(10/24/2016)

Just days before the CMS flips the switch on its new emergency preparedness requirements, we’ve been reminiscing about seemingly harmless oversights that can backfire in big ways, increasing risks to patients, hospital operations and revenue in the event of a disaster.
 
In this article we list three habits your organization must cultivate to avoid common tripwires that can worsen conditions as you go into crisis mode.

 Stop using obsolete information
 
The worst time to follow outdated guidance is when lives are at stake. And yet, many hospitals base their disaster planning on obsolete information.
 
Managing an incident takes more than vests and clipboards.  Healthcare incident management should fit the facility’s structure; you should change your structure to adapt to an incident management system. One of our first impulses during a disaster is to call the fire department, police, or emergency medical services.  Most do not understand hospital operations however, or hospital-specific threats like infections and blood-borne pathogens.
 
Years ago, during an Ebola outbreak, local hospitals called Scott Cormier, now our vice president of emergency management, safety and environment of care, and said, “We’re going to the local fire department to have them train us on our personal protective equipment.” The issue, Scott countered, is that fire departments don’t understand Ebola as well as infectious disease specialists.
 
“Hospitals need to flip that script,” says Scott, “and step up as the ones guiding local government and community agencies on matters of health.”
 
Develop (and practice) good response mechanisms
 
Sometimes you know a crisis is coming. We call those “disasters with notice.” Others hit unexpectedly.
 
For foreseeable disasters, it’s important not to assume all is under control because a plan is in place and you’ve faced a similar scenario before. Conditions change, sometimes with catastrophic ramifications. Following the same methodical approach as if you were encountering the situation for the first time helps you spot red flags early and increase your accuracy.
 
With hurricanes, for example, we start planning five days out before landfall. At that time, the direction the hurricane can go is pretty wide, so we plan for a wide area. As it narrows and gets closer to the coast, we narrow our focus. We’ve tackled plenty of hurricanes, but never presume we know how it will develop, nor wait to find out.
 
For disasters without notice, like tornadoes or earthquakes, you’ll need a strong response mechanism in place, able to deploy assets instantaneously. In any case, your team must be ready 24/7 for whatever may come.
 
Engage audiences with frequent, open communications
 
In the past, hospitals tried to hold back information that was unpleasant or embarrassing. We now live in a world where you can’t keep a secret.
 
Either way, people will find out. You have the opportunity to shape the narrative, build consensus, and give each of your audiences (patients, clinicians, facilities team, legal, supply chain, and so on) accurate information from the get-go, so they don’t speculate, spread half-truths or make decisions based on bad intel.
 
Communicate early, openly and often, and you’ll save everyone a lot of pain—including yourself.
 
Leadership & experience can make all the difference
 
In our last issue, we discussed the impact of emergency management experience and an engaged leadership on a facilities management program. Without either—first-hand experience or leadership involvement—your organization is destined to underreact, overreact, and overspend when tackling a crisis.
 
The first step is understanding where you stand today, what’s at risk, and where you’re going—placing biases and assumptions aside, and letting data drive discussions and decisions.  
 
It’s the only way to measurably shrink risks and ensure you’re able to serve patients and generate revenue, even in the midst of your darkest hours.