Today, the U.S. Department of Veterans Affairs (VA) operates that nation’s largest health care network, including 170 major medical centers that provide health care services of some type to more than nine million veteran patients each year (VA fast facts, 2019). Given that Iran recently classified all U.S. military personnel as terrorists and the high-profile nature of the VA in many major American cities, disaster preparedness has assumed new importance and relevance for the disaster preparedness administrators at these medical centers. The purpose of this paper is to provide the results of an interview with an emergency preparedness administrator at a Midwestern VA medical center that operates in the state’s capital city. Finally, a summary of the interview results is followed by a recapitulation of the research in the conclusion.
Disaster preparedness interview

The disaster preparedness administrator at the VA medical center in question is also the director of quality assurance (QA) who is a registered nurse with her master’s degree in public health. The quality assurance service oversees the medical center’s risk management function and the QA director is assisted by a full-time risk management program specialist. The results of the two main questions that were asked during this interview are provided below.

1) Question: “What do you consider to be the top three disasters for which you prepare?”

Responses:

a) Inclement weather and earthquakes: We live and work in “Tornado Alley” and we are routinely hit with major wind storms, power outages and thunder storms besides the ongoing threat of actual tornadoes. In fact, I was on the sixth floor a couple of years ago and we were able to see a tornado touch down just a few miles away. Our weather is also harsh in the winter, and ice storms and huge snow drifts are common. We’re also experiencing frequent earthquakes that are blamed on fracking. All of these events can disrupt patient care and surgical procedures so we try to train for these types of events constantly.

b) Fires: Current VA policy prohibits smoking on VA grounds so our patients and their families usually try to stay as close to our premises as possible while they smoke. Last year, there was a fire in our indoor parking garage that was attributed to cigarette smoking and the potential for more fires is always present. In addition, we handle lots of flammable materials here, including oxygen tanks, and an uncontrolled fire would be devastating. Fortunately, because we are located in the city’s health science center district, there is a fire station almost next door, but there is no room for complacency when it comes to...…largest group of staff in a tertiary health care facility and emphasize that, “The effectiveness of the healthcare system's response to a public health emergency or disaster is largely dependent on the surge capacity of the nurse workforce” (p. 188).

Finally, the interviewee made the point that disaster planning is an ongoing process that requires diligence in determining what changes have taken place in the medical center that require corresponding changes in disaster preparedness planning. This point is also consistent with the guidance provided by Blake and Wilson (2019) who report that, “Disasters have become a real threat to health care. They can strike at any time and preparedness is vital so healthcare facilities can continue to provide medical services to the community” (p. 24).

Conclusion

Hospitals are already dangerous places that require constant risk management analyses in order to provide the highest quality of health care possible. The research was consistent in showing, though, that hospitals are also highly vulnerable to natural and manmade disasters of all types depending most especially on the geographic location. The results of the interview with a disaster preparedness administrator at a VA medical center reinforced these points as well as highlighting the need for ongoing diligence in order to identify salient changes in the organization that require corresponding changes to disaster preparedness plans.…