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Thursday

Is it time to evacuate the hospital? 96 Hour Planning Part Two

96 hour planning as a decision making tool

How do you decide when to evacuate your hospital or healthcare facility? Who makes that decision and what resources are called into action? Chances are these things are covered in your emergency management plans. But how do you know when its time to activate those plans? Your 96 hour plan can help identify trigger events and make the evacuation decision.

Part one of this series on 96 hour planning discussed the Joint Commission on Healthcare Accreditation (JC) requirement for  emergency planning on the part of hospitals and healthcare facilities. We discussed the need to have an operational plan that sustains the facility when access to external resources are no longer available. Commonly known as the 96-hour plan, healthcare facilities must prove that they've considered the possibilities and impact on operations when they become cut off from the rest of the world by some catastrophic event. 96 Hour planning may be seen as something of a fuel gauge to manage inventory and as a means to survival for the facility. The process includes an assessment of materials on hand and consumption rates. Like other disaster plans, the 96-hour plan must integrate the facilities Hazard Vulnerability Assessment (HVA), existing community response plans and identify the ability to sustain communication, resources and assets, security and safety, staff, utilities and patient care.

The decision to shelter in place or evacuate is not a one-time-only event. This critical decision requires continual reevaluation and situational awareness. While keeping tabs on the external situation or crisis at hand is vital, it is equally important to understand how long you can safely remain in your location and continue to operate. These points are actually the premiss for doing an self-evaluation and creating a 96 hour plan. The value of this process is seen when you realize how the amount of supplies and materials you have (or don't have) on hand and how long your stockpile will last. In other words, given your occupancy rate, how fast will you consume these materials. One way to start this process is by asking how bad can this situation get or what if it did happen here?

This same process can be used to make the switch between standard of care and sufficiency of care. Let's define standard of care as the way we do business every day, with our normal resources and operation. With the normally available resources limited only to what we have stored (no resupply) how long will they last during normal operation? Chances are you'll recognize that you cannot (nor should you) maintain the standard of care (normal operation) when you access to outside resources are cut off the resupply becomes impossible. Switching to sufficiency of care means you'll do what you can or the minimum needed to keep the situation from getting worse. You may be faced with the burden to decide who lives and dies during disaster. Based on the findings of your 96 hour planning process you may:
  • Choose to conserve in-house resources early
  • Supplement with community resources if availble
  • Close to new patients (if that's possible) or redirect incoming people
  • Maintain staff for extended operational periods
  • Consider limited or full evacuation
The 96 hour plan as part of your larger emergency management plan and can help on your search for preparedness. These plans must include assessment of agreements with vendor/suppliers as well as a means of monitoring and reporting on the status of in-house materials. 

Tuesday

96 Hour Healthcare Emergency Planning Part One

Why a 96-Hour Plan?

The Joint Commission on Healthcare Accreditation (JC) requires emergency planning on the part of hospitals and healthcare facilities. Part of that preparedness requirement is to have an operational plan that sustains the facility when access to external resources are no longer available. Commonly known as the 96-hour plan, healthcare facilities must prove that they've considered the possibilities and impact on operations when they become cut off from the rest of the world by some catastrophic event. 96 Hour planning may be seen as something of a fuel gauge to manage inventory and as a means to survival for the facility. The process includes an assessment of materials on hand and consumption rates. Like other disaster plans, the 96-hour plan must integrate the facilities Hazard Vulnerability Assessment (HVA), existing community response plans and identify the ability to sustain communication, resources and assets, security and safety, staff, utilities and patient care.

96 hour planning is an excellent addition to your Emergency Management to-do list

Not sure how to start planning? Check out Pre-incident Planning and see What Good Plans Have and Bad Ones Don't

A solid 96 hour plan will help decision making when changing from a standard of care to a sufficiency of care, evacuation or conservation of resources. While the JC does not require stockpiling of supplies for the planning period, the expectation is that advance planning will take place and a process will be created to aid in decision making. Organizations that undertake a realistic approach to this planning will come away with and improved understanding of how resources and assets are used for daily operations. This level of planning is also relevant to other forms of emergencies such as biologic events and other threats.

Need help writing a biologic response plan? See How to Write Your Biologic Plan

The Tenent Health decision illustrates the need for 96-hour or resiliency planning for disaster operations and sets a tone of responsibility. Get the full Mitigation Journal two-part review on the Katrina/Tenent decision check out A Message from Katrina. Healthcare facilities must prepare for the following eventualities during a disaster:
  • Discharges from the hospital will be limited - limitations in travel as well physical damage to roads and residences will make discharge of patients difficult.
  • There will be a surge in patients seeking care - healthcare institutions will be seen as an area of refuge and people will expect some level of care in the form of shelter and food. At-risk and special needs populations will self refer in anticipation of need as well.
  • Supplies and materials from fuel to water will be limited if not impossible to obtain from vendors and routine delivery of supplies and materials will not occur. Facilities will be left with what they have on-hand.
See 7 Healthcare Preparedness Things You Need to Know for more on healthcare planning.

Hospitals must be considered critical infrastructure by local government and protected accordingly. With that said, healthcare facilities retain responsibility for the care of patients and support of staff during catastrophic events and must plan to be self sufficient.

Saturday

MJ Podcast #232 Emergency Management/Social Media

A conversation with Emergency Management/Social Media blogger, Todd Jasper

Click to subscribe to MJ free

I recently had the pleasure of speaking with Mr. Todd Jasper on the topic of emergency management myths and realities, social media, and emergency notification. Todd is the Associate Director of the Homeland Security Division of MSA and has added his expertise in preparedness to the social media world through his blog, toddjasper.com.







Click the player below to listen now.