I’ve had several interesting “pandemic preparedness” projects this last few weeks. A few in “crisis mode” but the most interesting has been facilitating a quick snapshot review of how well a particularly vulnerable hospital was prepared for a “surge” – especially coronavirus.
To give an independent view we used a straightforward gap assessment approach. The steps undertaken in this project have been straightforward and include:
1. Identify a best practice (Hospital Disaster Management) self-assessment tool which is available in the public domain
2. Ask the hospital (in this case the person who looks after the Disaster Management Planning Committee) if they would kindly administer the self-assessment and provide their response
3. Review the response to identify key issues (improvement opportunities)
4. Display the key issues on a “gap assessment” audit tool which is available in the public domain (the Excel tool used for this project is from the British Government Audit Office, c. 2003)
5. Distil the most significant gaps into a set of key recommendation (as this focuses on manageability) which will have a significant impact on improving disaster management capability.
Hospital Disaster Preparedness Self-Assessment Tool
This assessment tool was developed to assist hospitals in revising and updating existing disaster plans or in the development of new plans. The tool was originally used by a subject matter expert survey team to collect data for a Department of Homeland Security (DHS) grant so it is constructed in a survey format. The data was then used to develop a specialized instruction program for that facility that addressed any areas needing improvements. We feel this assessment tool can also be utilized in a self-assessment format by the institution in the review of their disaster plans.
The comparison involves creating a baseline and reviewing the practice with global best practices in mind but also with an appreciation of context. The Assessment is designed to inform the development of improvement plans. As noted on page four of the Hospital Disaster Preparedness Self-Assessment Tool, “the tool provides an excellent check list to assure every aspect of disaster planning is addressed”. The tool however may not suit everyone, all of the time – as it has been developed in an American context and has embedded assumptions within it which may or may not apply to others. On that basis, the tool also notes, again on page four, “the facility can determine if any items are not applicable to their particular facility”. Therefore, the survey response reviewed does exclude responses to some questions – especially those with specific American contexts. The responses that have been given provided significant data with which to identify key performance elements which when addressed, ought to significantly enhance emergency management capability.
Key gaps – key opportunities
While the hospital runs the emergency area well, there is scope to enhance capability. Again, while there are many things which could be addressed (as evidenced in the tables and graphs above), the strategic priorities recommended for the planning committee to consider were:
1. Immediately: Commission an independent Hazard Vulnerability Assessment
2. Within six months: Develop a needs-based Emergency Management Exercise Program
3. Within one year: Develop a stronger Business Continuity Plan / Continuity of Operations Plan