Emergency Preparedness - 5 Lessons Learned Since 9/11 - Gail Donovan
September 11, 2001 was the day that defined the need for emergency preparedness in healthcare. A new discipline and language were born.
Hospital and health system executives started to more robustly define what was needed to be prepared and continue operations during emergencies. Eventually, accrediting bodies such as The Joint Commission came to formalize policies and standards that must now be demonstrated by hospitals.
Over the last decade, there are 5 key lessons learned that the COVID pandemic (the largest and most universal of all emergencies experienced to date) crystalized for healthcare providers.
- Emergencies used to be thought of as relatively short-lived individual-type events like terrorist attacks, blackouts, floods, fires. COVID has now defined sustainability at a whole new level. Post 9/11, hospitals defined sustained operations beyond a day to 2, 3 maybe 30 days. Now, hospitals and health systems must be prepared to manage an emergency for more than a year with challenges that feel like roller coaster rides almost daily. Human life depends on the availability and access to expected trusted facilities, clinicians, supplies and drugs to treat and cure. Much is being written about how COVID management as a long-term event/emergency ultimately is defining a new normal.
- Investing in purchasing and managing inventory of defined critical supplies, drugs and equipment is required. The years of inventory being at the lowest possible levels, being proud of ‘just in time’ delivery systems, reducing and/or eliminating warehousing are over. Hospitals and health systems must stockpile and manage inventory it will need for sustained operations.
- Clinicians need to be more broadly trained and multi-skilled. During COVID, clinicians were re-assigned to critical jobs in the ED’s, ICUs, COVID units and elsewhere. Students and retirees were enlisted to help. We need to find ways to train more doctors and nurses and other professionals to work on these front lines when needs arise and surges occur without the extreme variability in skills and patient outcomes.
- Hospital facilities need to be more flexible with construction/renovation focused on universal beds (ICUs to discharge) and surge capacity in ED’s and isolation facilities. Universal beds and patient care units by definition would improve isolation capabilities and infection control. Expanding capabilities for EDs within a particular hospital or geographic footprint should be defined for easier, faster implementation in the future. Hospitals have historically been considered safe havens for community residents and patients. COVID changed that too by essentially locking down access. Managing to keep access open while operating restricted areas should be a goal.
- Hospitals and health systems need to be nimble with information technology to enhance care for patients. Employing technology that helps predict patient needs in real-time would help speed care for patients. The lack of interoperability of electronic medical records and health data must be eliminated. These impediments influenced the COVID response within health systems and in cities/regions that needed to transfer patients to different sites of care.
While there are countless lessons learned and still being learned from the COVID pandemic, the above 5 are highlighted looking at the last decade of emergency preparedness and management. What would you add to this list?
Gail Donovan
