Hospital Emergency Management Plan

Disasters often occur in modern society due to increased unexpected occurrences. They range from natural to manmade disasters, which often strain the community beyond its limits. Natural disasters may include floods, cyclones, landslides, and earthquakes (National Disaster Management Division, n.d.). On the other hand, manmade disasters include fatal accidents, explosions, and acts of terrorism among others. Other than the loss of lives and destruction of property, serious injuries occur during these unexpected events. The ultimate destination for injured disaster victims is hospitals in which emergency health care services can be found (UNDP, 2008). Plans are necessary to prepare for emergencies, so as to offer the appropriate response care to victims. Plans help in disaster prevention and are a part of preparedness (American College of Emergency Physicians, n. d.). This work describes a hospital emergency management plan, discusses how seven considerations apply to this plan and explains how it can be tested using various methods.

Purpose or Objective of the Plan

The core purpose of this plan is to prepare the hospital to respond and recover from emergency disasters affecting not only the staff but also the community, visitors, and patients. In achieving this objective, a plan should provide both an organized and coordinated response to disasters that may overwhelm the community healthcare system without proper planning. In short, the plan aims to prevent or mitigate the severity of the impact of disasters. The aim is such because many victims of disasters sustain both physical and psychological injuries that require immediate healthcare services for proper healing, recovery, and prevention of further deterioration of victim’s condition.

Coordination

Hospital facilities will continue to work in cooperation with local, state, and federal agencies with similar or complimentary roles in the coordination of emergency management efforts since their efforts cannot be independent as many agencies contribute to its success. Also, during an emergency plan, sharing of supplies, personnel, and equipment is feasible, especially when hospital resources are inadequate.

Plan Development, Review, and Maintenance

This plan gives facility administrators the sole mandate to delegate a person who will be responsible for the development, review, and maintenance of the plan. Moreover, the plan should be reviewed on a continuous and regular basis. A committee under the leadership of the delegated person in consultation with the facility administrator and other important and relevant parties determines the frequency of reviews. Responsibilities of the delegated person shall be to ensure a regular Hazard Vulnerability Assessment (HVA), accurate and up to date responsibilities and actions, and continuous training of personnel regarding emergency disasters. This plan should abide the law, and the hospital should acquire certification for emergencies from the relevant authorities.

Assumptions

This plan has several assumptions on which its actions are based. Emergency disasters can occur at any given time and differ in duration, size, scope, and type. Numerous hazards threaten the community, some of which cause injuries to the population and disrupt healthcare services.  Risks range from natural and manmade disasters to disease outbreaks.

Disaster Supplies and Resources

The Emergency Department (ED) should stock adequate emergency supplies and possess a list of supplies that should be kept in a safe area. In enhancing the transportation of supplies from stores to areas of service delivery, stretchers from the ED shall be used first. Also, wheelchairs and stretchers will help in the movement of victims from ambulances to the ED and other appropriate departments. Some of the equipment and physical resources, that all involved departments will need, are the ones required for communication purposes. According to the American College of Emergency Physicians (n. d.), they include Two-Way radios, televisions, radios located in appropriately designated areas, phones, and so forth.

On the same line, every department shall assess its needs when it comes to physical resources so as to procure and store enough supplies for use during a disaster. For instance, the emergency department may require medical supplies such as drugs and equipment while the security system may need to have appropriate communication equipment. All the departments should keep inventory lists and update what is currently available and what is up for restocking. UNDP (2008) asserts that departments are responsible for restocking supplies not only during but also after an emergency disaster or drill.

The most valuable resource in an institution is personnel since staff is responsible for using and coordinating the physical resources to achieve the goals of a plan. Human resources are organized into groups that work by interrelating and collaborating with each other to reach the objectives of the plan. They comprise of the administration, emergency, anesthesia, facility engineering, nursing, laboratory, radiology, operating room, and respiratory care departments. Other departments are those concerned with transportation and security. Each department should have proper leadership and management with everyone knowing their role and responsibilities.

Response to Emergency Disaster

Once an emergency occurs, the first order of business is to enhance the alert status. This happens when an event with a potential threat of unknown magnitude arises. Hospitals should ensure that resources are adequate to handle the impending incident. The Emergency Operation Center (EOC) remains deactivated at this moment while the staff on duty remain in their areas of work performing their duties. Some departments may be informed of the impending problem, especially the ED, nursing, and security. This may allow them adequate time to prepare themselves for the challenge if it becomes a reality. Alerting is essential since it’s the only ultimate thing that can inform staff of the impending problem so they can immediately prepare for what is to come.

