A Surge of Relief
EC.7.40: The hospital maintains, tests, and inspects its emergency power systems.
IM.2.30: Continuity of information is maintained.
LD.3.15: The leaders develop and implement plans to identify and mitigate impediments to efficient patient flow throughout the hospital.
IC.6.10: As part of community management activities, the hospital prepares to respond to an influx, or the risk of an influx, of infectious residents.
MS.4.111: Disaster privileges may be granted when the emergency management plan has been activated and the organization is unable to handle the immediate patient needs (see EC.4.10)
Effective July 1, 2006, revised standard EC.4.20 regarding emergency management drills will require healthcare organizations to improve the planning and evaluation of emergency management drills. This change is being made to help ensure that the field conducts emergency management drills rigorously and thoroughly.
There have been missed opportunities during drills to identify and improve weaknesses. The revised standards were derived from current literature on the characteristics of effective emergency drills and the input of two nationally recognized emergency management experts. Based on this research, the revised standard emphasizes a continuous quality improvement approach to planning, conducting, and evaluating emergency management drills.
Source: www.jcaho.org/news+room/press+kits/ems/06_hap_accred_stds.pdf.
Use an All-Hazards Approach
In order to plan for and respond to a variety of emergencies, hospitals must conduct a hazard vulnerability analysis (EC.4.10). This analysis is best done with community leadership to ensure that there is continuity at all levels of planning. This formal process for conducting a hazard vulnerability analysis has been a JCAHO requirement since 2001, although hospital standards previously had called for planning to address a variety of disasters.
The change in requirements simply provides a method—the hazard vulnerability analysis—for a hospital to focus attention on the disasters or catastrophes likely to have an effect on its operations. This analysis should be a dynamic document that is regularly reviewed and revised to reflect the latest information on the probability of events or threats and their effects.
By considering a complete list of potential hazards, hospital leaders can determine the effects that specific types of emergencies will have on their facility and the community. The hazard-vulnerabilities analysis also should take into account the fact that an emergency may have a cascading effect. Example: The hurricane in New Orleans did not initially cause as much damage as feared, but breaches in the levees from the hurricane’s rains caused massive flooding that resulted in nearly complete communications failures, loss of power, transportation breakdowns, and so forth.
After compiling as complete a list as possible of potential emergencies, hospital leaders [must work] with the community to prioritize the list considering likelihood and effect of such an occurrence. Then, the areas of vulnerability that most demand community and organizational attention can be addressed. Dealing with these issues requires hospitals to work with local and regional government agencies, emergency responders such as local fire and police departments, and other hospitals and healthcare organizations in the community.
By working together with other healthcare professionals and with community experts charged with responding to emergencies, hospitals can ensure that the full spectrum of likely emergencies and contingencies has been considered. The collaboration also allows the many organizations involved to understand their role in a larger crisis and anticipate how other partners will respond. An emergency affects the entire community, making it important for hospitals and other organizations to avoid “silo” approaches that leave each component of the community vulnerable if they are standing alone.
