The Great Snow Plan Debate

Every winter the same conversation I am sure happens at various hospitals that are south of the Mason Dixon but north enough to get a little snow.  ‘Do we provide rides via four wheel drive vehicles to employees or not?  At my system we call it the Snow Plan.  So let’s talk about the struggles that face a Health Care EM guy during this:

Community

Now I am sure colleagues and individuals that live in areas that a white Christmas is the norm think we are nuts, but this is an issue in some of these areas like central North Carolina where snow is not a way of life.  When it snows an inch and the roads are covered here is what happens in the public:

Schools close Businesses close Churches delay services Meals on wheels stop delivering 24 hour news crawler about closing and weather on the TV

Stop lights don’t work right People forget basic physics Groceries store run out of milk and bread

Public Works Infrastructure / Resources

Some of that is in jest but seriously it is honestly a culture change here.  I understand this is foreign to so many folks.  I have spent time in the NE during winter and they all think this is crazy but the fact of the matter is that a lot of places do not have the infrastructure or resources to handle snow.  Most public works in these areas do not have enough snow plows and snow removal equipment to clear anything more than primary roads.  So it can be days before secondary and tertiary roads are even addressed.  If it is late in the winter season some agencies can even run out of funding and supplies like salt/brine before the winter is over.

Impact on a Hospital

Even though most Health Care Emergency Managers do not necessarily list snow storm at the top their HVA (Hazard and Vulnerability Analysis) it is an event that can impact almost every facet of operations.  It is one of the few events that can affect:

• The community by impacting transportation and basic service provision
• Logistics by stopping deliveries and shutting down transportation networking.
• Operations by impeding staff ability to get to work if public transportation shuts down and the streets are impassable.
• Casualty Creation one wreck or power outage in a key area can create individuals needing care or shelter.

A good example of this is the snow storm that hit the Midwest a few years back when supplies had to be airlifted to facilities and staff were living at hospitals.

The reason for the Snow Plan is driven hugely by staffing but is also a big morale boost.  Last year we activated the snow plan two times with total accumulations greater than 6 inches both times.  A command system was put in place and a process is implemented for ride requests and then dispatching of drivers to get key staff.  A story that sticks out in my mind is not how we got in a key member to save a life but happened when I snuck out of the coordination center and drove to pick up employees. 

I was dispatched to get a food service worker.  When I arrived he hopped through the snow to get in the truck and greeted me with a small and a thank you.  He looked at me and I think he was a little disappointed though.  He told me ‘Yesterday our CEO picked me up, what is your role at the hospital?’  I explained that I was the “Disaster Guy” and he nodded his head understandingly.  He was so thrilled yesterday that the CEO too the time to come and get him.  He explained to me that ‘normally he rides the bus to work but our public transit service had been on snow route and the closest stop was over a mile away.’

Before the experience I was fairly well decided that we needed to revisit the Snow Plan and turn it into a plan of last resort but after my time with our dietary employee I was reminded that it is not all about the staffing matrix and provision of care but about the service you need to provide to your employees.

Describing the Role of Health Care Emergency Managers in 30 Seconds

When people discover I work full time as an emergency manager at hospital / health system they are sometimes confused and taken aback. After I quickly clarify that ‘I am not the individual that manages the emergency department, but I am sorry you had to wait 5 hours to have your toe nail evaluated.’  I find myself trying to give a 30 second primer of what I do.

            At health care institutions that have a full time emergency manager he/she is the individual responsible for the administration of the Emergency Management Chapter in the Joint Commission standards.  Unfortunately most institutions add these responsibilities on to a person that has emergency manager as just one of many hats in its organization, but we will focus on the former not the later in this post today.

            Principally, my role is to ensure that my organization is ready to respond to a disaster both external and internal.  This encompasses all four of the phases of emergency management (mitigation, preparedness, response, & recovery) and then some.  This is traditionally accomplished through Emergency Operations Plans (EOPs), policies, and procedures followed by education and training among other things. It also means most emergency managers in this setting are responsible for continuity of operations.  Now, ‘traditional emergency managers’ are coordinators and facilitators during incidents, in the health care realm emergency managers are integrated into the operations and tactics of a response.  The level of an emergency managers integration into operations and tactics is usually inversely proportionate to the size of the organization.

            Now external to a health care emergency manager finds himself in an interesting world, a mix between private and public sector or civilian and first responder.  These paradigms can either be seen as either a challenge or the best of both worlds.  A successful health care emergency manager can maximize both worlds where relationship management is key.  This leads to the incorporation of health care systems into overall disaster response in the community.  There are some that think hospitals don’t need a seat at the planning (aka funding) table but every year these numbers get smaller and smaller.

So there, 30 seconds about the role hospital / health care emergency managers.  Remember this is just a primer, more to come in the coming posts.

The First Post

Well there has to be a first post on every blog.  This blog will be focused specifically on Health Care Emergency Management.  A fairly new sub-specialty of Emergency Management, Health Care EM focuses on the specific needs facing hospitals, public health organizations, and other health care providers that need to maintain operations and/or provide care to patients before, during, or after a disaster.

I will post my opinions and thoughts about what happens in health care emergency management.  Appropriately now a little bit about me.  I have been working health care for over 10 years.  I have worked in hospitals, on the back of ambulances, in athletic training rooms, and various other arenas. Before my career started in health care I attended and graduated from Wake Forest University with a bachelors of science in health and exercise science.  I am currently an EMT-I certified in the state of NC and a nationally certified athletic trainer working too add Certified Emergency Manager to my list of acronyms behind my name.  Discovering that a bachelors was not going to meet the needs of my career goals I returned to WFU for a Masters in Business Administration, graduating in the winter of 2008.  My MBA program really provided me with the catalyst I needed to move my career to the next level.

I am currently an Emergency Management Coordinator for a large multi-hospital health system in central North Carolina.  I also occasionally return to the world of EMS or sports medicine for active patient care but mostly focus on my work with the health system and my independent consulting.  I have specific interests in disaster communication infrastructure, medical surge capacity, and crisis communication. I will seldom refer to my employer and clients out of respect for their privacy and the sensitive nature of what happens during disasters and crisis.  I hope to share lessons learned and progressive ideas on this blog.

I welcome followers that provide healthy discussion and respectful commentary.

Feel free to follow me on Twitter at http://twitter.com/healthcare_em 

Let the blog times begin.