In Case of Emergency: Plan to Keep the Hospital Functional

by Beth Leibson Hawkins

Hospitals historically have focused almost exclusively on patient care. But since the 9-11 wake-up call, more and more facilities have begun preparing for emergencies ranging from natural disasters to pandemics to criminal or terrorist attacks.

“Hospitals are the likely target of manmade crises,” explains David A. Kipp, PE, Senior Vice President and Chief Operating Officer of St. Louis-based technology and engineering firm Ross & Baruzzini. “They also are often the focal point of natural disasters and become overrun with patients.”

The first step to emergency planning is conducting a comprehensive impact analysis to determine how to best preserve the hospital’s functionality. This effort should include a detailed evaluation of operational processes, physical facilities, and technology requirements to ensure that personnel, equipment, communications, and procedures are fully integrated.

It is also helpful, suggests Kipp, to take a comprehensive approach, coordinating with local government and local law enforcement for stronger and broader communications.

Every detail is important and hospitals often turn to emergency preparedness consultants to ensure that their assessment is systematic. “For instance,” says Kipp, “we ask whether the hospital’s IT systems could be permanently or semi-permanently compromised by a power outage.”

However, a thorough assessment is not just a checklist; it focuses also on the facility’s specific concerns. Fires, for instance, are more likely in Southern California than floods. Terrorism is more apt to occur in urban, financial, or military centers.

D3R

Once a hospital has assessed its vulnerabilities, emergency preparedness experts recommend taking a four-pronged approach to the planning process: Deterrence, Detection, Delay, and Recovery, often referred to as D3R.

Deterrence often requires a new mindset. Many hospitals and other organizations routinely install equipment such as security cameras. “But those are mostly helpful after the fact,” points out Kipp. Rather, deterrence can involve such design features as gentle lighting and a pleasant environment. These qualities, says Kipp, encourage people to feel comfortable and behave well.

The second step, detection, refers to determining when a problem has occurred. In many locations, this is linked to interoperability between hospital staff and first responders to a crisis. “For instance, New York City is just now staring to create an interoperable communication system among the City of New York, the New York-New Jersey Port Authority, The Office of Energy Management, and other organizations,” says Kipp. Knowing what is going on—and what is headed their way—can help hospitals keep a step ahead.

Delaying a criminal may give the hospital critical time to protect patients, staff, and appropriate visitors. Design is also important here. Some hospitals, for instance, create a physical separation between their secure perimeter and their critical core, or sometimes they even design boxes within boxes.

Recovery plans must ensure that the technology infrastructure can be ready to assume mission critical operations instantly. Hospitals must be able to create seamless intercommunications and interoperations functions using remote nodes. The recovery plan phase is highly detailed, explains Kipp. The recovery plan phase includes questions like:

How do you get the generator back up?
How do you get the ventilation system back on line?
What do you do about the computerized medical records?

OSHA also recommends considering health issues such as: air monitoring to ensure the facility is safe for occupancy following treatment of contaminated patients and plan for managing emergency treatment of non-contaminated patients. “Recovery planning,” asserts Kipp, “is full of nitty-gritty details.”

In the end, though, security is about preventing, or at least minimizing, loss. Maintaining a safe and functioning hospital has more to do with critical operations processes than hardware, electronics, and the armed forces. “Planning operational processes, establishing preparedness and having a response and recovery approach,” says Kipp, “come first.”