Hurricanes. Earthquakes. Fires. Natural disasters and severe weather events strike with ferocity — disrupting operations, displacing internal care teams and, sometimes, requiring the movement of patients. Navigating them successfully requires proactive crisis leadership, and that starts with a comprehensive disaster plan.
How to use this guide
If your hospital accepts Medicare or Medicaid, use this guide in conjunction with CMS’s “Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule.” We also recommend using it alongside the Administration for Strategic Preparedness and Response’s Hospital Preparedness Program (HPP), the Joint Commission’s Emergency Management Standards, and any state recommendations/regulations.
1. Understand the threats in your area
Each region faces different natural threats. Severe weather arriving seasonally, such as “fire season” or “hurricane season,” appears to be changing. It’s more important than ever to be prepared year round.
- Identify severe weather events that are most likely to disrupt operations in your hospital.
- Are there any long-term conditions that you should be prepared for (e.g., drought)?
2. Know which structures and infrastructure will be affected
Natural disasters render infrastructure ineffective and can wreak havoc on your hospital. Create a plan to protect structures, manage waste, access potable water, and keep temperatures safe and electricity humming. Tailor it to the disaster you’re likely to face. For example, protecting your hospital from fire damage requires different actions than protecting it from water damage.
- What usually happens in your area when severe weather hits?
- What could happen? In each scenario, how will you maintain power, water, temperature, air quality? How will you manage sewage and waste?
- What will you do if you need to partially close your hospital?
- What are your hospital’s strengths and weaknesses? Is it located next to a body of water, by a forest, in tornado alley? Was it designed with local natural disasters in mind or will it need to be retrofitted? How might you reinforce your structures to make them more weather resistant?
- What actions will you need to take to secure your hospital when a weather event strikes?
- Ensure your plan is in compliance with state and federal regulations.
3. Prepare for communication challenges
Communication will be tough during a natural disaster. At the very least, you can expect your communication channels to lose their efficiency and effectiveness, if they don’t go down completely. Information and guidance you receive from local, state, and federal disaster command centers will change quickly, so you’ll need a plan to communicate what you know (and what you don’t know) to teammates, patients, families and other stakeholders.
- How will your team communicate if cellular/wifi networks are disrupted?
- What will your team do if communication systems break down completely? Is backup internet available in your area, such as satellite internet?
- How will your team obtain information from the disaster command center?
- How will your team communicate official information and guidance (as well as what you don’t know) to patients, their families and other stakeholders? Who is responsible for communicating to each group?
- Ensure emergency communications plans comply with state and federal regulations.
4. Prepare for supply chain disruptions
Supply chains are complex entities with many touchpoints, any of which can go offline during a disaster. If that happens, the supplies needed in your day-to-day operations will be unavailable.
- What supplies will you need in order to provide quality care to patients (food, medical supplies, etc.)?
- What will your workforce need if they cannot leave your hospital for an extended time frame (such as during a shelter-in-place order)?
- What disaster mitigation supplies will you need in order to keep everyone safe? How much will you keep in each category?
- How often will you audit disaster supplies, and who will be responsible for that?
- How will you update emergency supplies as patient needs change?
- Ensure your plan complies with state and federal regulations.
5. Prepare for care delivery disruptions
Natural disasters affect the entire community. During a weather crisis, it’s likely that your workforce will need to make tough choices as they face threats to property and family. They may not be able to fulfill their professional responsibilities.
- Who will care for your patients if some on your team cannot?
- When will you call on backup care providers? Have you already partnered with a workforce solution that can scale up and down quickly?
- What is your disaster care budget? Include any financial support you plan to offer to displaced employees.
6. Have a shelter-in-place plan
Shelter in place guidance varies by disaster, but it all involves moving to the safest area of the building and staying put. For example, during a tornado, you’d move to the lowest level of the building but during a flood, you’d seek the highest. You’ll also have to plan for a potential surge in patients, should your hospital need to help provide care to displaced community members.
- Audit previous shelter-in-place plans and experiences. What worked? What didn’t work?
