Five Lessons U.S. Hospitals Can Take From Haiti

Scott Wallask, January 19, 2010

Although the earthquake in Haiti has resulted in extreme emergency response situations that may never be repeated in this country, U.S. hospitals can nonetheless take away points that might prompt revisions to their emergency contingency plans.

There are several universal aspects of the quake response to consider:

Communications. It's become mundane to say that communications systems will go down in any emergency, but Haiti's circumstances have strictly reinforced that notion, as there are likely areas of the country with zero modern communication devices operating right now. Although satellite phones are a good option in such cases, that equipment is expensive for American hospitals. Human messengers are a last-ditch effort that U.S. healthcare facilities should build into their emergency operations plans in case communications equipment fails completely.

Morgues. The aftermath of Hurricane Katrina didn't see death tolls approach anything close to the estimated casualties in Haiti. U.S. hospital emergency planners probably can't reasonably design for tens of thousands of deaths after a disaster, but even several hundred deaths in a community would overrun morgues. Furthermore, the idea of burying the dead in mass graves may not be accepted by the American public. If your plans don't already account for large-scale body counts, contact owners of climate-controlled buildings, such as ice rinks and refrigeration warehouses, to find out how they may be able to help with temporary morgue set-ups.

Secondary triage sites. Many healthcare regulators require hospitals to establish alternative care sites if a primary location becomes untenable. Hospitals have suffered extensive damage from natural disasters in the United States, so in ways, Haiti's situation does ring true in terms of healthcare buildings being unavailable for treatment. An excellent disaster drill scenario could involve how caregivers will deal with triage should the main hospital be totally shut down.

The 96-hour period. The Joint Commission mandates that its accredited hospitals identify their capabilities to survive without outside help from the community for up to 96 hours following a disaster. If a hospital determines it couldn't last that long without help, it must establish contingency plans, such as evacuations. The grim scenes in Haiti show what can happen when days go by without outside assistance, so hospitals on U.S. soil should take the opportunity to critically review their 96-hour planning, including security measures that may be necessary to protect property and resources.

Freeing up beds for victims. Patients from Haiti have been air-lifted to hospitals in the United States for treatment. Regardless of whether such casualties come from a foreign country or a domestic disaster, this contingency requires far-flung medical centers to rapidly free up beds. Hospital emergency plans should address the criteria and time frame involved in discharging patients to make room for incoming casualties.

Scott Wallask Scott Wallask is senior managing editor for the Hospital Safety Center. He can be reached at
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