Biomedical Engineering Reference
In-Depth Information
have one that works on an everyday basis. The
second step is to realize that any system can be
overtaxed and that there will be some incidents
in which even the most durable system will fail.
Realistic expectations for communications systems
in disasters are essential for effective implementa-
tion of an emergency operations plan. Redundancy
is an obvious and desirable solution; simple low-
tech equipment can be effective. Satellite phones
and trunked and repeated radios that allow flexible
external communications are important, but if the
trunking system and/or repeaters are external to the
hospital, the most the hospital can do is buy into
the system. Likewise, amateur radio offers a vital
and achievable link to other hospitals and public-
safety providers, but by definition they are
outside
the facility. This is not meant to de-emphasize
the importance of being able to communicate with
public safety and other agencies, but rather to
focus on what can be done internally. A hospital's
communication system might be improved by use
of the following:
updated information to the staff working there.
Most hospitals have such boards in place, but
they are not necessarily used during emer-
gency operations. Status boards serve an impor-
tant function away from patient-care areas
as well: information management in hospital
emergency operations centers (also known as
command centers, coordination centers, and
facility command posts). Effective display
media in emergency operations centers are
essential for managing incoming information,
tracking resources and events, and making
appropriate resource allocation decisions.
•
Runners
: When all else fails—and even when
it does not—runners are commonly employed
to carry information between functional areas
or groups. Given the universality of this func-
tion, it might as well be part of the plan, to be
practiced and tested. Combining runners, status
boards, and digital cameras creates the oppor-
tunity to receive quick, non-intrusive status
reports from various parts of a hospital: literally
a snapshot of status that may be delivered to
the hospital's emergency operations center and
displayed there.
Business radios
: Inexpensive handheld radios
that do not require a license but will work in
multi-storey buildings with reinforced construc-
tion and extensive electronic machinery. These
are similar to the popular family radios but are
intended (and required) for business use.
•
Self-initiation
: This is more a training than a
communications issue, but the point is that
the better trained and exercised employees are,
the more capable they will be of independent
implementation of an emergency operations
plan when activation is initiated. If employees
can perform critical initial functions without
needing centralized communications in place,
successful implementation is far more likely.
•
Phone/intercom systems
: An internal commu-
nications system that is powered by emergency
generators and does not require functioning
external equipment (such as remote switching
stations). These systems can be surprisingly
robust, even if communications into and out
of the facility are disrupted. A facility that
owns its own phone switch (that is, switching
is done by an internal rather than an external
computer) is more likely to retain internal func-
tion than one relying on a service provider's
switch. This is even more important for large
campuses comprising multiple buildings.
•
1.13 Security
Of all the issues related to hospital preparedness,
security is one of the most important and one of
the least directly controllable by most hospitals.
Functional security is an everyday issue that is
greatly magnified during disasters; it is part of staff
protection and allows implementation of emer-
gency plans. Many potential solutions to security
issues require hospitals to increase their level of
interaction with local emergency management and
•
Status boards
: The bane of many a JCAHO
survey, further restricted by HIPAA (due
to open display of confidential patient
information). Simple dry-erase boards in oper-
ational areas are an effective way of providing
