Biomedical Engineering Reference
In-Depth Information
wide engineering disaster plan. Like in the Y2K
planning efforts, it is best to share insights and
capabilities prior to the event. This may even
be formalized with mutual aid agreements signed
among a group of hospitals at the engineering
department or senior administrative level. Mutual
aid agreements formalize the plan, but the plan
should be routinely practiced.
Of all the lessons learned, the most critical
one is that you will do what you practice, not
what is in the manual. In other words, practice as
close to real as possible. The military and civilian
emergency planners have learned this. As required
by the JCAHO, the hospital has two drills per
year to test the emergency preparedness plan. Has
the Clinical Engineering department participated
in these drills? Do they know that the drill is
ongoing? Is it just another routine day, or does
staff practices what they would do in a disaster
situation?
preparation, etc. Without the facility there is no
safe place for patient care and treatment. Hospitals
in parts of the country with potential for hurri-
canes and earthquakes have learned these lessons.
Building codes have been implemented to assist
with assuring facilities are available. (National
Building, Life Safety and National Electrical Code
promulgated by the National Fire Protection Asso-
ciation and implemented in many communities is
an example.)
16.3 Incident Command System
The Incident Command System (ICS) is part of
the comprehensive National Incident Management
System (NIMS). Participation in some form of
ICS is critical to span of control and positive
outcomes of a disaster event (ICS is discussed
in detail in Chapter 20). The ICS is based on
the principal that there is a single person in
charge. At the top of the chart that is the “Inci-
dent Commander.” There are four branches under
the Incident Commander: Operations, Logistics,
Planning, and Finance. Clinical Engineering as
a support service is typically part of the Logis-
tics Branch in ICS for hospitals. Operations are
primarily associated with direct patient care as well
as triage and specialty operations in the Emergency
Department. FEMA has excellent on line classes
in both ICS and NIMS that senior Clinical Engi-
neering staff should participate.
It is important to understand in a disaster situ-
ation that one person is in charge: The Inci-
dent Commander. That person communicates with
the Logistics Chief who provides Clinical Engi-
neering with tasks and responsibilities. Clinical
Engineering should not “freelance” projects, but
communicate its actions
16.2 Priorities
There is one primary understanding of emergency
preparedness planning for healthcare organiza-
tions: Protect Staff, Protect Patients, and Protect
Facility.
Staff is the most important resource in a hospital.
Physicians, nurses, technicians, engineers, and
ancillary personnel all are part of the team. If
anyone section of that team fails, the primary
mission of the hospital—provide safe patient
care—is in jeopardy. Therefore protection of staff
in whatever manner possible from disease, building
collapse, and hazardous materials is paramount.
Most patients are susceptible to any external
crisis. Many are not ambulatory, frequently on
medications that affect judgment, and are very
vulnerable. Protection of patients is one reason
hospitals exist and must be included in any emer-
gency planning. The features put in place to protect
staff, frequently are the same measures required to
protect patients. There is a mutual benefit.
While a hospital is primarily the staff, special-
ized facilities are required for treatment of patients.
CT Scanners, Operating Rooms, etc., are all part
of the facility as are medical gas distribution, food
(or planned actions)
within the ICS.
16.4 Communications
When reviewing disaster situations failure of
communications is typically one of the three most
mentioned areas for improvement. Therefore any
planning with Clinical Engineering departments
should include communications. Communications
