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Is your hospital prepared to handle an emergency?
6/13/2011
 
In March 2011, the Centers for Disease Control and Prevention released results from its 2008 hospital preparedness survey. Among the highlights of the survey:
  • Nearly all hospitals had emergency response plans to address chemical releases, natural disasters, epidemics, and biological incidents.

  • About seven in 10 hospitals also had response plans for nuclear/radiological and explosive incidents.

  • Most hospitals had plans for cancelling elective procedures and admissions to expand on-site surge capacity, and more than two-thirds had plans for alternate care areas.

  • More than half of hospitals had staged epidemic drills, one-third of which included mass vaccination or medication distribution.

  • Most hospitals had memoranda of understanding with other hospitals to transfer adult patients during an epidemic, and more than half of hospitals had an understanding for pediatric and burn patients.
Implications for hospitals
HCPro Hospital Safety Center interviewed several experts who offered the following suggestions:

Prepare for a wide range of events, but focus on the likely ones. The Joint Commission expects hospitals to focus on the top five risks identified in their hazard vulnerability analysis. Hospitals identify those hazards based on probability. So, hospitals may not plan their emergency exercises around preparing for a nuclear attack because blizzards, earthquakes, tornadoes, and flu pandemics may be far more likely events. “You have to put your limited resources where they will get the most bang,” says one expert.

Initiate better planning for special populations, including children. Planning for special populations is less common than planning for adult patients, the study found.

Prepare to handle sudden increases in volume associated with mass casualties. ED crowding is a major problem, with many hospitals now operating at or near full capacity, the study noted. Hospitals need plans to address surge capacity, such as opening up unused areas, doubling up inpatient rooms, canceling elective admissions and procedures, and using alternative areas, HCPro added.

“Hospitals should assume that in an emergency situation, 80% of casualties will self-report to the hospital or be brought in by bystanders and only 20% will arrive via emergency medical services. Hospitals must prepare for patients to show up at their doors during a disaster, and most won’t be processed through your typical emergency services,” one expert told the publication.

Prepare for critical shortages. Resources for patient care become scarce in disaster situations. For instance, there will likely be a shortage of mechanical ventilators for patients in respiratory failure. Only about half of hospitals had advance plans for adjusted standards of care for allocation of ventilators during mass casualty incidents, according to the CDC study.

Create and execute a training program. Base your training on your emergency operations plan, develop pandemic influenza exercise programs, and execute an exercise to test the validity of training and plans, the study suggested.

HCPro noted the study found that while more than half of participating hospitals had staged epidemic drills, only about one-third had included mass vaccination or community medication distribution specifically – key components in the H1N1 epidemic.

Plan for advance registration of outside healthcare professionals to volunteer in public health emergencies. Only half of hospitals have plans to do this, the study found. Federal grant money is tied to this requirement, HCPro noted.