EMERGENCY MANAGEMENT


Dynamic Process to Determine Sustainability for 96 Hours of an Emergency

John DiGirolomo, MBA, CHFM, SASHE, Senior Vice President,
Saint Barnabas Hospital, Bronx, NY

William M. Wagner, ScD, CHSP, CHEP, CHCM, Vice President,
Safety Management Services, Arlington Heights, IL

The Joint Commission has stressed the need for hospitals to identify their capabilities and response procedures in their Emergency Operation Plan (EOP) for sustaining services for 96-hours if local community support is not available (EM.02.01.01 EP3). Some organizations have misunderstood this requirement and have attempted to maintain quantities of materials for sustaining services for that period of time. To do so would bankrupt most organization in resource expenditures and consume valuable storage space, not to mention the potential waste of stockpiled food and medicines due to expiration. Therefore, an organization must utilize a process to determine the length of time it can exist based on established consumption rates, current inventories, patient census, and event conditions. This presentation will utilize the Inventory and Sustainability Tool, described in the September-October 2008 edition of Inside ASHE, to demonstrate the process for dynamically determining the sustainability of the organization during the 96 hours.

This process must be flexible and be able to use ever-changing data to project the appropriate response measures and consumption adjustments to sustain services for the organization until the emergency is over or an evacuation is necessary. The process can also be used during survey to demonstrate the organizations ability to assess the current situation and anticipate further actions based on known parameters in the case of an escalating scenario. There are major resources identified by The Joint Commission, including, fuel, water, and medical gases, that are routinely the responsibility of the healthcare engineer and will be featured during this presentation (EC.01.01.01 EP8).

Beginning with the Pre-Planning Activities, the essential elements, such as average patient census, resource inventory, and consumption rates will be developed for the audience based on real, hospital data. The variables associated with the Decision Points, namely, ability to obtain more resources and assets from outside the local community, requirements for consumption adjustment, or preparation for partial or complete evacuation will also be discussed based on the outcome of the calculations.

A specific emergency scenario will then be introduced and real data will be solicited from the audience and introduced into the Inventory and Sustainability Tools excel tables to determine the status of the organization during the 0-2 hours of the emergency. Audience members can contribute suggestions for adjusting the consumption of the resources based on the calculations presented on the screen. New data will be entered for subsequent time of 2-12, 12-24, 24-72, 72-96 to determine which actions must be taken during each period.

Participants will be able to utilize the information in this presentation to estimate a reasonable quantity of material that should be maintained for an emergency and establish actions that can be taken to prolong services by consumption adjustments based available resources The participants can utilize this demonstration to implement this process for the remaining key resource and asset categories, namely, personal protective equipment (PPE), medical, surgical, and medication related supplies required by The Joint Commission (EC.01 .01.01 EP8).

The Audience:

Healthcare Engineers
Plant Operations Director
Emergency Management Directors
Healthcare Safety and Security Managers
Incident Command Staff