The 5 Steps of emergency preparedness for hospitals

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CMC VELLORE – FIRE SAFETY AND EMERGENCY BEST PRACTICES

1. Know the risk

The first and foremost step is to understand the extent of risk in each area of the hospital. This can be done by a simple hazard vulnerability assessment. The areas in the hospital can be categorized as high risk, medium risk and low risk based on the assessment. Fig 2 has the simple categorization that we have developed in our hospital for the categorization of areas in the hospital. 

2. Build your team

In my experience of managing fire and safety preparedness in a large hospital, I feel we need to have very clear roles and teams. The most important team is the firefighting team or the fire response team. This should be headed by a trained, experienced person who can handle fire. The members of this team are trained fireguards who are available round the clock. This team should be involved in the day-to-day testing of all the fire systems in the hospital as per the prepared schedules and frequency. They should be supported by the Engineering team for addressing the repairs, leaks, maintaining the pumps etc based on the request of the fire team. The planning, organizing, and testing of the firefighting and emergency response plan should be the responsibility of the Quality and Safety teams in the hospital. They are also responsible for the preparation of the plans along with the multidisciplinary fire safety committee. The subject matter experts from different departments should be part of the committee and help with the preparation of the plan. Representatives from clinical, non-clinical, safety, security, HR, PR, facilities, operations, and top management should be involved from the start to prepare the plans for emergency preparedness. The fire safety committee headed by a senior management representative preferably the head of the institution should meet monthly and review all incidents, training, update on licences, mock drills and deficiencies, fire system maintenance and improvements to the system required. 

3. Prepare the plan

Emergency plans should be the product of an inclusive team instead of an individual or group. It should be concise as to the threat, risks, and mitigation steps. It should have an outline of each emergency: Whom to call, their contact number and what should an individual do to ensure their own safety and the safety of others. It should have a description of the specific tasks of all individuals. It should also specify the alternate care site, the route to take to reach the alternate care site, the role of the staff in the alternate care site and the method to evacuate sick patients, ambulant patients and patients who require help. Pictorial plans are more effective.

4. Test the plan

Once the plan is designed, the most important task is to test the plan. The plan should not be circulated to all the departments without testing or piloting it. 

 

There are two ways of testing a plan:

  • Lecture and response sessions: Present to the user the plan and have a brainstorming session to understand all the gaps in the plan.
  • Tabletop session: This session will help us understand whether the plan is going to work or not, the most important element is identifying the weak links or the action items that need to be looked into, there may be multiple weak links. This session should have multi-disciplinary teams and stakeholders who will understand the roles and responsibilities of the situation and how they will respond to it and whether the plan will work.

5. Update everybody

Every staff in the organization is a potential first responder. They need to know their role as a first responder and the way to use the fire extinguisher. They need to also know their role in a patient evacuation depending upon the area of work. There should be specific and focused training for different groups based on their need. The frequency of training should be defined and pre and post-tests should be conducted to check the effectiveness of training.

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