Weathering the Storm: 8 Necessities for Hospital Emergency Plans

In an Oct. 17 webinar from Healthcare Collaboration, healthcare leaders discussed best practices for hospital executives and management teams to prepare their organizations for disaster.

Patti Ellish, president and CEO of St. Tammany Parish Hospital in Covington, La., shared the most significant lessons she's learned about disaster preparation after guiding the organization through two hurricanes. Carl Taylor, JD, vice president for Miami-based Independent Living Systems and former director of the National Center for Disaster Medical Response, also explained the two types of hospital CEOs he's encountered when it comes to emergency planning.

Ms. Ellish led the 222-bed St. Tammany through category five Hurricane Katrina in 2005 and category one Hurricane Isaac, which passed through past spring. "When you've seen one storm, you've seen one storm," Ms. Ellish said, emphasizing that no two disasters are alike and hospitals need flexible emergency plans that apply to events of varying intensity.

Mr. Taylor says that he's encountered hospital CEOs who are either intimately involved in disaster planning, or those who say they don't have time for it. The second group of CEOs will say disaster planning is part of someone else's job, or they will be too busy with the board, officials and media when disaster strikes to handle the plan. And that's the wrong approach to take, according Mr. Taylor.

Here are eight tips for hospitals to strengthen their emergency planning and thrive in midst of a disaster.  

1. Effective disaster planning requires large imaginations. Hospital CEOs need to become their organization's chief imagination officers when planning for a disaster, according to Mr. Taylor, who has spoken with more than 10,000 healthcare professionals over the past nine years about emergency preparation. Something people have said again and again is that they didn't expect a disaster this big, like Katrina, the BP oil spill or the string of tornadoes that hit Alabama last spring. Hospital CEOs should anticipate and prepare for the largest disasters, not average-sized ones.

2. Never underestimate the power of redundancy. Over the years, St. Tammany allocated capital for a backup power generator. When the power went out during Katrina, this generator is what kept the hospital's electronic health records intact and operating rooms running on schedule, among other necessary operations. "We are looked upon in the community to be that beacon and to have the lights on when no one else has lights," says Ms. Ellish. The hospital also has a well to supply water to the facility and surrounding areas.

3. Remember: Disasters come in layers. Natural disasters often come in pairs, at least. The havoc brought on by Katrina was not from the hurricane itself, but from breached levees and a flood covering 75 percent of the New Orleans metro area. Japan's 2011 earthquake-tsunami-nuclear meltdown disaster was another layered disaster. Hospitals should avoid preparing for events in vacuums. "We need to understand that events trigger events," says Mr. Taylor. This not only applies to external disasters, but also events within the hospital. For instance, executives should discuss every repercussion of a power loss within the hospital and prepare accordingly.

4. CEOs should take control of the hospital's story. When Mr. Taylor is speaking to a hospital CEO who is distant from emergency planning, he asks one important question. "If you have the opportunity to write an article about that event, it could either have your organization overcoming the disaster, or saying, 'We never thought about that.' Which would you rather see above the fold of the newspaper?" He emphasizes that disasters are a matter of when — not if. It may not be a hurricane. EHRs could crash from a cyber attack. There could be a severe virus outbreak. No hospital is disaster-proof, and executives should be highly involved in the planning.

5. Ensure that vendors understand your situation beforehand.
Vendors know that if they don't hear from St. Tammany, they are still expected to deliver supplies that were lined up ahead of time, according to Ms. Ellish. "That was a lesson learned from Katrina, since we couldn't get any information to them since there was no way to get word out," she says. During Isaac, the hospital received its laundry and medical supplies without making any external calls to vendors.

6. CFOs should be involved in the conversation. "Disasters have long tails," says Mr. Taylor, meaning that even when an event seems to be over, the hospital still faces financial repercussions. For instance, what happens when a large number of residents relocate — as was the case with Katrina — and physicians don't have as many patients? These problems will deeply affect a hospital's strategy and spreadsheets, and the CFO should play a role in addressing those scenarios during the disaster planning process.    

7. Go one step further than you think necessary. One of the biggest mistakes a hospital can make is being overconfident in face of an emergency. Ms. Ellish knows this firsthand. "Even though we had redundant power and felt secure, when Isaac came around, the small engine that actually takes the fuel out of the tank and pumps it into the generator failed," she says. Fortunately, St. Tammany had anticipated this event in its planning. It bought a back-up pump and kept it on the hospital campus in storage, thus avoiding an all-out power less and large crisis. "A small fuel tank pump could have completely devastated the campus during Isaac, even though the storm was not as great."

8. Get the message out. During Katrina, St. Tammany was without external communication. Cell phones didn't work. The already chaotic situation could have easily spiraled out of control, but Ms. Ellish held briefings at least twice a day in the hospital's command center, which operated for 14 days. By the end, the sessions became town hall meetings. "We didn't exclude anyone from those meetings," she says. Hospitals should also ensure that even the most obscure information is noted in materials and manuals for hospital staff. For instance, during Katrina, officials asked Ms. Ellish for the hospital's helipad coordinates so they could land a helicopter with supplies. "I wasn't prepared to answer that," says Ms. Ellish. "Include all of that in a planning manual, especially when you're waiting for a helicopter to arrive with needed resources."  

More Articles on Hospital Crises Management:

8 Best Practices for Managing a Hospital's Reputation
Communicating a Hospital Crisis: Best Practices for 4 Scenarios
Report: U.S. Hospitals Improved Disaster Preparedness


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