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Ready for a Disaster? If Not, It Will Cost You.

Analysis  |  By Jennifer Thew RN  
   July 18, 2017

Orlando Health's corporate manager of emergency preparedness talks about his experience with the Pulse nightclub shooting and how healthcare leaders can better prepare their organizations to handle disasters.

Last week it rained hard here in northern Illinois. Many homes and towns flooded, and patients at Northwestern Lake Forest Hospital had to be transferred to nearby facilities due to a power outage and standing water inside the building.

As of Friday, July 14, (two days after the rain began) the hospital was still closed.

While this incident is nowhere near the size and scale of the flooding that took place after Hurricane Katrina, Mother Nature makes a point—emergencies and disasters know no bounds.

"This stuff's happening all over the place in different venues and at different times," says Eric Alberts, corporate manager, emergency preparedness at Orlando Health.

"A fertilizer plant explosion or a train derailment with chemicals or a vehicle that crashes into a building or a shooting. These things are happening everywhere, and you can't predict it."

But hospitals and health systems can, and should, prepare for it, he says. And administrative leaders should lead the charge.

Alberts says this from experience.

Just over a year ago, a few blocks from Orlando Health Medical Center, 49 people were killed and more than 50 were injured during a mass shooting at Pulse nightclub. Recently, he spoke with HealthLeaders to share insights he gained from the incident.

Know Your Neighbors

"When we did our planning efforts, we often had been thinking that something bad was going to happen at the big venues—like a big stadium with a bowl game, at a concert, at a fair, at a parade," Alberts says.

"We can no longer think that something bad's [only] going to happen at some big mass gathering. It could be the night club down the street. It could be the taxi waiting area. It could be at a convenience store. It could be at an apartment complex. Hospitals really need to take diligence now to be prepared."

He suggests hospital leaders type their facility's location into an aerial map on the Internet, and look at what is surrounding it. Ask staff members if they've noticed anything on their way to and from work that could be an issue.

"Oftentimes people don't think that way, but what I'm saying is it's time to be cognizant and vigilant to what is surrounding you," he says.

Take Practice Seriously

About three months prior to the Pulse incident, ORMC took part in a full-scale community exercise with 57 agencies, 533 volunteer victims, and 15 hospitals.  The drill scenario was an active shooter at a local elementary school.

"Going through as realistic as possible an exercise, like we did, puts the people in the same locations and gives them proper training," he says. "During the Pulse situation, it enabled them to get away from the flight mentality and go into fight mode."

After the incident, clinical staff told Alberts that without the realistic drill, "they would have been too scared and not known what to do in that stressful chaotic situation. But because of the training, they were able to stop themselves and just go into the moment and care for the patients."

Unfortunately, as Alberts travels the country speaking about the incident, he finds that many hospitals either do not have or do not practice their emergency plans.

"If they do practice it, they're not really practicing it. They're just doing a flu shot campaign and calling it an exercise," he says.

Being Unprepared is Costly

"If you don't properly respond during an emergency, it can, and does, shut down entire hospitals," Alberts says. Not to mention the cost of legal fees and to reputation when an emergency or disaster is mishandled.

Additionally, the Centers for Medicare & Medicaid Services final rule on emergency preparedness must be implemented by November 15 of this year.

"In there, it talks to healthcare facilities having to have a risk assessment, emergency planning policy and procedures, an emergency communication plan, and training and testing," he says.

CMS regulators can arrive unannounced and can pull funding from a hospital that is not in compliance with the rule, Alberts says.

Most importantly, being unprepared can cost lives.

"I had a lot of people tell me that that [large-scale community] exercise really did help save lives in Pulse," he says.

"To me that's extremely humbling because I'm not a clinician. I'm an administrative person. For the clinicians to tell me that those efforts helped save lives in Pulse, that means the world to me. It really fuels my fire to want to do this and to do a whole lot more to help the hospitals be better prepared."

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.

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