With new medical crises looming, experts offer emergency preparedness planning tips
The COVID-19 pandemic has exposed problems within U.S. health care systems that would be prudent to address now before another medical crisis surfaces, experts cautioned during a recent webinar hosted by U.S. News & World Report.
The webinar was held amid reports from mainstream media and state health departments that some states have either rationed health care or come perilously close to doing so in the past several weeks.
Many health systems are being asked to do more with fewer health care professionals, raising concern about health system’s ability to respond to future medical crises, John L. Hick, MD, the medical director for emergency preparedness for Hennepin Healthcare in Minnesota, said during the webinar.
“Staff has absolutely had it [and] are now being asked to take on additional responsibilities,” he said. “Our hospitals are surging in levels I haven’t seen in 25 years of practice. COVID is the tip of that spear.”
The potential for a “twindemic” — a simultaneous outbreak of both COVID-19 and influenza — represents another threat to health systems.
Paul Biddinger, MD, the director of Massachusetts General Hospital’s Center for Disaster Medicine, said that health systems need to seriously consider developing emergency preparedness plans for events like cyberthreats, unstable infrastructure, uncertain supply chains, terrorist attacks and weather-related disasters.
Bringing emergency preparedness plans to fruition will require a change in conversation that appeals to hospital administrators, according to Scott Cormier, another webinar speaker and vice president of emergency management at the business management company MedExcel in Indianapolis.
“If as an emergency preparedness planner, the only conversation with the c-suite is one that goes ‘can I have $10,000 to get radios in case we lose communications,’ you're not going to get anywhere,” he said. “You have to think like a c-suite person, which involves explaining that ‘during a disaster, we may lose communications. And if that happens, we won’t be able to receive patients or contact other organizations or our staff.’
“When you start thinking strategically, then you can have a better outcome,” Cormier said. “I like to call emergency management people fire extinguishers. Until there’s a fire and for the next couple of months, [everyone] knows where the fire extinguishers are and then that goes away.”
Emergency management planners “need to be relevant every single day, not just during a disaster, and do that by changing the conversation,” he added.
Some of the speakers acknowledged that establishing, implementing and maintaining an emergency preparedness plan costs money that health system administrators may be reluctant to disperse.
Hick encouraged health systems to create partnerships in the community to defray some of the costs. Other speakers said there are ways to present the need for such plans that may make health system administrators less hesitant to provide funding.
Biddinger said to explain that “if you don’t have an emergency management program that can work with your clinical leaders, your executives and your IT leaders to seamlessly protect patient safety and keep your operations going, you’re going to have a challenge and a lot to answer for when you talk to your board later on.”
After the health system administrators have agreed to support an emergency preparedness plan, Cormier recommended putting a trained professional in charge of developing it.
“Unfortunately, in health care, emergency management is looked at as a regulatory compliance issue,” Cormier said. “It’s typically a duty given to somebody in addition to their other duties such as a facility manager, emergency department nursing leader or even ... an administrative assistant. But it’s more than that.”
Health systems also should avoid using historical data when analyzing their risk for hazards, added Biddinger, who worked during a real-life emergency, the bombing at Boston Marathon in 2013.
“If you look at how often you flooded, how often you had a heat wave or had high wind speeds, in the era of climate change, you are automatically doing a flawed analysis since history is not going to predict the future well at all,” he said.
Health systems would also likely benefit from reaching out to peers with real-life experience of emergency management, according to Efren Manjarrez, MD, SFHM, FACP, a Society of Hospital Medicine board member and associate professor of clinical medicine at the University of Miami Miller School of Medicine.
“Reach out to your colleagues who may have previously” had similar experiences, he said in an interview that took place after the webinar. “The hospitals in Miami have hurricane preparedness plans and medical centers like Tulane, Ochsner Clinic and Louisiana State do this with some sort of frequency.”
FL1 News. Alaska has three hospitals rationing health care to patients amid COVID surge. https://www.fingerlakes1.com/2021/10/03/alaska-has-three-hospitals-rationing-healthcare-to-patients-amid-covid-surge/. Published Oct. 3, 2021. Accessed Oct. 4, 2021.
Idaho expands Crisis Standards of Care statewide due to surge in COVID-19 patients requiring hospitalization. https://healthandwelfare.idaho.gov/news/idaho-expands-crisis-standards-care-statewide-due-surge-covid-19-patients-requiring-0. Published Sept. 16, 2021. Accessed Oct. 4, 2021.
Lin R-G, et al. Some Central Valley hospitals on the brink as COVID-19 surge hits crisis point. https://www.latimes.com/california/story/2021-09-10/fresno-hospitals-on-brink-of-rationing-care-amid-covid-surge. Published Sept. 10, 2021. Accessed Oct. 8, 2021.
U.S. News & World Report webinar: Hospital emergency preparedness: Building resiliency into crisis management plans. Occurred Sept. 28, 2020 (virtual event).