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Add to these posts with 150 word each. Reference your work in APA formatPost One:Healthcare is becoming an essential aspect of emergency preparedness and its response efficiency. It is obvious that emergency preparedness in the healthcare framework can no longer be neglected. It is a vital element of emergency response as resources are where they need to be in the situation of an emergency. The culture helps in distributing the obligations and the responsibility between the different players. It also secures the resources to be used in different places. However, healthcare organizations should consider integrating some ways to enhance the efficiency of emergency preparedness response level and for example, involving the community. Involving the community in the disaster preparedness such as; stakeholders will maintain its effective contribution for better response in case of disaster. Also, continuous training for employees in the healthcare organization for disaster preparedness is another way; training is a very essential component of any emergency plan. It helps organizations to asses the severity of the threats and put multiple strategies and tactics to face all type of disasters. And constant vulnerability analysis to asses and plan for all kinds of potential emergencies that might disturb the continuity of the healthcare organization. In addition to that, sharing resources and information between different organizations, coordinate communications and have annual exercises would be a great asset in planning and responding effictvliy to all type of hazards.References : Toner, E. S., Ravi, S., Adalja, A., Waldhorn, R. E., McGinty, M., & Schoch-Spana, M. (2015). Doing good by playing well with others: exploring local collaboration for emergency preparedness and response. Health security, 13(4), 281-289.Post Two:Regulatory agencies such as the Joint Commission and Centers for Medicare and Medicaid Services give priority for communication and coordination in their standards. Accordingly, hospitals ought to enhance communication and utilize in preparedness for emergencies. As emergency preparedness is a general obligation and all staff anticipated to take part in this process. Emergency managers should educate the employees by surrounding hazards and recruit them in all emergency phases. For instance, hospitals might arrange meetings for departments chiefs to discuss and explain diverse roles during the staff should conduct in response to a particular emergency. After that, conducting drills and evaluate the competencies.Another example that most hospitals utilize is posters and billboards as well as screens in waiting rooms, yet still can be utilized in a better way to show targeting public messages and integral strategies to raise awareness. Emergency managers also have to attend a local emergency committee and take part in local drills and familiarize themselves with any new local hazards. Sometimes civilization can bring up industrial revolution which can provoke serious dangers. Therefore, hospitals are required to revise their plan and review local hazards periodically. Speaking out on these issues and sharing knowledge with other members of the committee will help in greater awareness which in turn lead to further comprehensive mandates. Doing so will bring about an up-to-date emergency plan that can handle all hazards. Finally, it is imperative for hospitals to establish a coalition to share experiences and efforts as well as boosting workforce competitiveness.Worden, Cory, MS, CSHM, CSP, CHSP,A.R.M., R.E.M.,. (2015). ONE CAUSE, ONE CULTURE. Ishn, 49(9), 65-67. Post Three:Where do you see hospital emergency management being in 10 years? A decade is not necessarily a long period to make significant changes in the Hospital Emergency Management discipline. However, only God knows what factors would make an evolutionary alteration in the future. It might be the Artificial Design, with more robots involved in the healthcare system, that would bring the attention more to cybersecurity as a first line to prevent a potential health disaster. The antibiotic resistance is another challenge to the disaster medicine field, and it is becoming worse as the days go on, which may suggest more preparedness plans will be relevant to pathogens more than any other potential hazards. Consequently, the role of the Emergency Manager in the hospital will probably be more than his role nowadays, and his responsibilities may be more complicated than now. As a guess, there will be an Emergency Manager in almost any health care organization in the future.Will healthcare emergency management be folded into municipal emergency management or into another hospital responsibility? If so, why?I predict that healthcare emergency management will be another hospital responsibility. Healthcare-related professions became more specialized nowadays compared to the past, and the position of Emergency Manager is not an exception. The responsibilities of an emergency manager had refined the meaning of the ‘Safety ‘ when the principle was disputed by the Facility Safety, Patient