Introduction
A detailed preparedness plan is essential for a healthcare organization’s operation in emergency events. Lindell et al. (2006) defined emergency preparedness as “preimpact activities that establish a state of readiness to respond to extreme events that could affect the community.” (p. 244). Therefore, a healthcare organization with a developed preparedness plan can minimize the adverse impact of emergencies. As a result, it becomes possible for an organization to protect the health and safety of community members in extreme conditions. Overall, an emergency preparedness plan negates chaos within the community and turns healthcare organization into a point of stability.
Key Elements of Emergency Preparedness
In general, emergency preparedness in a healthcare setting can be broken into three key elements. Thomas (2016) determined the following priorities for healthcare services: safeguarding human resources, maintaining business continuity, and protecting physical resources. Protecting humans takes a top priority in this triad, but it is important to realize that this element of emergency preparedness can be compromised if material resources are insufficient and community life is disrupted.
However, these elements compose only the preparedness phase of a disaster life cycle. According to Thomas (2016), the disaster life cycle includes the response, recovery, and mitigation phases. Nevertheless, it is possible to claim that the preparedness phase influences the whole disaster life cycle. For example, the effectiveness of recovery significantly depends on how well the organization performed during the preparedness phase (Thomas, 2016). In this regard, the disaster life cycle forces the emergency preparedness plans to be comprehensive and encompass possible means of response, recovery, and mitigation.
All-Hazards Approach in Healthcare Settings
The All-Hazards Approach (AHA) to disaster preparedness is a principal framework for developing emergency preparedness plans in healthcare. The approach works on the premise that certain commonalities are shared between different disaster scenarios (Bodas et al., 2020). Therefore, developing a general emergency preparedness plan to consolidate resources becomes possible. In this regard, AHA is beneficial for healthcare organizations since it allows saving resources, which would be difficult if all scenarios had special emergency plans.
However, AHA is not free from flaws, which might present challenges for healthcare organizations. Most importantly, one can argue that a broad approach to disaster planning can be perceived as a disadvantage rather than an advantage. For example, a tsunami warning system is different from the one used during hurricanes (Bodas et al., 2020). As a result, a healthcare organization might make an error in similarity evaluation and prepare for specific disaster scenarios inadequately.
Relevant Types of Emergencies
A large healthcare organization is likely to become one of the major responding forces in a disaster scenario. For example, the Metropolitan Medical Response System (MMRS) was initially created to enhance local effort in managing the consequences of mass casualty incidents (Lindell et al., 2006). In this regard, a big urban hospital is likely to take a crucial part in preparing and responding to major risk scenarios such as natural disasters, terrorist attacks, and pandemics.
An emergency plan developed per disaster life cycle can mitigate these emergencies. For instance, the mitigation phase includes public education and improving infrastructure (Thomas, 2016). In the case of pandemics, an emergency preparedness plan would highlight the need for additional beds and protective equipment. Terrorist attacks would lead to subsequent improvements in public security measures. Finally, the consequences of future natural disasters can be mitigated by developing early warning systems and educational campaigns among the community residents.
Roles of Internal and External Stakeholders
Every healthcare organization interacts with a variety of internal and external stakeholders. On an individual level, every patient can be considered an external stakeholder who wants to get healthcare services, and every hospital staff member is an internal stakeholder. However, a big hospital primarily interacts with community stakeholder groups, divided into social, economic, and political categories (Lindell et al., 2006). When a disaster occurs, success in response and mitigation efforts largely depends on communication between the hospital and its stakeholder groups.
During the crisis, the hospital must provide stakeholders with critical information in the shortest time possible. For instance, community residents must get informed where to get help or how to perform basic response services. In turn, the hospital needs to know whether stakeholder groups will assist in response activities. For example, it would be crucial to maintain contact with public utility providers since they supply the hospital with electricity, water, and communication services (Lindell et al., 2006). Overall, hospital and stakeholder groups must cooperate in crises, and the foundation for such cooperation can be laid in an emergency preparedness plan.
Hazard, Risk, and Vulnerability Analysis
It is impossible to develop an emergency preparedness plan without assessing potential risks in a particular region. This task requires gathering baseline data on healthcare organization’s current preparedness for disaster and evaluating the probability and severity of particular scenarios. Fortunately, various hazard and vulnerability analysis tools (HVA) are available for use, depending on the purpose and intended audience. The following three HVA tools were accessed to select the best option for an urban hospital setting.
Pennsylvania Public Health Risk Assessment Tool (PHRAT)
The PHRAT framework offers several advantages for use in public health. Most importantly, the tool is developed to be used exclusively in jurisdictions and the public health system. The intended purpose of analyzing health-related impacts of various hazards in a specific jurisdiction aligns well with potential use in a major metropolitan area (ASPR TRACIE, 2018). PHRAT also provides automatic jurisdiction-specific calculations, identifies hazards with the greatest risk, and offers a comprehensive assessment despite the simplicity in implementation. The only significant downside of this tool lies in possible data distortion if the information is entered by various users (ASPR TRACIE, 2018). Therefore, only a few designated staff members should be involved in work with PHRAT.
Community Hazard Vulnerability Assessment (CHVA)
The CHVA tool offers remarkable flexibility as it can be effectively used even by local public health agencies and healthcare facilities. In addition, CHVA has a multifaceted purpose — from conducting a comprehensive analysis of various impacts of different disaster scenarios to providing support mechanisms to external stakeholders (ASPR TRACIE, 2018). The tool possesses multiple useful features, such as graph generation for hazard analysis, and includes a customization option based on specific industry needs (ASPR TRACIE, 2018). However, CHVA lacks the baseline data and information on at-risk populations included in the PHRAT.
Hazard Risk Assessment Instrument (HRAI)
The HRAI tool is intended to be used by the state and local public health agencies. Therefore, it might be better to consider using other tools due to the difference in scope of analysis. Overall, HRAI is capable of identifying key hazards and estimating their potential consequences (ASPR TRACIE, 2018). Unfortunately, the tool is available only in PDF format, which hinders data entering. Furthermore, all calculations are not automatic, and at-risk populations are not addressed.
Conclusion
Given the setting of a large urban hospital in a major metropolitan area, the use of PHRAT instrument is advised. This tool offers multiple advantages — automatic and jurisdiction-specific calculations, hazard risk grading, and simplicity in use. The only potential downside for effective PHRAT use is a possibility of data distortion in case of misunderstanding between staff members. However, this issue can be resolved by introducing clear regulations on PHRAT operating procedures.
Reference List
ASPR TRACIE. (2018). ASPR TRACIE evaluation of hazard vulnerability assessment tools. Web.
Bodas, M., Kirsch, T. D., & Peleg, K. (2020). Top hazards approach – Rethinking the appropriateness of the All-Hazards approach in disaster risk management. Web.
Lindell, M.K, Prater, C.S, Perry, R.W., & Nicholson, W.C (2006). Fundamental of emergency management. Web.
Thomas, K. (2016). 10 keys to healthcare emergency planning. Web.
