Emergency Preparedness 2: Approaches to Planning
Five Strategies for Developing a Comprehensive Emergency Management Plan
Since September 11, 2001, significant improvements have been made to hospital preparedness and integration of plans with community emergency management plans. The overall goal is to continue to provide patient care services during the incident while ensuring that the hospital is safe and secure and that critical functions are maintained. During an increased surge of patients and patient care demands, a hospital needs to assure that adequate staffing is available and that processes to expand capacity are mobilized.
The following five strategies are invaluable aids for revising a hospital’s disaster policies/plans or upgrading to a comprehensive Emergency Operation Plan.1,2
Strategy 1. Review and, where needed, enhance and incorporate existing contingency or disaster plans as much as possible. It is not necessary to completely rewrite existing plans to conform to the Emergency Management Plan format, but all aspects of the existing Emergency Management Plan need to be critically reviewed.
Strategy 2. Build layered protection by developing plans to defend both mission-critical systems and mission-critical operations. The six key elements of this planning include:
Emergency communications during emergencies
Managing resources and assets during emergencies
Managing safety and security during emergencies
Defining and managing staff roles and responsibilities during emergencies
Managing utilities during emergencies
Managing patient clinical and support activities during emergencies.
Strategy 3. The Emergency Management Plan should use a common framework that incorporates four separate process components: Mitigation, Preparedness, Response, and Recovery. (See following)
Strategy 4. Those responsible for developing the plan need to involve community emergency management planners as well as public safety and public health providers to assure that the hospital’s plan coincides and integrates with those in the community.
Strategy 5. All Emergency Management Plans should be evaluated through regular exercises, and when necessary, revisions should be incorporated. Staff knowledge and competency fades with time, and hazards and vulnerabilities may change.
Four Key Aspects for Emergency Management Planning:
Mitigation, Preparedness, Response, and Recovery
Emergency planning focuses on facility preparedness, staff preparedness, and management of care recipients. When developing a comprehensive Emergency Management Plan to address an Emergency Incident–Disaster, it is imperative that those responsible for the planning understand the four key aspects of Mitigation, Preparedness, Response, and Recovery. The first step to employing these aspects successfully is to understand how these terms are defined in relation to the principles of emergency management planning for health care organizations.
- Mitigation
Mitigation is defined as activities an organization undertakes to attempt to lessen the severity and impact a potential Emergency Incident-Disaster may have on its operations. Those responsible for implementing the Emergency Management Plan must address mitigation from two perspectives:- Mitigation activities are employed prior to an Emergency Incident-Disaster that will eliminate or decrease the potential of vital system failures.
- Mitigation activities undertaken during an Emergency Incident-Disaster to reduce the effects of the disaster that were not adequately alleviated by pre-event mitigation efforts.
- Preparedness
Preparedness is defined as the aggregate of all measures and policies taken by those responsible for the development and implementation of the Emergency Management Plan before the event occurs, which in turn provides programs designed to minimize loss of life and damage, to organize and facilitate effective rescue and relief, and to rehabilitate after disaster. Preparedness includes warning systems, sheltering in place, evacuation plans, energy management strategies, and disaster drills and exercises. Contingency and response plans are included in the steps of preparedness. As preparedness increases, the ability of a hospital and a community to absorb the event and mitigate the impact (damage) is augmented as a dependent variable of the level of preparedness. Preparedness addresses educating and training the organization and its management as well as the public. This aspect of emergency preparedness includes knowledge of plans, training of personnel, stockpiling of supplies as well as ensuring that needed funds and other resources are available. - Response
Response refers to actual emergency management. Response involves treating victims, reducing secondary impact to the organization, and controlling the negative effects of an Emergency Incident–Disaster. The hospital must have an All Hazards Response Plan to provide the foundation for organization readiness and to address the hospital’s overall readiness. Each department needs to determine their responsibilities and how their response activities support and align with the hospital’s All Hazards Response Plan. - Recovery
Recovery consists of four key elements: Finance, Staffing, Service, and Communication. These are incorporated into the formulation of strategies and action plans and then implemented to address the primary and secondary effects resulting from the Emergency Incident–Disaster.- Primary effects are those that are a direct result of the event.
- Secondary effects are those that result from the primary effects or from the responses to the event.
Although described as acute, some effects may be ongoing and stretch over long periods of time (eg, famine, drought, epidemics, complex human emergencies). These effects are functions of the vulnerability of the population and the environment and the human responses to the impact of the event.
By utilizing these key aspects, those responsible for revising their current disaster policy/plan or developing a comprehensive Emergency Management Plan can proceed to the next phase, a Hazard Vulnerability Analysis.1
References
- Guide to Emergency Management; Planning in Health Care. Joint Commission on Accreditation of Healthcare Organization, 2002.
- Emergency Management (EM) Principles and Practices for Healthcare Systems, The Institute for Crisis, Disaster and Risk Management at George Washington University for Veterans Health Administration, Department of Veterans Affairs Washington, DC, June 2006