Safety, and Quality professionals, giving an integration of the entire process of emergency preparedness.Besides, merging the healthcare emergency management into municipal will slow the process of hospital response due to the bureaucracy of the municipal, and because the process of assessing hospital risks is a continuous process and require close, and internal inspection and supervision in daily, weekly, and monthly basis.Post Four:Where do you see hospital emergency management being in 10 years? Providing advanced health care management during disasters is one of the highest priorities for the governments to protect their population and to guarantee better health situation. As a result of that, Health care emergency management will continue to grow because of advanced technology, research, and treatment in today life. Providing high-level of health care management during disasters is one of the highest priorities for the governments to protect their population and to guarantee better health situation. For example, after the terrorist attacks on 9/11, the Joint Commission response was in the shape of significant changes to their preparedness standards such as increasing preparedness efforts to encompass the disaster cycle which are mitigation, preparedness, response, and recovery. Moreover, federal government support was raised to be more than $1 billion for more than 3,000 local public health systems. Those supports did not only prepared healthcare emergency response systems against human-made disasters, but it also made the emergency management more able to respond when disasters strike and enhanced the surveillance and the inner system connections between public health, clinical medicine, and the other healthcare emergency response systems. Health care organizations now want to be proactive rather than reactive, so they have plans and resources set aside for these eventualities.Will healthcare emergency management be folded into municipal emergency management or into another hospital responsibility? If so, why? In my opinion, I think yes. There are many issues that could be solved when healthcare emergency management be folded into municipal emergency management or another hospital responsibility. For example, many hospitals are not well-prepared because they are suffering from the lack of unity of command in hospitals, high-cost implementation for preparation, lack of competitive atmosphere for progress and excellence and planning among hospitals, absence of a common management language, constant change in regulations, and low compatibility and lack of communication/coordination between hospitals in the different regions. Moreover, during the response to a disaster, there are too many decision maker authorities, lack of authorities’ support, lack of qualified managers in different levels, and poor communication and coordination in crisis team. On the other hand, the finances play a significant role in the development of healthcare emergency management field even though the funding efforts typically do not include the actual planning process, but they focus primarily on resourcing and hospital infrastructure. The preparedness cost of the disaster cycle which are mitigation, preparedness, response, and recovery will be decreased when healthcare emergency management become folded into municipal emergency management or another hospital responsibility. The lower cost of preparations will enhance healthcare emergency management since the financial management of health care organizations could boost or decrease the preparedness efforts against disasters.Barbera, J. A., Yeatts, D. J., & Macintyre, A. G. (2009). Challenge of hospital emergency preparedness: analysis and recommendations. Disaster Medicine and Public Health Preparedness, 3(S1), S74-S82.Petinaux, B. (2008). Financial Burden of Emergency Preparedness on an Urban, Academic Hospital.Prehospital and Disaster Medicine 24 (5) 372-375Reilly, M. J., & Markenson, D. S. (2010). Health care emergency management: Principles and practice. Jones & Bartlett Publishers.Ronald Simon, S. T. (November, 6, 2001). The World Trade Center Attack: Lessons for disaster management. National Center for Biotechnology Information.Sauer, L. M., McCarthy, M. L., Knebel, A., & Brewster, P. (2009). Major influences on hospital emergency management and disaster preparedness. Disaster medicine and public health preparedness, 3(S1), S68-S73.Yarmohammadian, M. H., Atighechian, G., Shams, L., & Haghshenas, A. (2011). Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS). Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences, 16(8), 1070.
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DISASTER READINESS
Connections Matter
When Disaster Hits
By COLETTA C. BARRETT, RN, FACHE, and ALLYN T. WHALEY-MARTIN, M.A.
As a net is made up of a series of ties, so everything in this world is connected by a
series of ties. If anyone thinks that the mesh of a net is an independent, isolated thing,
he is mistaken. It is called a net because it is made up of a series of interconnected
meshes, and each mesh has its place and responsibility in relation to other meshes.
