Disaster could strike any time — whether it's a natural disaster or a man-made emergency — and ambulatory surgery center physicians and staff need a plan.
Associate Director for the Standards Interpretation Group at The Joint Commission Virginia McCollum, MSN, RN, spent 23 years as a trauma nurse and responded to all types of disasters, from floods and tornados to Hurricane Katrina and terrorist attacks on 9/11. Now she is an associate director in the department of standards interpretation for The Joint Commission. Among her numerous responsibilities is assisting ambulatory healthcare providers with preparing their emergency management plans.
"My personal advice is to prepare for the worst and hope for the best," she says. "An emergency is an unexpected, sudden event that significantly disrupts the health center's ability to provide care or disrupts the environment of care itself. Sudden significant changes increase demand on ASC services.”
ASCs should have a plan for several types of emergencies and disasters focusing on those events most likely to occur in their geographic location. These events include:
• Earthquakes
• Violent storms
• Radiation spills
• Hazardous chemical spills
• Terrorist attack
Here are a few key thoughts about forming your plan:
1. Appoint one person to execute the plan in case of emergency. "In a well-run plan, everyone has a role," says Ms. McCollum. "The facilities person might be in charge of communicating the resources in storage to the leadership and circulating information about what tools are available and still functioning."
2. Champion communication to everyone in your organization. Your ability to communicate with physicians and staff during disasters could be tricky but is extremely important in executing your plan. "Consider how you'll communicate if the power lines are down," says Ms. McCollum. The safety and security of staff members is important and everyone should know their responsibility when disaster strikes.
"Your plan should be documented based on your risk assessment for each emergency and define the role your center will play," says Ms. McCollum. "Do drills and evaluate the plan and then modify it if adjustments are needed based on the emergency response drill and previous responses to actual emergencies."
Communication with city organizers is also key. Let city leaders know where your facility is located and your position on providing care — whether you'll be able to accommodate victims, patients or volunteers.
3. Plan for how the ASC might be used — for medical care or otherwise. The surgery center could serve as a safe place for injured and sick people during a disaster if the hospitals are over-crowded or inaccessible. However, make sure there are parameters set so all medical care distributed at the center is appropriate for the outpatient setting. "ASCs might think they'll just shut down during an emergency, but the hospital might not be able to accommodate emergency surgery and your surgeons might want to open the center," says Ms. McCollum.
The center may also be used as a key location to triage care for victims or a meeting place for people who lose their homes. It could become the central location for disaster volunteers or other organizations administering care. "Have a plan for that so your center isn't compromised," says Ms. McCollum.
4. Your plan should be flexible. When disaster strikes, people do things they never thought possible. Even the most well-laid plans, or simplest plans, can be cast aside in times of need. "There are cases where ASCs are opening by request and take less critical trauma patients," says Ms. McCollum. "It depends on the disaster and community coordination."
5. Figure out how to replenish supplies if your center will stay open during disasters. Consider the pipeline for replenishing medication and supplies during different emergencies so you're ready. You'll also need to consider an alternate power or energy source if the electricity disappears.
6. Keep your plan simple. "Don't make your plan complicated because that will be the first thing that goes out the window in the middle of a disaster," says Ms. McCollum. "You want to make it simpler and accessible, and hope you never have to use it. I've been in a few disasters and that humbles you."