After that activation follows, then deactivation. Activation comes after the confirmation that the disaster is likely to exceed departmental resources and may have an operational effect on some departments. The EOC gets activated. Administration, radiology, laboratory, transportation, nursing, security, anesthesia, media relations, facilities engineering, and many others should perform a personnel and resource assessment that includes the need to call-in or retain staff. The information obtained should be channeled to the EOC. However, departments whose activities may not be affected directly should continue with their routine activities unless they receive a notification from the EOC. All the staff should remain intact and wait for assignments while proceeding with their usual activities. In the case of new assignments, every employee should perform the right and appropriate action in the shortest time possible. According to UNDP (2008), all departments should complete an assessment of the available resources both human and physical and relay the information to the EOC. Depending on the information obtained, the EOC may call for additional staff and support.

The security department will announce activation and call for the relevant departments to take action after being notified by the EOC Director. The announcement should last for approximately thirty minutes. Similarly, the security department will again announce the deactivation of the plan’s functions after determination and direction from the EOC Director. The security should not declare anything except when directed by the EOC Director to alleviate confusion that may arise during emergency events. After deactivation, all the personnel should return to the pre-emergency status. For instance, those who were working should go back to their departments and continue with their routine work.

Organization and Performance of Activities

Treatment Areas

The ED shall be divided into several areas with various functions. For instance, the department may have a patient reception area to receive casualties from the scene of an emergency, a resuscitation area for resuscitation purposes, and a patient observation area. Other hospital organizations can entail sections such as a minor treatment section, an operating theater, and wards with appropriate beds. In the case of shortage, more resources should be outsourced in addition to discharging some patients such as the ones for elective surgery. The mortuary is another important area since some casualties may arrive at the health facility already dead, die immediately or after some time after arrival. The bodies of such victims should be removed from the active areas and be kept in the mortuary. Other areas such as the staff, media, and public debriefing areas are critical.

Medical and Nursing Supplies and Services

Those in charge of all medical services should enhance the proper administration of healthcare services to victims upon arrival at the hospital. Furthermore, any information that may help in improving the response to an emergency should be communicated to the EOC for help. For instance, if there is a shortage of medical and nursing staff, communication to EOC can assist in calling in more staff to address the shortage. Moreover, the officer in charge of the medical and nursing supplies should open storage immediately after the announcement of the disaster so that supplies are not a problem in addressing the emergency disaster.

Public Relations, Security, and Others

The hospital administrator will have the sole responsibility to delegate someone or deliver information by himself to the public, relatives of the victims, and the media. The one disseminating information should work in liaison with a public relations officer. More so, the security system should work by declaring the start and end of an emergency after receiving information to do so from the EOC Director. Other departments and personnel will play a role in an emergency. At this juncture, the plan allows reviews and addition of information with time.

After the Emergency

The hospital administrator shall call all the stakeholders and brief them on how the plan was worked. Nevertheless, there will be a discussion of the identified weaknesses of the plan. This will enable improvement in preparation for any emergency that may occur in the future. For example, if staff competency is a challenge, then the hospital may organize staff training sessions to address the gap.

Applicable Considerations in the Plan

Acceptability. A plan is acceptable only if it meets the scenario requirements and can be implemented within the intended timeframe. Also, a plan is acceptable if it’s consistent with the laid down laws and regulations. This plan is acceptable because it meets scenario requirements as it has shown what every department should perform, organized units, etc. Furthermore, resources have been mentioned in the plan in detail to help achieve the objectives in time. The plan has stipulated that the hospital should have a fire certificate and abide by the law when dealing with disasters. The security system is involved, which can sometimes include the police, who are law enforcers. Therefore, this plan is acceptable.

Adequacy. Adequate plans are those that comply with applicable guidance in addition to identifying tasks to fulfill stated objectives. This plan is adequate because it has pronounced its goals, the ways to achieve them, and guidance through which performance of every function will follow. These tasks include communication and offering quality healthcare services. For instance, the security system should communicate the onset and the end of an emergency disaster after consultation with the EOC Director. The functions of the storage official, healthcare professionals, and the administrator are all outlined in the plan. The plan has also shown the need to eliminate weaknesses through things like staff trainings. Therefore, this plan has met adequacy requirements.

Completeness. This hospital emergency disaster plan is complete since it has addressed numerous dimensions. The National Fire Protection Association [NFPA] (2014) says that plans should encourage the participation of many stakeholders involved in emergency events. This plan has addressed all the interested parties ranging from the hospital administration, medical and nursing staff, and security personnel to the public relations staff among many others. All these parties are involved in the emergency by performing several tasks, making decisions, and planning. For instance, the hospital administrator releases information to the media and the public while medical personnel is endowed with the responsibility of delivering quality healthcare services to the disaster victims. In addition to this, security department is supposed to announce the presence of the disaster. Completeness also comes when a particular plan clearly states the necessary resources in a well-documented manner. This plan has stated the required human resources such as personnel and physical resources like communication equipment, medical supplies, and so forth. Additionally, the plan is detailed and documented in a manner that everyone can understand. This is essential as people can refer to it at any given moment, especially when the need arises. Therefore, it is complete.

