Responsibilities of the Health Care Organization During Disaster

Disaster Management

The Role of Healthcare in Disaster Management

Events such as the terrorist attacks on September 11th, 2001 and the tragically mismanaged response to Hurricane Katrina in 2005 would demonstrate the need for greater disaster preparedness at every level of civil order. Critical first-responders, rescue workers and law enforcement groups require the appropriate resources, plan of action and high-level coordination to handle the intensive demands that often arise in the face of a natural or manmade disaster. Among those participants in emergency planning and disaster management, few will be taxed the way that healthcare organizations will be. This was incredibly well-demonstrated during Hurricane Sandy last year, when destructive flooding and power outages engulfed New York City. Among the best remembered images of that powerful storm were the workers at one city hospitals transporting intubated newborns while manually pumping oxygen into their lungs. This indelible image highlights the unpredictable role that healthcare workers must often fulfill in the face of a disaster. This is why emergency management strategy has come to increasingly recognize the importance of comprehensive disaster planning for hospitals, emergency rooms and available medical personnel.

Planning begins at the federal level, where legislation created over the last decade in response to events like 9/11 and Katrina provides basic blueprints, educational resources and important contacts to regional or local healthcare organizations. To this end, in 2008, the United States would adopt the National Response Framework. With this new initiative would come renewed efforts at bringing coordination and communication about between umbrella federal agencies and state, local or communities stakeholders. The Framework would be focused on providing clear procedural guidelines for effective coordination and communication between collaborating agencies. Accordingly, Petersen et al. (2008) indicate that the "NRF provides guidance for conducting all-hazards emergency response. The framework describes specific statutory and executive authorities, and what DHS describes as 'best practices' for managing incidents that range from the serious but purely local, to large-scale terrorist attacks or catastrophic natural disasters. DHS says that NRF focuses particularly on how the federal government is organized to support communities and states in catastrophic incidents." (p. 5)

This should be the first point of reference for healthcare organizations seeking to improve preparation for the possibility of a disaster scenario. In particular, the NRF directs our attention to the coordination called for between area heath agencies and organizations. This interaction between agencies can help to create a unified strategy for directing mass patient loads, for sharing resources and for offering personnel support to one another. The NRF also serves as a blanket informant for important sub-agencies such as the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), which sets standards and grants accreditations for healthcare organizations. The JCAHO calls for six critical capabilities in the face of a disaster; Communication, Supplies, Security, Staff, Roles and Responsibilities and Utilities.

The support resources provided by the JCAHO for local and regional organizations are designed to help direct plans of action when disasters occur. Recommendations include plans for medical staffs would to work overtime to help improve treatment outcomes, to help move patients effectively through the system and to promote strategies for weathering post-disaster survival. This should also include extensive availability of psychological resources for grief counseling as well as for treatment of post-traumatic stress disorder (PTSD).

Additionally, the imperative for effective communications means that healthcare workers are expected of function as emissaries of critical public health messages. Indeed, for many senior citizens who may otherwise live in some degree of isolation or immobility, interaction with personnel at a community hospital, doctor's office or senior nursing clinic might well represent their only social or public interaction. Therefore, nurses and other healthcare professionals should serve as a direct channel for public health warnings relating to the crisis situation.