— Buddha
D
isasters are the great equalizers, they do not discriminate. All who live in a community that experiences a disaster become “those most in need.” It is during these times
that Catholic health care and its commitment to the community have the opportunity to differentiate themselves.
Our Lady of the Lake Regional Medical Center in Baton Rouge, La., and other hospitals in the
region, face challenges from natural disasters as
well as man-made emergencies. In addition to the
devastating fallout of hurricanes Katrina and Rita
over the past decade, we have contended with prolonged loss of electricity, chemical plant explosions, total closure of the interstate and potential evacuation of the hospital due to an accident
involving a tanker truck transporting hazardous
chemicals. Our preparedness in these situations
has been critical to our ability to respond to the
community and continue to take care of patients.
This culture of preparedness does not happen
by chance. It takes organizational commitment,
continuous training, community collaboration
and coordination to be successful in the everchanging health care environment. Louisiana’s
HEALTH PROGRESS
approach to emergency preparedness is grounded
in the belief that our community is stronger when
we stand as one and act for the common good. For
more than a decade, under the leadership of the
Louisiana Hospital Association and the Louisiana
Department of Health and Hospitals’ emergency
preparedness division, hospitals in the state have
worked together.1, 2 Our regional response efforts
to build, maintain and expand networks of health
care services have focused on communication
and resource coordination during communitywide emergency and disaster events. The primary
objective is to sustain health care, to keep our
doors open and to be present to all those affected.
Our shared mission lives in times of disaster.
As part of this regional network, each hospital defines its capabilities and works with other
health care providers in a coordinated response.
www.chausa.org
NOVEMBER – DECEMBER 2013
37
BUILDING A CULTURE OF PREPAREDNESS
E
nsuring a hospital’s preparedness is
both an operational necessity and
a regulatory expectation. Regulatory
agencies including the Joint Commission and Centers for Medicare
and Medicaid Services have defined
standards to ensure accredited facilities actively prepare for emergencies
which affect that facility and their role
in a communitywide response.1,2 Regulatory standards focus on issues common to disaster events, such as communication and coordination, both
within the facility and with community
agencies, facility safety and security,
staff roles and responsibilities, patient
management, patient care resources
and support for building systems.
Regulatory agencies expect plans
to be living documents that are tested
frequently and revised as often as
necessary to address changes in the
organization’s services and capabilities. Planning should focus on defining
procedures and securing resources to
sustain operations during an event, as
well as on how the organization will
recover from the disaster.
Funds and resources to support
emergency preparedness are available
through federal grant programs such
as the Hospital Preparedness Program
(HPP) to support planning for public
health threats and the Cities Readiness Initiative, funded by the Centers
for Disease Control, for preparedness in large cities and metropolitan
areas.3,4 Hospitals participating in
these programs not only gain access
to programs that will help prepare
their facility, but they also may find
the programs offer an opportunity
to network with key community
stakeholders and build support for the
community as a whole. In Louisiana,
the HPP grant is an integral part of the
structure used to create our unique
regional coordination plan.
38
Here is a checklist that can help
build a culture of preparedness:
BUILD RELATIONSHIPS
Identify key stakeholders in your
community. Consider hospitals, nursing homes, outpatient service providers for dialysis or diagnostic testing
and ambulance services, as well as
individual practitioners.
Meet with local governmental
agencies such as the county Office of
Emergency Management/Homeland
Security and Office of Public Health.
Participate in planning meetings hosted by the Local Emergency
Planning Committee, Department of
Health or other community agency.
CREATE PROCESSES THAT SUPPORT
EFFECTIVE COMMUNICATION
Require leaders and staff to learn
the Incident Command System so it
becomes hardwired into your organization. (See sidebar, page 30.)
Establish an internal report telephone line for staff so they can hear
current operational status information
during an extended disaster.
Create templates for internal
alerts and messages for team members, patients and guests.
Consider electronic tools such as
mass notification systems to support
timely communication.
