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What’s New in the
Patient Safety World
September
2021
Have You Added Pandemic Preparation to Your Hospital
Disaster Plan?
In our November 1, 2016 Patient Safety Tip of the Week “CMS
Emergency Preparedness Rule” we discussed hospital emergency plans or
disaster plans. But most such plans have dealt with acute emergencies that are
of limited duration. How many of you have updated your emergency preparedness
plan or disaster plan for dealing with pandemics?
Disaster plans may take into account potential sudden influx of patients and
need to rapidly mobilize excess staff for disasters such as a mass casualty
accident or a mass hazardous material exposure. But those are limited to short
timeframes. The COVID-19 pandemic led to massive influx of patients for long
periods of time and resulted in significant workload burdens and staff
shortages over the long haul.
Wei and colleagues
recently published “Nine Lessons Learned From the COVID-19 Pandemic for Improving
Hospital Care and Health Care Delivery” (Wei 2021). It includes a valuable table containing elements to include in
a hospital disaster plan for dealing with increased volume of patients or workforce
shortages. Elements in that table are:
- Determination of
what areas of the hospital would be most suitable for expanded services
- Cancellation of
elective surgeries
- Cancellation of
routine outpatient appointments
- Rapid discharge of
stable patients
- Transfer of patients
to less affected hospitals
- Reassignment of
staff with “just in time” training
- Same-day
credentialing of outside clinicians
The table and text
outline considerations for each of those elements.
Given that the
COVID-19 pandemic may not be over yet and there may well be a surge this fall
(or a new pandemic in the future), you really need to address all these
elements in your emergency preparedness or disaster plans.
Go to the Wei paper
for its excellent recommendations, not only on the disaster plan elements, but
also on each of their 9 lessons learned from the COVID-19 pandemic:
- Prepare for
Unexpected Increases in Demand for Services
- Maintain Line of
Sight
- Mind the Air
- Emotionally Support
Health Care Workers
- Masks Forever (at Least
for Some)
- Use Technology to
Connect Families Near and Far
- Maintain Caches of
Supplies and Diversify Supply Chains
- Reduce the Burden of
Unnecessary Documentation
- Address
Persistent Racial and Ethnic Disparities in Health
And, if you are a
teaching hospital, you also need to consider how a long pandemic will impact
your training programs. A timely “Checklist Framework for Surgical Education
Disaster Plans” (Matthews 2021) provides good recommendations for surgical
residency programs but many of the recommendations could apply equally to other
residency programs as well.
References:
Wei EK, Long T, Katz
MH. Nine Lessons Learned From the COVID-19 Pandemic for Improving Hospital Care
and Health Care Delivery. JAMA Intern Med 2021; Published online July 23, 2021
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2782429
Matthews JB, Blair
PG, Ellison EC, et al. Checklist Framework for Surgical Education Disaster
Plans. Journal of the American College of Surgeons 2021; Published online: July
12, 2021
https://www.journalacs.org/article/S1072-7515(21)00493-2/fulltext
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