Biomedical Engineering Reference
In-Depth Information
evaluation findings and improve the EMPs based
on these “Best Practices.”
a “Hazard Vulnerability Analysis (HVA)” which is
meant to identify those hazards in the community
that a hospital can potentially be subject to; second,
the hospitals need to develop an Emergency
Management Plan (EMP) and finally, the hospital
is required to conduct drills twice annually. The
HVA has been a common practice for Local emer-
gency Planning Agencies for years. “The environ-
mental protection agency (EPA) commissioned a
national study in 1985 to look at hazardous chem-
icals and the sources of their release” [3]. Since
then, the HVA has been a method utilized by
many regulatory agencies including the Occupa-
tional Safety and Health Administration (OSHA),
the National Institute of Occupational Safety and
Health (NIOSH) and the National Fire Protection
Association (NFPA). The results of the HVA assist
the acute care hospitals in developing the EMP.
Based on the identified threats of the external
environment and the perceived threats including
domestic and international terrorism, the EMP
should identify the hospital's role in planning,
response to, mitigation and recovery from a large-
scale emergency.
Figure 22.1 is an example of a Hazard Vulnera-
bility analysis Matrix.
The EMP is the plan that the acute care hospital
utilizes when it is forced with responding to and
mitigating a mass-casualty or disaster situation.
These plans should be developed to address the
overarching response with the identification of an
Emergency Operations Center (EOC), the internal
“Codes” that are announced to alert the employees
required to respond to a disaster and the develop-
ment of incident-specific annexes that address the
responses consistent with the disaster. The EMPs
are living documents in that they are constantly
being updated and new sections are being added
based upon the after action results from a large-
scale event including drills and real-life events. It is
recommended that the hospital establish an Emer-
gency Management Committee under the auspices
of the Environment of Care to plan drills and
develop evaluation tools and in a similar manner
to examine the results of the evaluations after
the drill and make recommendations based on the
22.2 Hospital Drill Planning
Since 2001, JCAHO has required that the hospital
perform drills that meet
the listed in criteria
Figure 22.2.
Hospitals, in general, continue to comply with
the JCAHO standards, however, over the past
several years, recent natural and terrorist events
have added yet another paradigm shift for the
acute care hospital. A shift that will require
the hospital to ready itself for the likes of
“Patient Surge,” “Worried and Concerned citi-
zens,” “Nerve Agent Exposure,” “Radiation illness
due to the 'Dirty Bombs,' ” “Biological Toxins,”
“Avian Flu/Pandemic Influenza” and “Incendiary
Devices.” All were perceived threats in previous
HVAs but none truly realized until the onset of
the terrorist attacks on New York and Wash-
ington DC on September 11, 2001. These attacks
not only altered the paradigm, but they unnerved
the citizens in the community and proved to the
protective services and first responders that we
are vulnerable as a nation. The attacks also forced
the emergency management professional to focus
on “All Hazards” due to the fact that the natural
or man-made disaster is much more likely to
affect the public and the community infrastruc-
ture.
In January 2006, JCAHO will begin to
take a closer look at the Hospitals EMPs,
how they perform their respective HVAs and
how they integrate and collaborate with the
resources that are available within the commu-
nity. JCAHO will evaluate the effectiveness of
these plans by assessing the results of scenario-
driven drills that the hospitals are required to
perform. JCAHO will evaluate the drill's “After
Action Reports”(AARs) to identify deficiencies
that were uncovered during the drill and a
list of objectives established to assure process
improvement.
Hospitals are beginning to re-prioritize their
emergency preparedness initiatives as well as
the development of
their drills and exercises.
