By: ProAssurance
Risk Resource Department

There is no better time than now to reevaluate and update your disaster response plan. Various states have recently been hit with extreme weather and wildfires. Armed attacks have also occurred. These events serve as a reminder of the importance of having an up-to-date disaster response plan. ProAssurance risk resource advisors recommend physicians and other health professionals conduct drills to test disaster preparedness, as well as the potential for crowds associated with emergencies or disasters.

The Agency for Healthcare Research and Quality (ARHQ) recommends a “continuous cycle of disaster preparedness,” which includes practicing the plan by conducting drills. Information, including assessments, evaluations and briefs on various types of disasters may be found on AHRQ’s website at www.ahrq.gov/prep/#projects. Drills may be carried out in a variety of ways:

• Physical drills to improve knowledge of the disaster plan and highlight weaknesses.
• Teleconferencing to reach a larger audience.
• "Smart" patients or mock victims for one-on-one training.
• "Tabletop" exercises or "paper" drills that focus on systems and do not require physical movement of patients, personnel or equipment.
• Computer simulations; these can be less expensive and still identify weaknesses in disaster planning.

Disaster plans should address evacuation and diversion of incoming patients and encompass provisions for power loss and telephone line, cellphone service or internet interruption.

Another consideration for physicians is a practice’s or hospital’s need for crowd control. For example, following a disaster, medical facilities may experience a flood of volunteers, both medical and non-medical. A plan for efficiently organizing volunteers and using them where needed should also be created. Staff should have a central area to triage volunteers by credentials, experience and ability.

Assignments should include information about travel routes through the facility.

Limiting access points is also an important part of crowd control. Crowds not only impede the ability of physicians, health care providers and volunteers to do their work, they subject patients to unnecessary noise, stress and possible infection. One aspect of crowd control is limiting access to patient care areas. Entrances to the practice or hospital should be limited to one, if possible, and entry should be systematically granted or denied by a guard. This also means providing some form of identification for staff and/or volunteers, family members and/or friends, clergy and administration. Depending on time and resources, identification may be verified by badge, armbands, passes, etc.

ISMA members who have medical malpractice coverage with ProAssurance may contact the Risk Resource Department for prompt answers to risk management questions by calling 844-223-9648 or sending an email to RiskAdvisor@ProAssurance.com.