Emergency Management (EM) Consulting

Emergency Management (EM) Consulting

Our experts will help you develop a scalable emergency management plan.

Health care institutions must have an emergency management program (Emergency Operations Plan – EOP) so that patients/resident/client care can be continued effectively in the event of emergency situations. The EOP has to address both external and internal disasters. An Emergency Operation Plan should be general and allow specific responses to the types of disasters likely to be encountered by the organization and applies to business occupancies. The emergency management program is based on the priorities identified in the Hazardous Vulnerability Analysis (HVA). Based on an evaluation of incident probability/frequency specific to the organization, disasters that might be considered in an organization’s plan include, but are not limited to, (based on definitions of Red Cross and the Disaster Relief Act of 1974) Natural disasters, including the following types:

  • Meteorological disasters: cyclones, typhoons, hurricanes, tornadoes, hailstorms, snowstorms and droughts;
  • Topological disasters: landslides, avalanches, mudflows and floods;
  • Disasters that originate underground: earthquakes, volcanic eruptions and tsunamis (seismic sea waves);
  • Biological disasters: communicable disease epidemics and insect swarms(locusts).

Man-made disasters, including the following types:

  • Warfare: conventional warfare (bombardment, blockade and siege) and non-conventional warfare (nuclear, chemical and biological);
  • Civil disasters: riots and demonstrations, strikes;
  • Criminal/terrorist action: bomb threat/incident, nuclear, chemical, or biological attack, hostage incident;
  • Accidents: transportation (planes, trucks, automobiles, trains and ships), structural collapse (buildings, dams, bridges, mines, and other structures), explosions, fires, chemical (toxic waste and pollution) and biological (sanitation).

New Standards

The new standards have been in development over the past 3 years. These new standards reflect the major lessons learned from core debriefings of recent catastrophes. The revised standards emphasize an “all hazards” approach with a “scaleable” response. They also stress the importance of planning and testing plans without the assistance of local community support. There are six critical component areas integrated into the revision as well as the additional standards within other chapters are integral to the emergency response thus promoting cross chapter integration.

The major expectation for the new standards is the development of an Emergency Operations Plan (EOP). This replaces the emergency management plan and must be specific in addressing the six critical functional areas. There is a mandate for an incident command structure that should be consistent with the community. It must also address staffing patterns as well as procedures for initiation and termination of emergency operations.

The EOP must identify the organization’s capability to self sustain for at least 96 hours without community support. This standard does not specifically state, nor intend, that the health care facility must be self-supporting for 96 hours but instead looks to identify the process for scaling back service and identifying associated thresholds for decision making (evacuation is an acceptable response). For example, a facility may only have enough fuel for the emergency generators for 24 hours. The intent of the 96-hour standard is to have the organization document the process for procurement of additional fuel or how services cut be curtailed to conserve fuel and what the threshold for shutdown or the evacuation of the facility will be based on the lack of fuel resources.

Six Critical Areas

  1. Communication
    Communication strategies must be established to direct and communicate response information to the staff, patients, families and external agencies. There must be back up communications processes and technologies in place and the use of common terminology.
  2. Resources and Assets
    Resource and asset management strategies to continue care of the staff and patients are essential for an emergency response. Plans must be developed to address inventories of resources as well as critical supply procurement, possibly from multiple vendors.
  3. Safety & Security
    During an emergency, it is crucial that the hospital control the movement of patients, staff, visitor and volunteers within the hospital. Processes for Hazardous Material management, decontamination and control of access and egress must be developed, coordinated and practiced with outside community partners.
  4. Staff Responsibilities
    Staff must be orientated and trained in their assigned responsibilities during an emergency based on the Hazard Vulnerability Analysis. The use of job action sheets and checklists to assist staff members could be instituted. Cross training of personnel to perform other than normal duties during an emergency is an important consideration. An example of this would be using accounting people as patient transporters.
  5. Utility Management
    Hospitals must find alternative means to provide potable and non-potable water, sanitation, fuel and electricity. Memorandums of understanding and/or relationships with suppliers and emergency managers of community can enhance implementation of this process in a time of crisis.
  6. Patient and Clinic Support Activities
    Fundamentally, protecting life and prevention of disability is the goal of emergency management. A process for swift triage of those patients able to be discharged should be in place. Management of the treatment of patients should include attention to the special needs population as well as the personal hygiene and sanitation. The ability to scale back non-critical operations or elective procedures to open up space and personnel for the emergency is critical. Hospitals must be able to create a scalable response to meet the needs of the emergency.

TSIG Consulting, Inc. (TSIG) specializes in documentation review, by critiquing key and essential documents related to Emergency Preparedness. Our highly trained staff can review your documentation and provide comments, and suggestions; we can help develop new documents that reflect the nuances of the new standards. TSIG resources can be used by your institution during the “tabletop” exercises to monitor or participate during the drills to develop better outcomes. Finally, we can provide training for your staff in preparation for an actual incident.

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