Why emergency unpreparedness can be disastrous

It's every person's worst nightmare: Tornados ripping through Joplin, Mo. Earthquakes and tsunamis in Japan. Floods in Australia, Brazil, South Africa, and Sri Lanka. Recent years have seen some of the worst natural disasters, according to disaster reporting from the Federal Emergency Management Agency (FEMA). And with hurricane season fast approaching, many worry about what would happen if worst-case scenarios become reality.

Recent studies show that nearly all hospitals, in fact, have response plans for natural disasters, chemical releases, epidemics, and biological events, according to a report (.pdf) from the Centers for Disease Control and Prevention released in March. However, hospitals are not as prepared for other types of disasters, including explosive or incendiary events.

As FierceHealthcare has noted, 85 percent of hospitals (6,300 hospitals) participate in the Hospital Preparedness Program, a national program developed in response to September 11. Three-quarters of those hospitals meet 90 percent of recommended program measures to combat hazards, according to a report (.pdf) by the U.S. Department of Health & Human Services (HSS) released in May.

Although those numbers are promising, there are still many institutions that are not ready. What happens when the place that heals the sick is unprepared? Too many hospitals faced with disasters found themselves unprepared and at the epicenter or on the front lines of devastating events. Why? Emergency responsiveness isn't carried out to plan, or what's worse, a plan doesn't exist. Even though the major accrediting bodies mandate emergency preparedness, many plans are not well coordinated, especially when it comes to hospital evacuation.

Because outside help from other state and federal resources could take days to arrive, hospitals therefore must rely on their own internal resources and plans.

The Joint Commission not only requires that accredited hospitals carry out the critical factors of emergency response but also requires that they monitor their response efforts, that is, how their resources and patients are holding up during the event. If they cannot sustain their efforts, they must evacuate their patients to other hospitals.

"Some hospitals plan for several years for a one-day transfer, but in an emergency, you don't know what day that will be," said Clif Carothers, president of EPI-Center, Inc., a company that specializes in medical evacuation, and president of care transportation company U.S. Air Ambulance, in an interview with FierceHealthcare.

In his blog post this week, Carothers explains the top reasons why hospitals are unprepared, specifically for evacuation in a large-scale emergency. He cites limited transportation plans, funding, and communication challenges, as well as the sheer number of people as some of the reasons for unpreparedness.

Carothers urges not only regional partnerships between hospitals, but a nationwide collaboration, particularly from the HHS, to improve mass hospital evacuation efforts everywhere.

"Our country should overcome our federalist history and bring these [efforts] together on a national mission to respond to large-scale emergencies on a very fast responsive basis. It's doable," Carothers said. "That means tying all of our hospitals and our emergency services and emergency management together into a much tighter, managed evacuation process," he continued.

If recent history has taught us anything, it's that emergency preparedness is a must, no longer an item relegated to the bottom of the to-do list. I urge you, in honor of National Safety Month, to look at your hospital's emergency plan and update or create one. Start the discussion with the risk management and emergency departments in your own intuitions, your region, and nationwide.

"In reading your plan, if you can visualize the myriad details that must be done to evacuate a patient, then you're ready. If you can't, then you're not," said Carothers. - Karen