Consistency and standardization. This plan has both consistency and standardization to other conventional plans.  Just like the NFPA (2014) Fire Emergency Plan, this plan has stipulated its objectives, tasks for performance, resources, etc. For example, the purpose of the plan is to allow the hospital to respond quickly and appropriate to an emergency scenario so as to mitigate the effects of disasters. In achieving this objective, the plan has outlined tasks such as communication, delivery of health care services, training of personnel and so forth. The plan further emulates that of NFPA (2014) by having a detailed statement of resources such as human resources that include nursing, medical, security, and public relations personnel. Physical resources such as medical supplies and communication equipment are also outlined in the plan. That notwithstanding, the plan is not rigid since there is an allowance for review and improvement with time. These and many other factors make it consistent and standardized.

Feasibility. Feasibility applies to any plan the resources of which can accomplish stipulated activities. The hospital emergency plan is feasible since the stated resources can perform all the tasks. For instance, the delivery of healthcare services requires performance of activities that require both physical and human resources. This plan has outlined some of the personnel including the nursing and medical teams. Their functions will be aided by the availability of medical supplies and equipment such as stretchers, wheelchairs, and drugs. All these are included in the plan. Also, the security team communicates by alerting the hospital of an impending emergency and the end of it if necessary. The resources for accomplishing this are established in the plan. Therefore, feasibility applies to this plan.

Flexibility. Flexibility applies to a plan that embraces collective decision-making and accommodates all kinds of hazards. This plan is flexible because it does not dwell on a particular emergency disaster. It aims at curbing the effects of all emergency events rather than dwelling on a particular one. The victims that it helps get service can come from different kinds of disasters. Also, the plan involves every stakeholder not only during the actual disaster but also during the planning and review stages. The security, medical, radiology, and laboratory departments are also involved.

Collaboration and interoperability. Interoperability and collaboration apply when plans identify different shareholders who play either similar or complementary roles during emergency events. This phenomenon applies to the hospital emergency plan since it has outlined some stakeholders who will not only work together but also collaborate with each other in fulfilling the plan’s objectives. For instance, the medical team that comprises of nurses and doctors will rely on the security to announce the presence of a disaster before reacting. Moreover, the public relations officers and hospital administrators will depend on the information from every department before delivering messages to the media and the public. Similarly, units cannot work without getting supplies from storage. Those in the storage acquire the same supplies from the work of the hospital procurement office. This means that there is a need to have everyone perform either similar or complementary task so as to achieve the goals of the plan.

Hospital Emergency Management Plan Testing

Talk Through Exercises

These exercises entail a detailed and thorough discussion of the plan. It can test whether all the key stakeholders understand the particulars of the plan, especially the performance of tasks among (Cabinet Office, & National Security and Intelligence, 2013). While discussing the plan, areas that shareholders may not understand can be picked, and necessary action can be taken. For instance, staff training can be an action to enable the relevant personnel to eliminate their weaknesses. Talking through the plan helps all the stakeholders gain a mastery of all the plan’s guidelines in addition to knowing their roles and those of others in fulfilling the plan’s objectives.

Tabletop Exercises

Tabletop exercises are staged events that test how the stakeholders would implement the plan during a hospital emergency disaster event. Tabletop exercises test the viability of a plan regarding the outlined resources and tasks in meeting the stated objectives (Cabinet Office, & National Security and Intelligence, 2013). Since this plan has stated its resources and activities, this method can help a lot in testing its viability. This method will achieve the best results since it simulates an actual emergency event and any flaws can be identified for further improvement.

Field Exercises

Just like the tabletop exercises, field exercises test all aspects of a plan. Eastwood et al. (2010) assert that these rehearsals enhance consolidation of preparedness through plan testing. The elements that can be tested in this plan may include how the hospital responds to an emergency, how it is prepared to act during an emergency at any moment, and interdependence when working to achieve the plan’s objectives among many others. Drills are a good example of these exercises. An identification of weaknesses can help in improving the plan, especially in equipping resources and performance of activities.

Walk Through Exercises

Such a method involves a verbal implementation of a plan not only to assess it viability but also to identify its weaknesses. This method is useful in testing the plan on whether it has any weaknesses or omissions (Cabinet Office, & National Security and Intelligence, 2013). At this juncture, improvements to the plan will be paramount.

Conclusion

Emergency disaster events are deadly as they affect human population by causing injury and death. Hospitals are the only option in helping disaster victims after detrimental emergency events. Therefore, they need to have plans for effective response to emergencies. This work has given a detailed description of a hospital emergency management plan, which contains clearly stated objectives, resources, activities, and organization of the hospital resources to achieve the stated goals.

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