November 2006

Statement of the Issue

Due to the complex nature of emergency preparedness, it is critical that healthcare executives ensure their organizations develop an all-hazards emergency operations plan relevant to their location and type of organization. The emergency operations plan should include a determination of which hazards are most probable and cover applicable responses to a natural disaster as well as potential CBRNE (chemical, biological, radiological, nuclear, explosive) events.

Hospitals and other healthcare delivery organizations must be prepared to care for those in need of medical services and, to the extent possible, protect staff and patients from being exposed to any further risk. The organization’s emergency operations plan should recognize that a healthcare organization may be directly impacted by a disaster as well as be the recipient of victims. This is true for incidents of terrorism and natural occurrences such as hurricanes, tornados, floods, earthquakes or epidemics/pandemics.

It is vitally important that healthcare organizations monitor and update their emergency operations plans on an ongoing basis, maintaining a constant state of preparedness to ensure appropriate response and recovery within the shortest possible timeframes. Without proper planning, an incident involving the organization may result in either a temporary or permanent failure, thus disabling a crucial community resource. The emergency operations plan also should be fully integrated with that of other organizations and appropriate agencies at the local, state, regional and national levels. This is particularly important in situations such as a pandemic that may simultaneously impact large geographic areas for several months and disrupt national and international supply chains.

Policy Position

The American College of Healthcare Executives (ACHE) believes healthcare executives should actively participate in disaster planning and preparedness activities, striving to ensure that their emergency operations plan fits within overall community plans and represents a responsible approach to the risks an organization might face. Chief executive officers should lead efforts to ensure a comprehensive plan, including establishing board policy that delineates the organization’s responsibilities and procedures to be followed. Healthcare executives also have a unique opportunity to help educate the community about infectious disease prevention and control efforts that may mitigate large-scale death during events such as a pandemic.

In developing a comprehensive emergency operations plan, ACHE encourages healthcare executives to pursue the following actions on an ongoing basis:

• Establish a process to understand and stay current regarding applicable national standards for emergency preparedness, including the National Response Plan and the National Bioterrorism Hospital Preparedness Program, as well as legal and ethical issues associated with emergency preparedness.

• Adopt an all-hazards framework to analyze the operational issues that would arise in relevant emergency situations.

• Coordinate and integrate organizational resources to address a full spectrum of actions (mitigation, preparedness, response and recovery), and ensure that the organization has the appropriate programs, trained and credentialed staff, supplies and equipment in place to quickly respond to events that their organization might face, which is identified by the organization’s all-hazards analysis.

• Ensure active involvement in inter-agency planning efforts with all relevant organizations, including the development of an integrated communication plan and community-wide exercises and drills to assess effectiveness and implement improvements.

• Develop policies and processes to ensure that all reasonable efforts are made to protect employees, patients and families while maintaining quality patient care to the best of the organization’s ability during a crisis.

• Ensure that services are provided equitably and impartially based upon the vulnerability and needs of the individual and community affected by a disaster, including supporting the development of mental health response plans for patients, families, employees and their families.

• Adopt an incident command system and support the integration of a nationwide standardized approach to incident management and response (e.g., National Incident Management System).

As a critical component of a community’s infrastructure, healthcare organizations should require proper planning for all-hazards events they may face. Healthcare executives should be active leaders in that planning and the creation of systems and processes to ensure that the emergency operating plan can be effectively and efficiently executed if ever needed.

Approved by the Board of Governors of the American College of Healthcare Executives on November 6, 2006.