Managing during disasters: how to build an effective healthcare emergency response plan for mass casualties, weather disasters and other crises

Proliferating severe weather events, mass shootings and other disasters in the United States mean that hospitals and healthcare systems must have a well-thought, up-to-date plan for handling various crises.

In an August webinar hosted by Becker's Healthcare and sponsored by TeamHealth, three speakers from TeamHealth —Gene Johnson, Executive Vice President, Northeast Group; Scott A. Scherr, MD, Regional Medical Director, Emergency Medicine, West Group; and Jim Frenchik, MD, Regional Medical Director, Emergency Medicine, Southeast Group — discussed the important components of an effective plan, key elements to executing it successfully and what to expect from a staffing vendor partner.

Four key takeaways were: 

  1. An effective disaster response is grounded in the basics. The best plans have an overall organizational plan and follow a logical patient flow, as a patient would move through the system. There is also a plan for each functional area, rather than a departmental plan. The best plans are checklist style for simplicity with checklists for type of disaster, including external weather-related disasters (for which there is usually a few days' notice), and internal crises, such as an active shooter or an explosion in the hospital. 
  2. Pay attention to the details. A best practice is having a command center staffed by decision-empowered leaders, located away from patient treatment areas. Cellphones may not be reliable, so ensure that staff are equipped with and trained to use handheld radios. And pay close attention to what other organizations are doing to avoid reinventing the wheel. "The reality is the best checklists are developed by those institutions that have unfortunately had to deal with a mass casualty incident or a mass crisis fairly recently," Mr. Johnson said.
  3. Be prepared to adapt, based on the situation. Dr. Scherr was involved with treating victims of the October 2017 shooting at the Harvest Festival in Las Vegas, when a gunman opened fire at a concert, resulting in 867 people injured. "The velocity and the sheer number of patients that we saw that night was different than the normal, dedicated ribbon triage," Dr. Scherr said, which forced his team to immediately adapt. "We triaged by level of acuity and put patients who needed surgical assets closer to the surgeons and the anesthesiologist, and those who needed just airway or chest tube management in another part of the emergency department."
  4. An overarching goal of an emergency management plan: standardizing your vendor's role. Modeled on hospital incident command systems, an emergency management plan should be reviewed annually; for example, prior to hurricane season in the Southeast, Dr. Frenchik said. "Your hazard vulnerability analysis is used to identify areas of focus for your emergency operations plan," he said. "So, what's your greatest exposure in your region? That's important because it guides you in developing your plans and educating your providers," including staffing vendors like TeamHealth.

Crises impacting health systems are on the rise, and a well-organized partner with experience in disaster planning can be crucial when staff are unable to get to work or when the scale of an event is so large it can overwhelm any health system. Solutions like Team Health can complement even the best-prepared health systems.

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