list of the type/quantity of food available
- Extra stocks of common pharmaceutical medications
- Extra medical supplies and equipment
- Establish procedures for collaborating with local police, fire, and EMS agencies, as well as the local emergency management agency on policies for sheltering-in-place versus evacuating the facility.
- Identify and assign specific staff members to handle different tasks.
- Develop a plan for emergency financing, including establishing emergency funds.
DEVELOP EVACUATION PLANS
Ensure that patients can be evacuated quickly and safely; if absolutely necessary, do the following:
- Appoint an individual to implement evacuation of the facility (whether an outside evacuation order is given or not).
- Establish evacuation locations (at least two: one primary, one backup), secured by a contract/agreement, with comparable facilities that have suitable space, utilities, security, and sanitation for patients, staff, and others. At least one evacuation location should be 50 miles away (in case of disasters that have a large impact zone).
- Identify evacuation routes with alternatives, and create maps of those routes.
- Document food and water (at least 1 gal/person) supplies needed, and establish the logistical support for transporting food and water in case of evacuation.
- Ensure logistics for transporting medications are in place, including refrigeration for perishable meds; a registered nurse should accompany the transport person.
- Establish procedures for transporting the records of patients/residents.
- Establish procedures for notifying patients, their family members, and staff of the evacuation and communication methods during and after the evacuation.
- Establish methods for tracking the arrival of each patient/resident at the evacuation facility.
- Identify staff member responsibilities for caring for patients/residents during and after the evacuation.
- Ensure that the needs of wheelchair-dependent/bedbound patients are met (e.g., they have incontinence supplies and transfer boards, etc.).
- Establish procedures to ensure that patients are accompanied by staff members at all times.
- Establish procedures in case a patient should become ill or die en-route.
- Establish procedures for responding if a patient/resident goes missing during an evacuation, including notifying law enforcement and nursing home staff.
DEVELOP AN EMERGENCY PLAN
In order to safely shelter-in-place or carry out an evacuation, a facility needs an emergency plan, which should include the following information, at a minimum:
- Information about the specific hazards of the region (e.g., hurricanes, earthquakes, blizzards, etc.)
- Copies of local and state emergency planning regulations/requirements
- A facility organization chart
- Names and contact information of all facility personnel (updated regularly)
- Detailed information about the needs of patients/residents
- Information about which staff members will carry out which responsibilities
PREPARATION AND COLLABORATION
- Develop an All Hazards Continuity of Operations (COOP) Plan. Hazards will vary by region, especially when it comes to natural disasters. While terror attacks are more likely to occur in densely-populated cities, they can also happen in rural communities. Disease outbreaks can happen anywhere. This is why it’s important to examine the specific vulnerabilities of the facility in question. Tailor the plan to respond to all hazards (e.g., hurricanes, floods, blizzards, tornadoes, earthquakes, pandemics, bioterrorism, etc.).
- Train staff members to ensure they know how to respond in an emergency and what their specific responsibilities are; staff members should know who to report to in case of an emergency. Staff training should address the psychological and emotional aspects of an emergency on patients/residents, caregivers, and the community.
- Conduct periodic exercises and drills to test the plan and staff readiness; conduct drills at least semi-annually and correct any deficiencies immediately.
- Collaborate with local emergency agencies (police, fire department, etc.) to develop an effective emergency preparedness plan.
- Establish emergency transportation arrangements (e.g., ambulance, non-emergency medical transport, buses, helicopters, etc.) with local vendors; ensure they have the resources to be able to respond adequately in case of an emergency.
- Review emergency plans through an internal review annually; ensure the plan reflects the most current information from agencies like Federal Emergency Management (FEMA); update outdated information.
ENSURE STAFF MEMBERS ARE PREPARED
Creating a solid emergency plan requires a good deal of planning and preparation, but it’s absolutely essential for hospitals and healthcare facilities. In fact, there is no more critical time for a hospital to be up and running than during an emergency or disaster. Make sure you have a plan in place and that your staff members are prepared to handle emergency situations competently.