The Challenges within the Healthcare Emergency Management Program

By Tim Ketchie, VP and Senior Consultant at Disaster Management Consultants

Our nation’s healthcare system faces many challenges in emergency and disaster preparedness. In 2002 the U.S. Department of Health and Human Services (HHS) established the Hospital Preparedness Program (HPP). The program’s goal is to provide funding that would help ensure that the healthcare systems are adequately prepared for all types of catastrophic events including terror attacks, natural disasters and other man-made disasters. This funding effort targets planning, preparedness, training and equipment provision.

A recent study [1] conducted by the Biosecurity Center at The University of Pittsburg Medical Center states that although improved “the U.S. healthcare system is not currently capable of effectively responding to a sudden surge in demand for medical care that would occur during catastrophic events, such as those described in the Department of Home¬land Security (DHS) National Planning Scenarios [2]. Emergencies of this magnitude would overwhelm the medical capabilities of communities, regions, or the entire country and require drastic departures from customary health¬care practices”.

Many healthcare institutions often delegate the Emergency Management (EM) program to the Security or Safety Directors, Facility Managers, or Nursing Administrators who are already wearing many different hats as they manage the daily operations of the facility. In some cases, this pushes management of the emergency manage program down the priority ladder.

Proper management of the EM program requires many man hours of work and expertise that, in many cases, the EM coordinator simply does not have. Some of the more time consuming elements of managing the program include cache management, training and education, drill management and compliance with requirements of federal or other regulatory agencies.

Cache Management for the EM program include bio-terrorism caches, mobile surge capacity supplies, burn care, decontamination, pharmaceuticals and incident command response cache, to name a few. These caches require purchasing, inventory, rotation, maintenance and training on new equipment. The program manager has to assure that the end user is knowledgeable of its use and limitations.

Training and education is one of the most time consuming elements of the program. The EM coordinator must stay current on the latest changes that affect the EM program such as the Incident Command System, training the decontamination warm and cold teams, the disaster triage teams, the surge capacity or alternate care site teams. The training schedule for these teams to remain proficient in the event of a disaster is very time consuming and require extensive training hours for staff as well as executive level training.

The changes required in drill management are challenging for healthcare facilities. The requirements for drill management include the use of the Homeland Security Exercise Evaluation Program (HSEEP). This program will, in all likelihood, be required for all facilities utilizing federal funding in their EM programs. Florida has already made this a requirement for facilities receiving Assistant Secretary Preparedness and Response (ASPR) grant funding. The HSEEP is a tool that will guide multi-year training and response initiatives throughout the facility. The HSEEP program has elements that already tie with Joint Commission EM standards.

Finally, another time-consuming element is remaining knowledgeable of changing regulatory requirements. The Joint Commission updates its Emergency Management standards annually. OSHA mandates requirements for personal protection fit testing as well as training requirements for hospital first receivers (decon team). Being federal grants are a primary source of funding for the EM program, it is imperative that the coordinator remain knowledgeable of its requirements.

Many hospitals have found the use of out-sourced assistance a valuable solution to these challenges. These companies or consultants can work directly with the EM manager and have the experience, expertise, and time to develop and manage a comprehensive all- hazards disaster preparedness program that is specifically tailored to each institution and its community. They are able to manage every facet of the emergency management program including plan development, training, drill programs, equipment attainment and support, grant acquisition, and compliance assistance. This valuable asset can often be funded by grant monies and can truly prove be beneficial.

Since the catastrophic events of the 9/11 attacks, Hurricane Katrina and the recent pandemic events, the general public and media has developed expectations that our healthcare institutions are doing everything within their power to ensure that they are properly prepared for any disaster. It is of the upmost importance for the executive staff within these institutions to make certain that their emergency management program is sound and ready.
“Disasters are unpredictable, your response shouldn’t be”.

References:
[1] Toner E, Waldhorn R, Franco C, Courtney B, Rambhia K, Norwood A, Inglesby TV, O’Toole T. Hospitals Rising to the Challenge: The First Five Years of the U.S. Hospital Preparedness Program and Priorities Going Forward. Prepared by the Center for Biosecurity of UPMC for the U.S. Department of Health and Human Services under Contract No. HHSO100200700038C. 2009.
[2] U.S. Department of Homeland Security (DHS). National Preparedness Guidelines. http://www.dhs.gov/xlibrary/assets/National_Preparedness_Guidelines.pdf., September 2007.

Tim Ketchie is Vice President and Senior Consultant at Disaster Management Consultants, Inc. He has 15 years experience in hospital disaster preparedness and 25 years experience in the emergency medical services. He current serves as an active member of The National Disaster Medical System Disaster Assistance Team FL-4 and the Florida Region-3 State Medical Response Team. He is an Emergency Medical Technician and Certified Medical Transport Executive.