Hospital Preparedness

Hospital Preparedness Programs

Hospitals are mandated by designated state, regional, and national accreditation organizations to develop a specific and unique disaster plan, with certain elements of the plan universally applicable. An important component of all hospital disaster plans is the Hospital Preparedness Program (HPP). One of the principal concerns of hospital preparedness is the assurance of adequate staffing capabilities during times of disaster. The current healthcare situation is marked by a lack of surge capacity and general nursing shortages. At many levels of hospital operations, workers may be employed simultaneously by several hospitals, emergency management service (EMS) agencies, and disaster teams, thus limiting adequate staffing.

Hospital disaster preparedness can only be achieved by the active participation of all key medical service providers within a multidisciplinary team. Pharmaceutical services are one of the most important and yet under-recognized services in mass casualty care and disaster medical situations. The American Society of Health System Pharmacists has described the importance of an active pharmaceutical services participation in disaster planning.

HPPs enhance the ability of hospitals and healthcare systems to prepare for and respond to bioterrorism and other public health emergencies, as was the case during the second phase of the severe acute respiratory syndrome (SARS) outbreak in 2003. Ninety cases were confirmed, and 620 potential cases were managed. More than 9,000 persons had contact with confirmed or potential cases; many required quarantine. The main hospital involved during the second outbreak was New York General Hospital, where hospital preparedness and relief included such factors as building preparation and engineering, personnel, departmental workload, policies and documentation, infection control, personal protective equipment, training and education, public health, management and administration, follow-up of SARS patients, and psychological and psychosocial management and research.

Current HPP priority areas include interoperable communication systems, bed tracking, personnel management, and planning for fatality management and hospital evacuation. During the past five years, HPP funds have been used to improve bed and personnel surge capacity, decontamination capabilities, isolation capacity, pharmaceutical supplies, training, education, drills, and exercises. Hospitals, outpatient facilities, health centers, poison control centers, EMS, and other healthcare partners work with the appropriate state or local health departments to acquire funding and develop healthcare system preparedness through HPP. Funding is distributed directly to the state's health department or a political subdivision of a state, such as cities and counties. HPPs support priorities established by the national preparedness goal established by the Department of Homeland Security (DHS) in 2005. The HPP goal guides [Page 310]agencies at all levels of government in the development and maintenance of capabilities to prevent, protect against, respond to, and recover from major emergencies, including incidents of national significance.

Hospital preparedness for disasters is enhanced when the hospital is also a main trauma center. For example, Queens Medical Center (QMC) in Hawaii offers a comprehensive range of primary and specialized care services, and plays a major role in the overall response to natural disasters and other emergencies in Hawaii. QMC currently has over 4,000 employees, including 1,300 physicians. QMC's trauma facility has been certified as a level two trauma center by the Committee on Trauma of the American College of Surgeons, the national accrediting agency for trauma services.

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