UNDERSTAND THE HAZARDS
IN YOUR COMMUNITY
Learn about what kind of industry operates in your area. Ask to work
with them to plan for an emergency
involving their business.
Talk with the state law enforcement agency about hazardous materials that may be transported through
your community via interstate highway or railways.
Contact the Local Emergency
NOVEMBER – DECEMBER 2013
www.chausa.org
Planning Committee about its assessment of hazards for the community.
Complete a hazard vulnerability
analysis for your hospital and share
the results with other hospitals and
community agencies.
PRACTICE YOUR PLAN
AND EVALUATE THE RESULTS
Seek opportunities to test your
emergency operations plan throughout the year. Contact your local airport
to ask about participating in FAA (Federal Aviation Administration) drills.
Invite community partners,
including other hospitals, to participate in emergency plan drills whenever possible. If a practice scenario
does not involve community coordination, invite a partner to be an exercise
evaluator.
Take time to methodically evaluate each exercise or plan implementation.
Use the lessons learned to refine
detailed action plans
— Allyn T. Whaley-Martin
NOTES
1. The Joint Commission’s Emergency Management Standards, www.jointcommission.org/new_revised_reqs_emergency_
management_oversight/.
2. Centers for Medicare and Medicaid Services, Condition of Participation: Disaster
Preparedness, Title 42 CFR 485.727.
3. U.S. Department of Health and Human
Services, Office of the Assistant Secretary
for Preparedness and Response, Hospital
Preparedness Program, www.phe.gov/
Preparedness/planning/hpp.
4. Centers for Disease Control, Cities Readiness Initiative, http://emergency.cdc.gov/
cri/.
HEALTH PROGRESS
DISASTER READINESS
For example, a large, academic medical center large and small. The Federal Emergency Managesuch as Our Lady of the Lake is expected to pro- ment Agency (FEMA) offers courses in incident
vide acute medical care and a fully functioning command through the FEMA independent study
emergency department, while a surgical specialty program that will provide a solid foundation for
hospital or a long-term acute care hospital pro- anyone in health care.3 Once they learn the convides refuge or space for sheltering the medically cepts of incident command, leaders should be
needy and patients dependent upon electric- required to practice using it in drills.
ity. Each institution brings a different resource
It also is important to focus on processes and
and capability to the response table, and all are tools to provide accurate, up-to-date information
equally important to supporting the whole com- to team members, patients and guests throughmunity in times of disaster.
out a disaster situation. During early stages of any
In our area, the group got its start by simply emergency, rumors abound, and it can be hard to
asking hospitals to communicate more effec- refocus efforts as the situation evolves. Accurate
tively during times of disasters and to work more information can quell anxiety over the unknown
closely with public health officials to
respond to community need. It now Each institution brings a different
has grown to a collaborative statewide
network that includes nursing homes, resource and capability to the
emergency medical services, dialysis
response table, and all are equally
and home health providers.
Each entity has committed to com- important to supporting the whole
municate, collaborate and coordinate
resources toward sustaining the com- community in times of disaster.
munity. The expanding network allows
individual providers greater flexibility and pro- and allow teams to focus on their responsibility
vides a depth of support for one another and the to provide care to those affected by the event.
community.
Both in planning as well as during a response, be
Creating a culture of preparedness involves vigilant for instances of miscommunication and
four components: Strong relationships, effective resolve them quickly. Small miscommunications
communication, clear understanding of potential can work silently to erode vital trust and support.
hazards and the testing of response plans.
1. Build strong relationships around a single
mission: to provide care for those most vulnerable, those most in need.
Developing a collaborative network within a
competitive health care community is not easy, so
it’s important to establish why preparing together
for disasters should be an important priority. The
ministry of Catholic health care calls us to serve
the whole of our communities, paying special
attention to those most vulnerable, those most in
need. Communitywide disasters highlight community needs and the fact that no one hospital or
provider can meet those needs alone. By working
together, the community can make itself whole.
2. Invest time and energy into processes that
support effective communication.
