Loss of Employees (Department XXX). Consider the departments that have the largest influx of patients on a daily-basis. List each of those out and consider what would be the impact and probability (standard HVA rating areas) if you lost 75% of the staffing in that work unit.
Loss of IT Applications (Application XXX). Consider the IT supported (in-house) applications your hospital uses. Focus on the top 3-5 that your systems depend on or have the most users. Now, consider the impact if each of those were to go down.
Loss of Facilities (Location XXX). There are several key areas within your facility that are used for critical treatments or see a majority of your patient population travel through. Add each of those to your list and rate the risk of losing that part of the facility.
Loss of Critical Supplier (Supplier XXX). Critical suppliers can sometimes impact a majority of your facility without your realizing. List out each of the suppliers that reach the majority of your work units. Then rate the loss of the supplier. (Assume they are unable to meet any orders for 7 days as a starting point.)
One of my first experiences in healthcare disasters was as the Safety director for large children’s hospital in Texas during the winter storms of 2012. The region was coated in several inches of ice and snow, rendering roadways inoperable for even short distances. Though we had plenty of routine medical supplies and able to manage with low staff turnout, we noticed immediate shortages in things like cafeteria food and even Pedialyte- quickly having to track down stocks at local drug stores and physically walking to get them for our patients.
After that incident, I took a hard look at our planning. I realized we had nothing in them about how to cope with the operational issues that happen when a hospital is trying to continue basic functionality during serious circumstances.
As many of you now know, on November 15, 2017 The Joint Commission updated its emergency management requirements for hospitals. These updates align with Centers for Medicare and Medicaid Services (CMS)’s final rule on emergency preparedness. They are designed to ensure healthcare professionals and suppliers would meet the needs of patients, residents, clients, and communities during and following the aftermath of emergency events.
If your team is struggling to figure out what steps are needed to incorporate continuity of operations planning (COOP) in a logical way, one of the first focus areas you should consider is modifying your risk assessment tools. Here are few immediate action steps you should consider.
Add to your hazard vulnerability analysis (HVA)!
Hospitals are required to conduct and annually review their Hazard Vulnerability Analysis (HVA). The HVA provides a systematic approach to recognizing hazards that may affect demand for the hospitals services or its ability to provide those services.
We tend to focus on the traditional disaster scenarios (natural, technological, man-made) because that is what we tend to hear more about. However, as you begin the continuity of operations planning process, you must also add business disruption scenarios to this activity.
An easy way to begin this process is to add some of the following scenarios to your list:
Your HVA could start to look like this:
This may take a bit of trial and error, but the key is to start out with the most likely scenarios and build from there. Surveyors are looking for the hospital leadership to have at least considered business disruptions as real possibilities, so they will look for them on the HVA as confirmation you’re considering this holistically.
In Part 2, we will discuss an additional tool I’ve used over the years to help hospitals start to understand the impacts to individual departments and the high-level recovery strategies they would use to respond.
Shane Mathew is an Sr. BCM Consultant for Virtual Corporation and an accomplished builder and leader of risk reduction programs. With experiences in government, healthcare and Fortune 200 resilience programs, Shane has a soft spot for those new to this field.
Virtual Corporation can help organizations ensure they are prepared to continue in crisis. Our goal is to create the best and most cost-effective resilience programs available.
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