- What areas of your hospital will be used for shelter-in-place?
- How will your team gather all the patients in those areas?
- How will your team deliver care in those areas?
- How will you track the movement and locations of patients and team members? Who will be responsible for tracking them?
- How will you communicate your shelter-in-place status with patients, families and other stakeholders?
- How will you access and integrate state and federally designated healthcare professionals into your care team if needed?
- How will you update your shelter-in-place plan as patient needs change?
- Ensure shelter-in-place plans comply with state and federal regulations.
7. Have an evacuation plan
Evacuations are extremely disruptive to your patients and your care team. In an evacuation, it’s crucial to transfer patients to facilities where they can receive the appropriate level of care. You must also ensure that protected health information (PHI) is transported and communicated safely.
- Audit current evacuation plans. If you’ve evacuated your hospital before, note what worked and what didn’t work.
- What is the building evacuation route?
- Where will you send patients and team members once they have evacuated?
- How will you communicate the evacuation orders to your team?
- How will you transport your patients, their medications and, if possible, their belongings?
- How will you transport/transmit PHI?
- How will you communicate with patients and team member families? Other stakeholders?
- Ensure evacuation plans comply with state and federal regulations.
8. Train your team and run regular drills
Once your evacuation, communications and shelter-in-place plans are ready, train your team and schedule regular drills so that care teams become familiar with the process. Review the Joint Commission’s Emergency Management Standards and CMS’s “Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule” for guidance on training and how often to run drills.
- How will you train current team members?
- How often will you run drills?
- How will you train new team members?
- Who will be responsible for training your team and running drills?
- How will you document your training and drills? Who will be responsible for managing the documentation process?
9. Form community partnerships
During a weather emergency, your local EMS, fire, rescue and police teams will be critical lifelines. If your hospital doesn't already have relationships with those organizations, start building them. If it does, now’s the time to invest in those relationships. Connect with leadership at fellow hospitals and skilled nursing facilities to coordinate emergency action plans. Additionally, audit and reinvigorate relationships you built during the COVID-19 pandemic.
- Which organizations does your hospital already have relationships with?
- Which relationships does your hospital need to build in order to be disaster-ready?
- Which professional organizations can help your hospital prepare?
- Who can provide housing support for emergency care providers or team members who have lost their homes?
- Who can provide mental health support to care teams and patients if needed?
10. Heed weather warnings
If you have advance notice of a threat, like a hurricane warning or a fire in your area, expect the worst. Prepare for supply chain, communication and utility disruptions. Make sure your team knows how to execute shelter-in-place and evacuation plans. Connect with local hospitals, skilled nursing and post-acute care centers, and get familiar with potential needs. Check in with your employees to see how they might be affected by the disaster, and start to find backup care.
11. Have a plan for recovery
Recovery from natural disasters and severe weather events takes a long time. It could be weeks before the lights come back on. Team members could be dealing with the personal aftermath for months. Disasters are also expensive, and the financial impacts will linger.
- What short-term financial impacts will a disaster likely have on your hospital?
- What about the long-term financial impacts?
- Will you financially support your team during the disaster? If so, how?
- How will you support the mental health of your workforce and patients?
- How will you support your community?
12. No matter how well you prepare, there will be surprises
Natural disasters and severe weather events don’t follow a script. If one hits your area, you’ll need to adapt to rapidly changing circumstances and stay agile. Patient care will be much more challenging. Your most trusted employees might not be able to make it to the hospital.
Connect with the American Hospital Association and local professional associations for guidance and resources. Plan to the best of your ability. Run drills and build community connections. Familiarize yourself with local, state and federal laws and regulations. If you need a backup care network, ShiftKey’s technology can help. Contact us today to see how.
*ShiftKey's "Emergency Weather Preparedness for Hospitals” is for general informational purposes only and is not intended to be legal or compliance advice. While we strive to ensure the accuracy and reliability of the information presented, it should not be relied upon as a substitute for professional or legal advice as it may not be applicable to your particular situation or circumstances.
