Geoffrey Krueger, BA, RRT, RCP
President 
Proactive Solutions HME Consulting LLC 


Concern ~ Focus ~ Purpose
Emergency / Disaster Preparedness Planning: What If . . .?

The recent destruction from severe weather in the South and Midwest is a stark reminder that disaster can strike quickly and with devastating effect.  HME providers in some areas found themselves in extremely challenging circumstances in relation to maintaining business operations and customer services.  While forces of nature and many acts of man cannot be controlled, their compromising effects on operations may be mitigated and managed to some extent with thoughtful planning and thorough preparation.  No matter the size or location of an HME or medical supply organization, a well-conceived and implemented emergency/disaster preparedness plan is essential.
    

QUESTIONING

The emergency/disaster preparedness planning process basically begins with a series of questions starting with the words: “What if...?" (Sometimes referred to as What-if scenario planning).
   
For example:

What if there is a significant power outage in our service area?
What if our business and/or customers experience weather-related damage (storm, flood, earthquake, etc.)?
What if there is a fire at our office and/or warehouse facilities?
What if there is a significant outbreak of influenza or other highly-contagious infection in our community?
What if there is a terrorist attack that affects our area?
What if our computer security is compromised?
What if our computer system (hardware or software) is damaged or destroyed?
What if the phone lines are down?
What if the effects of a disaster exceed the limits of our ability to service all of our customers adequately?
What if our delivery vehicles are damaged / destroyed?

These are but a few examples of some of the important questions that require specific answers in order to begin building a preparedness plan.  It is often helpful to include as many company personnel as possible at this stage to obtain input from all aspects of your organization’s operations.

Actually, the most important question to ask initially probably is:  What if we don’t have a plan at all?

The answer to that question, while pretty much self-evident, is actually two-fold:

We won’t be in compliance with our accreditor’s standards.
We will most likely at some point find ourselves (and, by extension, those we serve) “up a creek without a paddle”.
 

ASSESSING

A risk assessment (hazards vulnerability analysis) to determine the types of threats most likely to affect a particular provider is also an important part of formulating a preparedness and response plan.   Risks for vulnerability to specific threat events will vary according to the size, location, and service-scope of the organization, but the assessment process for each potential threat/vulnerability should generally be an evaluation of:

Risk Source

         >Internal (originating within the organization)
         >External (originating outside of the organization)

Risk Level

         >High (must be addressed in preparedness plan)
         >Moderate (addressed as deemed appropriate by organization)
         >Low (addressed as deemed appropriate by organization)

Risk Preparedness

         >Good
         >Fair
         >Poor (requires documented remediation and improvement)

An organizational risk analysis should be repeated at least annually and as necessary to maintain an up-to-date, relevant, and effective emergency/disaster preparedness plan.

An assessment of available resources is also an integral activity at this stage.  After identifying risks, it is necessary to find out what you have or need to have available in terms of materials and personnel in order to ensure the implementation of effective responses to emergencies/disasters.  Potential resources include both internal (e.g., personnel, inventory, vehicles, safety equipment, communication devices, etc.) and external (e.g., suppliers/vendors, “911” services, mass media information, other HME providers, etc.) sources.
    

FORMULATING
 
The natural progression of thought immediately after posing the question of “What if?” is (or should be):  “What then?”
After all, while the “What if’ing” process is the indispensible starting point, it is the answers to the “What then?” questions that will constitute the plan itself.  In other words, “What will our responses be and how will we accomplish them?”  Again, it is important to involve as many leadership and staff members as possible in order to adequately address the responses to contingencies that could affect varied and specialized areas of operations and customer service. 

In general, the formulation of the action/response plan should address, but not necessarily be limited to, the following:

How the plan is to be activated and by whom;
How notification of personnel is accomplished (e.g., by use of a “telephone tree” contact system);
Emergency communication among organizational staff including back-up/alternate communication systems;
Alternate methods of safely transporting staff and equipment / supplies;
Utilization of emergency power back-up systems, as appropriate and available; 
Prioritization of customer needs.
Monitoring of emergency information from governmental authorities;
Utilization of “911” emergency services for staff and customers, as necessary;
Preservation, back-up, and recovery of important materials and data;
Emergency equipment maintained in office, warehouse, and delivery vehicle areas;
The paramount importance of staff and customer safety throughout the emergency/disaster conditions.

The preceding list, while not exhaustively detailed, is intended to point-out some of the major considerations involved in planning.  Always refer to your accreditation standards or other applicable sources for further guidance.
   

COMMUNICATING

No matter how brilliantly conceived and eloquently written an emergency/disaster plan may be, it will remain just that – something smart and pretty on paper – without letting everyone involved know what's in it.  The words need to be translated into knowledge (and potentially action) through communication of the plan.  There are two main target audiences for this communication/education:

Internal (i.e., organization leadership and staff)

         >Initial training at orientation
         >Availability of written Emergency / Disaster Plan for all organization personnel
         >At least annually, a review/drill for disaster preparedness plan

External (i.e., customers, clients/patients)

         >Provision and review of written safety and emergency preparedness information at initiation of service and as                     needed


CONTINUING
 
The HME provider industry is different from other business sectors in many ways, not the least of which is the fact that many of its customers have medical needs that must be met on a continuous basis, regardless of weather or other conditions.  The overall goal of emergency/disaster preparedness is to have a concrete action plan in place that has accounted for and addressed as many potential emergencies and responses as possible, has been communicated to staff and customers as applicable, and has been reviewed and practiced within the organization on an ongoing basis.  This, in turn, helps to ensure mitigation of adverse consequences of disaster situations, continuity of services to customers, recovery of essential business and operational resources, and the continued viability of the provider organization.  If you haven’t reviewed or practiced your organizational preparedness and response plan lately, now may be a good time to review it, make revisions as needed, and retrain everyone.  


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