Emergency management moves out into ambulatory care

Well, not strictly speaking—I’m pretty sure we’ve been working on preparedness in the ambulatory care settings for a while now. I suspect that this is more of a recalibration to ensure that all applicable elements of the CMS Emergency Preparedness Final Rule are clearly accounted for in all the accreditation programs. I suppose it also represents an opportunity for additional survey findings specific to the setting. Isn’t that a joy to consider?!?

At any rate, you can review the changes for yourself here. The changes apply to ambulatory health care, office-based surgery, and rural health clinics, with specific updates for each program.

In general, existing programs should be able to account for the changes (perhaps with some modifications). The “big bucket” elements that are required look like this (the following is specific to ambulatory health care; more on the other programs in a moment):

• A written comprehensive emergency management program
• Oversight of emergency management activities by organizational leaders
• Conducting a hazard vulnerability analysis using an all-hazards approach
• Development of an emergency operations plan, gain, using an all-hazards approach
  
  • Communications plan
  • Staffing plan
  • Provision of patient care and clinical support plan
  • Safety and security measures plan
  • Managing resources and assets plan
  • Managing essential/critical utilities plan
• Maintaining a continuity of operations plan
• Maintaining a disaster recovery plan
• Provision of emergency management education and training
• Conducting exercises to test the emergency operations plan and response procedures
• Evaluating and, if indicated by the evaluation, revising the emergency operations plan

The requirements for office-based surgery and rural health clinics are somewhat lesser in number and complexity, but I think the overarching elemental requirements carry across. Certainly, one would want to establish policies and procedures that reflect the complexity of the individual settings and the hazards they are likely to have to respond to. Again, some tweaking, but I think it’s all within the realm of the adjustments that were put into place during the pandemic. We learned a lot about a lot of things these past few years, we just need to make sure our programmatic structures adequately support future preparedness and response.

Apropos of that last thought, the good folks at the Department of Health & Human Services recently hosted a webinar on lessons learned about a year ago in response to a fire at the hospital in which I grew up, so to speak, Signature Healthcare Brockton Hospital. If you go to the ASPR-TRACIE homepage and scroll down towards the bottom of the page, you’ll be able to link to a recording of the webinar (you can try this if you want to directly link to the presentation). Living in the community impacted (and continuing to be impacted) by the fire, I’ve been able to see first-hand how ambulatory care sites can be pressed into service in new and innovative ways, so there may be one or two (or three..) nuggets of useful information in the webinar.

About the Author: Steve MacArthur is a safety consultant with Chartis Clinical Quality Solutions (formerly known as The Greeley Company) in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at stevemacsafetyspace@gmail.com.