With much of the eastern seaboard is at risk of flooding, power outages, and massive property damage, from Hurricane Sandy, 9 states have already declaring a state of emergency.
In preparing for a disaster like Hurricane Sandy, most hospitals and healthcare providers based their primary emergency preparedness plan on defending in place, where supplies, resources and contingency plans will allow critical services to continue. This could include cancelling outpatient services and elective surgeries; stocking up on food, water, and emergency generator fuel and rescheduling staff to assure 24 hour coverage until the disaster event ends.
East Coast hospitals have had the better part of a week to prepare for the effects of this monster storm, but it is impossible to prepare for every contingency. Undoubtedly, there will be situations that will develop that can still result in a hospital having to evacuate some, if not all, patients if their resources are insufficient to handle what this storm can deliver.
Preparation is only one component of an emergency preparedness plan. It should be no mystery, to health care providers, that once the storm has subsided, the implementation of a sound recovery plan will be the next integral part of any overall health care emergency preparedness plan. When properly implemented, a disaster recovery plan will assure a higher probability of an acceptable level of percentage of recovery to pre-disaster service levels.
In a community disaster, hospitals can rely on outside response such as local authorities and community first responders and agencies such as FEMA, US Department of Health and Human Services, the American Red Cross or the Army National Guard to assist. However the degree to which these agencies can assist is diluted when a disaster involves not only entire communities but neighboring communities and entire states. That assistance is for the initial phase of response and seldom contributes to the long-term, individual health care facility recovery efforts. Once the event ends, the health care facility is left to put the pieces back together.
Recovering from a true event may entail the utilization of resources and supplies not normally part of the daily hospital’s or health care facilities business routines, or not utilized or needed prior to the disaster. Depending upon the extent of the disaster, recovery often requires the involvement of risk management; insurance carriers; managing staff activities, such as arranging transportation, stress debriefing; and logistics of moving and securing critical supplies, to mention only a few. Full recovery will only be realized once the service levels and physical plant conditions are back to pre-disaster levels.
The mystery in disaster recovery is that you never know what to expect or what will be expected. Each department in a hospital or health care facility should have its own specific recovery plan, or that mystery will remain unsolved.
Recovery can take many forms, including but not limited to:
- implementing structured contractual agreements with outside contractors or suppliers to prioritize each department’s needs
- replacing equipment, chemicals and supplies
- rebuilding a facility
- submitting and processing damage and flood insurance claims
- removing contaminated materials
- replacing floor and wall coverings
- converting even temporarily to manual systems
- cash advances to employees who do not have access to direct deposit funds when local banking is impacted
- drying flood soaked walls
- preventing or removing mold as a result of flooding (not necessarily covered by insurance companies)
- long-term rental of emergency equipment
Following a disaster hospitals, clinics and physician offices can expect a surge of chronically ill patients. According to Linda Landesman, MD, author of Public Health Management of Disasters: The Practice Guide, as quoted in an article in Medscape Medical News; “People lose their medicine, or it gets wet,” “They lose power, and there goes the medicine in their refrigerator.” They lose their canes, their glasses, their dentures, and the list goes on. Exposure to the elements can exacerbate medical conditions.
Physicians in private practice may have to consider “postponing some of their noncritical appointments so they have the capacity to see the emergency walk-ins” in the days or weeks following a disaster.
A disaster recovery plan is a matter of due diligence to assure continuation of the critical service levels, related to direct and indirect patient care.
Additional information: FEMA, US Department of Health and Human Services, American Red Cross, Army National Guard
Sources: Wikipedia Org; Medscape Medical News; Assuring a Safe Environment for Patients, Employees and Visitors: Preparing Healthcare Organizations for Emergency Response, 2003, MS Thesis, by J. Douglas Roill; FEMA