Emergency Preparedness 1:
Community-Wide Collaboration Portal
Rural hospitals play a crucial preparedness role for public health emergencies. Citizens expect health care organizations in their communities to be prepared to provide medical care to those injured during a mass casualty incident or disaster. The community expects this level of preparedness regardless of the nature of the incident: natural (tornados, floods, blizzards), unintentional (chemical contamination, explosions, nuclear incidents, biological outbreaks), or intentional (chemical attacks, explosions, biological releases).
Hospitals not prepared to respond effectively to public health emergencies risk increased morbidity and mortality of casualties, reduced ability to protect their own staff and facilities, and a prolonged recovery phase resulting in financial losses and negative publicity within the community.1
Historically, most health care organizations have not been actively involved in their community’s emergency management planning. Following a decade-long dramatic increase in the incidence of major disaster in the United States,a this gap is progressively narrowing. Recent incidents reveal the vulnerability to all communities, regardless of geographic location or population and as such compel health care organizations to incorporate an all hazards approach for emergency management. Hospitals must understand how they support their communities and how the community can support them in a public health emergency.
Vulnerabilities to emergencies and threats permeate governmental and public safety agencies as well as health care and business institutions, creating the potential for large-scale interruptions in key community services. The number of natural catastrophes recorded in 2007 was 950 (compared with 850 in 2006), the highest figure since 1974, when Munich Re began keeping systematic records in its NatCatService database. 2 Therefore, each hospital must review current emergency operation plans to safeguard the continuity of operations and to be better prepared to deal with Emergency Incidents, Disasters, or Catastrophic events that may occur in local communities. This is challenging, given that hospitals as a whole are facing difficult financial times: approximately 30% of U.S. hospitals are operating at a financial loss, with many more teetering on the financial brink.3
No definition of Emergency Incident-Disaster is universally accepted. The definition seems dependent upon the discipline using the term.b An Emergency Incident-Disaster disrupts the infrastructure of the society stricken by the event.
Many tasks are required to be adequately prepared for the wide range of potential emergencies that may occur. To some healthcare organizations, this may seem overwhelming. This section provides a logical and systematic approach for rural hospitals to proactively plan to fulfill preparedness activities that will mitigate internal problems as well as simultaneous external failures that can result in chaos and catastrophe.
Collaborating with the Community for Domestic Preparedness
The
concept of community-wide preparedness systems is new to most health
care organizations. While most have long prepared and tested disaster
plans, health care organizations have operated in isolation, and their
disaster plans reflect this mindset.
Developing a community-wide emergency preparedness program for domestic preparedness requires that health care representatives collaborate with their public safety and emergency preparedness agencies to develop a clear appreciation for each other’s capabilities and limitations.
It is no longer sufficient to develop disaster plans and refer to them only if a threat appears imminent. Rather, a system of preparedness must be integrated across communities and must be in place every day.6
Since early 2002, the US Department of Health and Human Services (HHS) has been working at planning and funding efforts to enhance and improve the role of healthcare organizations for emergency planning. In 2006 HHS created the Office of the Assistant Secretary for Preparedness and Response (ASPR) formerly the Office of Public Health Emergency Preparedness. ASPR serves as the Secretary's principal advisory staff on matters related to bioterrorism and other public health emergencies. ASPR also coordinates interagency activities among HHS; other federal departments, agencies, and offices; and state and local officials responsible for emergency preparedness and the protection of the civilian population from acts of bioterrorism and other public health emergencies. ASPR funds state departments of health to partner with hospitals to assure that hospitals, clinics, public health services, and emergency medical services are coordinating and collaborating with their communities and regions. Annual funding established in 2002 is expected to continue through 2011. ASPR establishes plans, systems, and processes that ensure integration and coordination during a public health emergency response effort to improve surge capacity and enhance community and hospital preparedness for public health emergencies.
Program Priorities
Required Funding Capabilities
The following capabilities MUST be prioritized and funded during the FY
2007 budget period by all award recipients:
Interoperable Communications System
Bed Tracking System
Emergency System for the Advance Registration of Volunteer Health Professionals (ESAR-VHP)
Fatality Management Plans
Hospital Evacuation Plans
Optional Funding Capabilities
The
following program capabilities have been funding priorities in previous
years. If funding permits, the following capabilities may be
prioritized after the required funding capabilities, mentioned above,
during the FY 2007 budget cycle:
Alternate Care Sites (ACS)
Mobile Medical Assets
Pharmaceutical Caches
Personal Protective Equipment
Decontamination
Overarching Requirements
The
following components must be incorporated into the development and
maintenance of ALL capabilities that are funded by the States and
jurisdictions:
National Incident Management System (NIMS)
Education and Preparedness Training
Exercises, Evaluations and Corrective Actions
In Minnesota, each region has selected a Regional Hospital Resource Center that provides organization and leadership in preparation for and during a biological event. If there is a large-scale emergency involving multiple hospitals, the Regional Hospital Resource Center serves as the regional lead coordinating hospital to provide coordination with Incident Command and Communications for healthcare facilities in the region. Each region’s Regional Hospital Resource Center will report to and communicate directly with their state’s Department of Health and Emergency Operations Center. For example, in Minnesota, the Regional Hospital Resource Center would report to and communicate with the Minnesota Department of Health and the Minnesota Emergency Operations Center.
See http://www.health.state.mn.us/oep/healthcare/index.html for Hospital Bioterrorism Preparedness Program Technical Assistance.
References
- Guide to Emergency Management; Planning in Health Care. Joint Commission on Accreditation of Healthcare Organization, 2002.
- Natural disasters cost insurers US$75bn in 2007 Source: Munich Re Published Dec. 28, 2007
- Hospital Preparedness for Mass Casualties: Summary of an Invitation Forum, final report, August 2000. (Summary of an invitational forum convened 8-9 March 2000 by the American Hospital Association with the support of the Office of Emergency Preparedness, U.S. Department of Health and Human Services.)
- Prehospital and Disaster Medicine (Volume 12, number 1). Al-Mahari and Keller. Journal of Prehospital and Disaster Medicine; Department of Medicine University of Wisconsin-Madison.
- Perez E, Thompson P. Natural disasters: causes and effects. Lesson 8—desertification. Prehospital Disaster Med. 1996;11:147-157.
- Health Care at the Crossroads; Strategies for Creating and Sustaining Community-Wide Emergency Preparedness Systems. Enlist the community in preparing the local response. Talking With Your Community About Disaster Readiness. American Hospital Assn. Disaster Readiness Advisory #7, 28 Aug. 2002.