An “Incident Command System” sets up a management structure that applies to any emergency
or disaster and gives community leaders a common language and method of dealing with events
HEALTH PROGRESS
3. Understand the potential hazards in the
community.
Although it’s impossible to anticipate every
disaster scenario, understanding the hazards
present in the community can provide a foundation for developing an organizational structure for
response. Hospitals accredited by the Joint Commission are required to complete a hazard vulnerability analysis annually and to use the information gleaned from the assessment to guide their
planning efforts.4
The hazard analysis should be a living document, developed through assessment of hazards
specific to a facility and community. Consider
vulnerabilities linked to industry and transportation, technological interdependencies, as well as
natural threats from severe weather or geography.
Learning about local industry and its emergency
planning efforts can help the hospital not only to
gain a more thorough understanding of the risks,
but it also creates the opportunity to develop a
relationship potentially critical to an emergency
www.chausa.org
NOVEMBER – DECEMBER 2013
39
response in the future.
Another resource to consider is the state’s
National Guard civil support team. The mission
of these teams includes advising civilian responders about weapons of mass destruction hazards
and how to respond to them. For us, the Louisiana
National Guard 62nd Civil Support Team has been
a committed partner, supporting hazard identification, training and response support for several
years.
4. Practice the plan and evaluate the results.
Plans for responding in an emergency are
effective only when the team knows how to use
them. Training to ensure awareness of hazards
is often the first step to securing an effective
response. Will the emergency department staff
recognize the signs of a chemical exposure? Are
physicians alert to symptoms that may signal an
emerging biological threat? Subtle signs may be
missed in many emergencies because of a lack of
experience or awareness that the hazard exists.
Following training, invest in exercises, whether
a tabletop discussion or full-scale drill, to test the
plan and response procedures thoroughly in a safe
setting. These exercises allow team members to
learn their roles, as well as how to interact with
each other. Drills give an opportunity to develop
organizational memory that makes responding in
an actual event more familiar.
It’s also important to practice responding with
partners outside the organization whenever possible. Not only will it help establish lines of communication before an event occurs, it also helps
clarify what resources do or do not exist in the
community. Transparency and humility are very
important in these exercises, and all players
should feel comfortable to speak openly about
their capabilities and needs.
Finally, take time to thoroughly evaluate both
drills and responses to actual events. Be candid,
and use a critical eye to ensure opportunities for
improvement are captured. Online tools available through the Homeland Security Exercise and
Evaluation Program include detailed guides and
forms for planning and evaluation.5
In Louisiana, experience with both natural and man-made disasters has taught us that
40
NOVEMBER – DECEMBER 2013
through collaboration, we gain the strength to
face adversity. The relationships established to
guide communication have become the foundation of our culture of preparedness, and they are
key to our resilience as a health care community.
Maintaining them is a top priority to ensure that
we can continue our mission of service and care
for the vulnerable and those most in need in our
community.
Many colleagues have asked, “What is the
secret to creating a culture of preparedness?”
There is no secret. It takes hard work, leadership,
commitment to being prepared and a willingness
to be a part of a larger response effort (which may
mean giving up control and some decision-making). Most importantly, it requires a belief that
strength is drawn from being connected and committed to each other.
COLETTA C. BARRETT is vice president, mission,
Our Lady of the Lake Regional Medical Center,
Baton Rouge, La.
ALLYN T. WHALEY-MARTIN is director, safety, Our
Lady of the Lake Regional Medical Center, Baton
Rouge, La.
NOTES
1. The Louisiana Hospital Association Emergency
Preparedness Program, www.lhaonline.org/display
common.cfm?an=1&subarticlenbr=138.
2. Louisiana Department of Health and Hospitals, Emergency Preparedness Program, www.dhh.louisiana.gov/
index.cfm/subhome/17/n/173.
3. Federal Emergency Management Agency Independent
Study program, https://training.fema.gov/IS/crslist.
aspx.
