Emergency response drill procedures in hospital settings

Emergency Response Drill

DISASTER READINESS

The increasing need for emergency preparedness has been triggered by the rush of many kinds of emergencies (Adini et al., 2012). These include mass casualty events, mass poisoning events, and biological occurrences, such as pandemics and bio-terror events. Emergency preparedness in hospitals and other healthcare facilities stands out as a major setting. A recent evaluation conducted among 29 surveyed general hospitals in Israel found a significant relationship between the level of emergency preparedness and the availability of needed components for preparedness. These components include appropriate standard operating procedures, training, and drill programs for various emergencies. A team of 16 experts in emergency management from the Israel Ministry of Health and the Home Front Command used an evaluation process. This process consisted of an evaluation of the hospitals' SOPs for the emergency events, and a state visit. Their overall findings revealed the need for an all-hazard approach to emergency preparedness (Adini et al.).

The team expounded on the importance of SOPs as a primary element in achieving emergency preparedness for future events and on know-how as the basis for dealing with familiar emergency situations (Adini et al., 2012). The team recommended that policy makers should identify and establish these specific knowledge and skills, which apply to particular emergency situations, and then give due emphasis on them during training programs. It further discouraged the formulation of unique plans for every emergency and instead identify common characteristics of different emergencies and invest resources and effort in preparing the specific components required by specific emergencies (Adini et al.).

Emergency Response Drills

The objective of an emergency response drill is to practice for some anticipated or possible emergency event (ESHQ, 2013). It conducts training, disseminates inform in order to reduce confusion, and evaluates the adequacy of emergency response activities and equipment. A drill is an exercise held in a given external emergency organization or location. It is a planned activity and intended to educate everyone involved on the appropriateness of the response to a real emergency (ESHQ).

. An emergency manager is the authority who exercises discretion over the activity (ESHQ, 2013). He plans and initiates the mock emergency and emergency response drill. He is also the exercise coordinator unless he assigns this function to a competent subordinate. An exercise coordinator links all affected staff and external entities. His function is to minimize disruption in the drill operation and occurrence of hazards. He also documents all lessons derived from the exercise and monitors remedial actions. An operations manager reviews and approves all activities and relevant details, such as the date of the drill and the report on lessons learned and corrective actions. There should also be support personnel, such as safety wardens, line managers and workers. They provide building information, monitor response times or play the role of "mock" victims. And the fire protection engineer checks the fire safety of the occupied building (ESHQ).

A drill goes through 6 process steps (ESHQ, 2013). These are planning, preparation, pree-meeting, exercise, post-meeting, and final report. At the planning step, the emergency manager develops the drill, which includes the type of emergency; background, actions, and anticipated limitations; and participants. The operation manager reviews and approves the draft with or without comments. Under the preparation phase, the emergency manager assumes the function of exercise coordinator. As such, he assembles a planning group, determines the date for drill for the approval of the facility manager; sets the schedule of the pre-meeting, exercise, ad post-meeting; and identifies the evaluators. The exercise planning group fixes the schedule of the drill and contacts the needed support personnel, who are thereafter informed about the details of the drill. At the pre-meeting, the exercise coordinator sets the final schedule for the support personnel; prepares the drill worksheet; trains and equips the support personnel on the procedures, their assignments and equipment; coordinates with the lead emergency responder on any changes in the drill; and confirms all the details of the drill with the facility. During the exercise proper, the lead emergency responder directs the conduct of the drill, resolves issues, and maintains the flow of the drill until completion. The exercise coordinator takes down notes and the minutes, handles additional issues and limitations, insures the accuracy of the exercise, and resolves conflicts or confusions if they arise. The support personnel insures that no actual emergency happens during the drill; notifies the exercise coordinator if the activity must be stopped for whatever cause; records the times and major actions; and prepares a written report on the completed drill. The evaluators observe the drill and fill out and submit the evaluator worksheet to the evaluator coordinator. At the post-meeting, the exercise coordinator gathers the lead emergency responder, the exercise planning group, and the support personnel to evaluate the drill and to gather notes and the equipment used. And the last step is the preparation of the final report by the exercise coordinator. This final report includes the title or type of drill event, the date, the location, the scope, the critique members, the background, the timeline of the drill, the final drill scenario, the final exercise schedule including extraneous issues and limitations, timeline of the actual drill, any deviations from the schedule, the lessons learned, and corrective actions. This is submitted to the emergency manager for review and to the operations manager for approval (ESHQ).

Conclusion: Lessons Learned

The down-to-earth appraisal of 38 public health emergency preparedness or PHEP drills for real-life scenarios with reliable and accurate results has repeatedly shown their usefulness in many ways (Biddinger et al., 2010). PHEP is defined as the ability of the public health and health care systems, communities and individuals to prevent, ward off, rapidly respond to, and recover from health emergencies. Effective preparedness requires the satisfactory performance of specific capabilities, like surveillance, epidemiologic investigation, laboratory testing, disease prevention and mitigation, increased capacity for services, risk communication to the public, and coordinated system of response through effective management. Effective methods of measuring PHEP assess both physical and infrastructural resources and a public health system's collective capabilities. These capabilities utilize assets in a coordinated manner in effectively identifying, describing, responding to, and recovering from an emergency. They must align with the established public health functions of assessment, policy development and assurance, leadership, coordination and communication (Biddinger, et al.).

The lessons learned in this exercise are the existing barriers to measuring PHEP capabilities (Biddinger et al., 2010). One is the infrequency of large-scale public health emergencies, which limits the chances of adequately measuring the responses. And even when they occur, advanced warning and the complexity of the emergency make systematic evaluation difficult. The other is the lack of a reliable or "gold" standard of appropriate response on which to develop preparations on account of the variations among public health systems and the range of possible emergencies that can emerge. A truly effective response can, therefore, only be multi-factorial, an all-hazards approach, and which must thus secure and insure the support or involvement of several partners beyond the already-involved participants. These include formal public health agencies, healthcare organizations, the media, EMS and law enforcement (Biddinger et al.).