Environmental Emergencies Preparedness for Healthcare Practices: Developing a Response Plan

Laura M. Cascella, MA, CPHRM

History has shown society's vulnerability to environmental disasters, but it also has shown how preparedness efforts can have a significant impact on disaster outcomes. Despite an element of unpredictability that is inherent in many natural and manmade environmental emergencies, planning and preparation are powerful and effective tools for managing these situations.

As a first step in planning and preparation, healthcare practices should conduct a risk assessment to identify vulnerabilities and assess potential adverse outcomes. The information culled from this assessment will help inform efforts to develop or evaluate the practice's emergency response plan. A comprehensive response plan is a critical element of emergency preparation because it provides the basis for prompt and appropriate action.

Because no two healthcare practices are exactly alike, emergency response plans should reflect the specific needs and circumstances of each practice. Also, different types of environmental emergencies will require different responses, so your practice's plan should individually address the most probable emergency scenarios (as identified by the risk assessment). Further, your practice's plan should cover staff emergency roles and responsibilities, contingency plans, resources, and training. Visit Ready.gov for a sample emergency response plan template.

Staff Emergency Roles and Responsibilities

Your practice's environmental emergency response plan should specify staff roles and responsibilities by position and include all team members as active participants in emergency response.

As your plan takes shape, consider the actions and responses that each type of emergency might require, and determine which staff position is best suited to handle the responsibility. For example, who will:

• Serve as the safety coordinator, providing oversight of all emergency functions and making critical decisions about safety protocols and procedures?
• Serve as the emergency response leader, implementing the practice's response plan and coordinating staff activities?
• Oversee technology and equipment, including moving, maintaining, or shutting down systems as necessary?
• Monitor local disaster warning systems and media and communicate essential information to staff members?
• Communicate with external organizations and resources, such as emergency service providers; local, state, and/or federal authorities; local hospitals; and other healthcare organizations?
• Contact vendors, business associates, utility providers, building management, etc.?
• Maintain keys to the office and provide onsite assistance if necessary (e.g., turning off utilities)?

When developing staff responsibilities, make an effort to include all team members in the planning process. Collaboration and staff insight can reinforce the team approach to disaster management, help team members understand their individual roles, and foster an overall awareness of the practice's emergency response plan.

Contingency Plans

An environmental emergency can have short- and long-term consequences, ranging from minor issues or disturbances to severe outcomes or damage. For example, "roads may be blocked or jammed, telephones may be overloaded or nonfunctional, emergency responders and the public health system may be overwhelmed, electricity may be out, and major facilities may be damaged."²

Emergency response planning requires determining how your practice will react and respond if an environmental disaster compromises your staff, infrastructure, or technology. Because different types of emergencies may result in different outcomes, contingency planning often requires thinking about a range of potential scenarios and critical functions. For example:

• How will you notify providers, staff, and patients if an environmental emergency affects your office?
• How will you implement safeguards if an environmental emergency occurs while providers, staff, and patients are in the office?
• Will you be able to provide continuity of care in the event of utility failures, technological interruptions, or loss of vital services?
• What is the maximum amount of time that you can close your practice or experience system downtime without significant consequences?
• How will you identify and procure necessary resources?
• How will you recover from physical damage or losses?³

Major areas of consideration in contingency planning include communication, utilities, technology, emergency equipment and supplies, sheltering or evacuation, and relocation. MedPro's checklist Environmental Emergency Preparedness for Healthcare Practices includes fundamental questions in each of these categories and may serve as a helpful tool in developing, evaluating, or updating your practice's emergency response plan.

Additionally, you can find detailed guidance about how to develop contingency plans for certain types of environmental disasters at Ready.gov's Disasters and Emergencies webpage and the Centers for Disease Control and Prevention's (CDC's) Information on Specific Types of Emergencies webpage.

Although contingency planning requires a commitment of time and effort, well-developed plans can help minimize the impact of an environmental crisis; establish appropriate safeguards for providers, staff, and patients; and facilitate recovery efforts.

Emergency Resources

Another crucial component of emergency planning is identifying important contacts, vendors, and suppliers whose assistance might be required during or in the aftermath of an emergency. Examples include:

• Local emergency contacts, such as the local hospital, emergency management agency, fire department, emergency medical services, public health department, and the police department
• State and federal authorities, such as the Environmental Protection Agency, CDC, the Federal Emergency Management Agency, and the Department of Homeland Security
• Insurance carriers
• Building and construction contractors or the building landlord
• Utility companies and utility repair workers, such as electricians and plumbers
• Health information technology vendors
• Medical equipment and supply contractors⁴

Maintain an up-to-date list of contact information for these resources, and post it in a location in your practice that is accessible and visible. Keep the most current version of the list in an offsite location as well. The list should include the type of service, the main point-of-contact and a secondary contact, the standard business phone number, and an emergency phone number.

Remember that in the aftermath of an environmental emergency, some resources might be diverted or overwhelmed due to high demand. To address this issue, healthcare practices should consider vendor/supplier location, emergency response clauses in vendor contracts, and possible alternate or backup resources.⁵

Learn More

For more information about planning and response for a range of emergency situations, see MedPro's Risk Resources: Emergency Preparedness and Response.

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¹ Occupational Safety and Health Administration, Occupational Safety and Health Standards, 29 C.F.R. § 1910.38.

² Glotzer, D. L., Psoter, W. J., & Rekow, D. (2004, November). Emergency preparedness in the dental office. Journal of the American Dental Association, 135, 1565-1570.

³ Insurance Institute for Business and Home Safety. (n.d.). Stay open for business toolkit. Retrieved from www.disastersafety.org/open-for-business/

⁴ Federal Emergency Management Agency. (1993, October). Emergency management guide for business and industry. Retrieved from https://www.hsdl.org/?abstract&did=486400

⁵ Insurance Institute for Business and Home Safety, Stay open for business toolkit.

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