Case: Yale New Haven Center for Emergency Preparedness and Disaster Response: Contingency Planning
The Yale New Haven Center for Emergency Preparedness and Disaster Response was established by the Yale New Haven Health System (YNHHS) in 2002. The Center’s mission is to develop and deliver services that improve healthcare planning, preparedness, and response for emergency events and disasters. It is responsible for identifying the status of emergency preparedness within the three YNHHS member hospitals (Yale-New Haven Hospital, Bridgeport Hospital, and Greenwich Hospital); preparing YNHHS to respond effectively to emergency preparedness and disaster response issues; providing leadership to healthcare delivery organizations (e.g., acute care hospitals, skilled nursing facilities, community health centers, home health agencies, urgent care centers, emergency medical service providers, and community medical practices) and their workforce regarding emergency preparedness and disaster response issues; serving as a model for emergency preparedness and disaster response initiatives at the national and international levels; and advising statewide and national legislative and nongovernmental organizations on the development of standards and policies for emergency preparedness and disaster response in healthcare delivery organizations. These objectives are achieved through a complex of web of partnerships with healthcare delivery organizations, professional health associations, and agencies on the local, state, regional, national, and international levels. This case study focuses on the intricacies of contingency planning and disaster recovery planning
a. What is the difference between a tabletop exercise and a full functional disaster recovery drill? Identify the advantages and disadvantages of each.
b. What is a Hospital Emergency Incident Command System? Identify, and explain the functions of, the five sections of an HEICS. Explain how an HEICS provides unity of command and helps to improve the quality of communication during disaster response.
a. Table top exercises: No real time action is done in it rather only emergency simulated scenarios are deliberated among some key people who are entrusted with handling emergency response planning and management system of hospital. They discuss handling methodology customised to each simulated situation problem. This is not done in a proper formal setting rather takes form of a casual discussion.
Advantage: Suitability and adequacy of established emergency response plans are discussed
Disadvantage: lack the real feel of the situational response and is superficial in approach
Valuable Time is lost as discussion may not result in fruitful results.As it is set in informal setting the personnel may digress from matter in hand
Full functional disaster recovery drill: is actually action based. Here a simulated emergency situation is communicated to people working in hospital and they respond, allocate duties among them, act on it and resolve the issue. It involves movement and utilization of resources to respond successfully by co-ordinating among all the department of hospital.
Advantage: It entails in identification of gaps in policy, planning and its procedural operationalisation.
It figures out whether the emergency team comprehends their roles and have enough skilled to discharge it.
It incorporates multidrill activity. It involves use of all emergency response drill until complete foolproof plan emerges.
For e.g. It may involve a simulated occurrence of a sudden casualty and enactment of role by all concerned department and people to see availability of beds on the basis of triage made by doctors and nurse team using computer technology from emergency department. Then their performance gets evaluated and wherever loophole exists, the gaps are fixed.
Disadvantage: It involves massive deployment of resources and real incident may be quite different and more complex from what is used here. So result in heavy expenditure.
People may perform way different when real emergency falls on as they panic.
b. The five sections of HEICS are
1. Incident commander:
He is usually supported by medico technician team and is heading administration function. He delegates the authority to centre command as and when required for increasing quickness in emergency response.
Three officers work under him who are responsible to act as link pin to outside agencies in emergency situations, the other is spokesperson to media / public and the crucial one is safety officer who assess risks and continuously upgrade and ensure safety of patients, hospital facility and employees who are working there.
2. Chief of Operations: He is the organiser; hence perform tasks and discharge responsibilities assigned to him by centre command and looks after successful operations at hospital and staffing matters. He also provides assistance to patients family.
3. Chief of Planning: He formulates action plan for all emergent situations and has resources at his disposal for the same.
4. Chief of Logistics: He is responsible for patient care, and proper functioning of hospital by supplying necessary supplies and equipment wherever needed immediately.
5. Chief of Finance: He is responsible for purchase, cost management in hospital as well as for payment of claims and compensation.
During emergency situation at hospitals, the Incident commander in HEICS, takes up everything in his stride and even overlooks policies, standard operating procedures and the hierarchy, to give directions to all sections of HEICS for increasing the response capacity of hospital for saving life of maximum patients. – And this is how improves quality of communication by providing single direction with no confusion to all and ramp up the disaster response.