Emergency Preparedness: Response and Recovery
February 15, 2019 | Aging Services Risk, Quality, & Safety Guidance
In evaluating the readiness of the national healthcare system of providers, CMS found that while many providers and suppliers have considered emergency preparedness, their strategies do not go far enough in ensuring that they are equipped and prepared to help protect those they serve during emergencies and disasters. (CMS "Final Rule") It is no longer sufficient to manage emergencies as they arise; rather, facilities must prepare in advance to mitigate, respond to, and recover from natural and human-made emergencies and disasters.
Studies of emergency preparedness before the 2001 attacks on the World Trade Center showed that, although the level of preparedness varied, most facilties were in the early stages of developing emergency preparedness plans. Little planning was under way for large-scale events, and much of the planning focused on chemical incidents. Formal interfacility and community collaboration on emergency preparedness was uncommon, and while most facilities were in compliance with Joint Commission standards, those standards focused primarily on physical threats to individual facilities, such as bomb threats or loss of utilities (Toner et al.).
Since then, facilities in the United States (and the world at large) have faced a wide variety of large-scale emergencies and disasters from natural, technological, and terrorist-related causes. While the United States has been lucky to have had fairly few events involving more than 1,000 fatalities, the sheer geographic reach of the disasters has affected large numbers of people, providers, and suppliers across the nation. (Furin)
Over the past 15 or more years, the United States has been challenged by several natural and human-made disasters. Between 2007 through the end of January 2018, the Federal Emergency Management Agency (FEMA) has declared an emergency 1,359 times (FEMA "Disaster Declarations"). The correct question to ask is not if, but when, will an emergency occur. Then ask, will the organization be ready?
Beyond the tragic loss of life, the cost of damages from natural disasters has been climbing. From 1980 through 2007, no single natural-disaster damage estimates reached $10 billion. In five of the years between 2008 and 2018, damage costs from natural disasters equaled or exceeded $10 billion (see Figure. Billion-Dollar Disaster Event Types by Year (figures adjusted for the consumer price index).
In 2017, disasters and healthcare providers' poor responses to disasters made national headlines (Milstein and Rosenbaum; Breslin). Such disasters extract both a human and a financial toll. Death toll estimates vary, but 82 deaths were attributed to Hurricane Harvey and 61 to Hurricane Irma; initially, more than 55 deaths were attributed to Hurricane Maria, but later updates put Maria-related deaths at 2,975 (Santiago et al.; Willingham). In addition, the financial cost of these disasters has been extraordinary. The financial losses demonstrate the widespread nature of the events that might negatively impact the time needed to fully recover from such an event. According to estimates from the National Oceanic and Atmospheric Administration (NOAA) National Hurricane Center, in just six weeks in late August and September 2017, damage estimates from Hurricane Harvey reached $125 billion; Hurricane Irma, $50 billion; and Hurricane Maria, $90 billion. Cost estimates from multiple California wine-country wildfires in fall 2017 have already reached $9.4 billion. (National Hurricane Center; Kasler).