4. The Joint Commission requires the hospital to conduct a hazard vulnerability analysis to identify potential
emergencies that could affect demand for the hospital’s
services or its ability to provide those services; the likelihood of those events occurring; and the consequences
of those events. The findings of this analysis are
documented. www.jointcommission.org/standards_
information/standards.aspx.
5. Homeland Security Exercise and Evaluation Program,
https://www.llis.dhs.gov/hseep.
www.chausa.org
HEALTH PROGRESS
JOURNAL OF THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES
www.chausa.org
HEALTH PROGRESS
®
Reprinted from Health Progress, November – December 2013
Copyright © 2013 by The Catholic Health Association of the United States
BUILDING A CULTURE OF PREPAREDNESS
E
nsuring a hospital’s preparedness is
both an operational necessity and
a regulatory expectation. Regulatory
agencies including the Joint Commission and Centers for Medicare
and Medicaid Services have defined
standards to ensure accredited facilities actively prepare for emergencies
which affect that facility and their role
in a communitywide response.1,2 Regulatory standards focus on issues common to disaster events, such as communication and coordination, both
within the facility and with community
agencies, facility safety and security,
staff roles and responsibilities, patient
management, patient care resources
and support for building systems.
Regulatory agencies expect plans
to be living documents that are tested
frequently and revised as often as
necessary to address changes in the
organization’s services and capabilities. Planning should focus on defining
procedures and securing resources to
sustain operations during an event, as
well as on how the organization will
recover from the disaster.
Funds and resources to support
emergency preparedness are available
through federal grant programs such
as the Hospital Preparedness Program
(HPP) to support planning for public
health threats and the Cities Readiness Initiative, funded by the Centers
for Disease Control, for preparedness in large cities and metropolitan
areas.3,4 Hospitals participating in
these programs not only gain access
to programs that will help prepare
their facility, but they also may find
the programs offer an opportunity
to network with key community
stakeholders and build support for the
community as a whole. In Louisiana,
the HPP grant is an integral part of the
structure used to create our unique
regional coordination plan.
38
Here is a checklist that can help
build a culture of preparedness:
BUILD RELATIONSHIPS
Identify key stakeholders in your
community. Consider hospitals, nursing homes, outpatient service providers for dialysis or diagnostic testing
and ambulance services, as well as
individual practitioners.
Meet with local governmental
agencies such as the county Office of
Emergency Management/Homeland
Security and Office of Public Health.
Participate in planning meetings hosted by the Local Emergency
Planning Committee, Department of
Health or other community agency.
CREATE PROCESSES THAT SUPPORT
EFFECTIVE COMMUNICATION
Require leaders and staff to learn
the Incident Command System so it
becomes hardwired into your organization. (See sidebar, page 30.)
Establish an internal report telephone line for staff so they can hear
current operational status information
during an extended disaster.
Create templates for internal
alerts and messages for team members, patients and guests.
Consider electronic tools such as
mass notification systems to support
timely communication.
UNDERSTAND THE HAZARDS
IN YOUR COMMUNITY
Learn about what kind of industry operates in your area. Ask to work
with them to plan for an emergency
involving their business.
Talk with the state law enforcement agency about hazardous materials that may be transported through
your community via interstate highway or railways.
Contact the Local Emergency
NOVEMBER – DECEMBER 2013
www.chausa.org
Planning Committee about its assessment of hazards for the community.
Complete a hazard vulnerability
analysis for your hospital and share
the results with other hospitals and
community agencies.
PRACTICE YOUR PLAN
AND EVALUATE THE RESULTS
Seek opportunities to test your
emergency operations plan throughout the year. Contact your local airport
to ask about participating in FAA (Federal Aviation Administration) drills.
Invite community partners,
including other hospitals, to participate in emergency plan drills whenever possible. If a practice scenario
does not involve community coordination, invite a partner to be an exercise
evaluator.
Take time to methodically evaluate each exercise or plan implementation.
Use the lessons learned to refine
detailed action plans
— Allyn T. Whaley-Martin
NOTES
1. The Joint Commissio …
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