Archive for: Emergency preparedness

Wildfire Preparation Tips for Your Organization

By: October 28th, 2019 Email This Post Print This Post

By Christopher Douyard, EHS Daily Advisor

Wildfires can happen at any time, though changes in land use combined with the steady and continuing rise of global temperatures over the past decades have helped create the perfect environmental conditions for them to thrive. To compound the problem, more and more people are living and working in communities where the risks posed by wildfire are most severe. It’s imperative that your facility takes every precaution to ensure that it doesn’t become another casualty of these increasingly common natural disasters.

The good news is that despite a great cause for concern, there are steps that you can take to assess and protect your buildings in advance. Here are some tips to help you prepare in the event that a wildfire threatens your organization.

Assess Your Facility’s Current Risk

There are several factors to consider when determining the potential risk for wildfire damage at your facility’s site. Foremost, it is important to understand the conditions at your facility, including weather patterns, types of local vegetation, and topography. Some regions are more fire prone than others, though there are a few key factors that apply, regardless. During your initial visual assessment, take note of the following:

  • The presence of wild vegetation, including wild grasses, brush, and timber, as these can be highly combustible. However, vegetation used in landscaping can be equally combustible.
  • Plants with a higher probability of combustion:
    • Contain volatile oils or resins. These are typically aromatic;
    • Have long and/or narrow leaves or needles;
    • Have leaves that are fuzzy or waxy;
    • Have loose or paper-like bark; and
    • Will have dead plant material accumulating beneath them.

Keep in mind that wildfires move both horizontally and vertically. Some of the most devastating fires start on the ground and then travel to bushes and shrubs, where they can then move into treetops or to a roofline. Take note of tall shrubs or overhanging tree branches near your facility or its outbuildings.

Also, recognize that these factors work in reverse. A fire that starts inside your facility can easily spread from your building by jumping to nearby vegetation, from which it can spread outward into the community.

Create a Defensible Space

Once you’ve assessed the vertical and horizontal risks posed by the vegetation and outbuildings adjacent to your building(s), you must create a defensible space around them. This space should consist of three nested zones, each with a unique set of requirements.

Zone 1: within 30 feet (ft) of facility

  • Remove all combustible materials, such as fire-prone vegetation, firewood, furniture (such as picnic tables), and/or lumber decking.
  • Remove combustible litter from the roof and/or gutters.
  • Trim branches that overhang your facility.

Traditionally, the landscaping closest to a building helps keep the facility attractive and inviting to workers, clients, and the community, but it should also be as fire-resistant as possible. For example, plant drought-resistant native plants that are low maintenance instead of ornamental species, and any lawn needs to be well-irrigated. Hardscapes are also good in Zone 1, and features like stone, gravel, or otherwise paved walkways can serve as firebreaks across the property. Using crushed stone rather than mulch for beds that are placed up against the building will also help mitigate the risk of fire reaching the building.

Zone 2: between 30 and 100 ft from facility

  • Incorporate hardscape features into your property to act as firebreaks.
  • Plant fire-resistant vegetation, and limit trees to individuals or small clusters.
    • Prune dead or dying branches regularly, and be sure to remove them.

In addition, any outbuildings located on the property should be placed in Zone 2 and should be a minimum of 50 ft from your facility if they are used to store combustible materials. Double-check your state and local building codes to make sure any fuel tanks are properly located at the minimum required distance (if not farther) from the building. If they are required to be above ground, make sure they are placed on a noncombustible pad.

Zone 3: more than 100 ft from facility

The health of the vegetation should be the maintenance focus in Zone 3. Though the trees may be more densely packed, especially if your facility is in a relatively unpopulated area, you should still prune and remove any dead or dying branches. Be sure to prune both horizontally and vertically to help minimize the potential for fire to spread.

While you don’t need to “rake the forest,” remove any larger concentrations of dead materials from the ground.

Other Steps to Consider

If you have any questions or concerns about how a wildfire event would impact your facility, first and foremost, you should reach out to your local fire department, state fire agency, or a qualified fire management specialist for an on-site consultation. Any of them can help you assess your facility’s risk and help prepare a plan for addressing issues. You could also reach out to your local planning and zoning office if you’re unsure about requirements in your area.

It’s also important to keep in mind that any codes or requirements represent the minimum effort that you should incorporate into your facility. If your building(s) are located in an area with an elevated wildfire risk, it doesn’t hurt to spend a little more on design, materials, and maintenance that could be the difference between keeping your facility safe or having to make a very expensive insurance claim.

The chronic issue of cybersecurity

By: October 14th, 2019 Email This Post Print This Post

By Suzanne Widup

Healthcare institutions large and small can be left black and blue by a cyberattack. Larger institutions have more patients and thus have more user health records that attackers can compromise. Smaller institutions, on the other hand, may not have the financial resources to protect themselves against an attack or respond to one when it occurs.

In the event of an incident or breach, repairing a security system can take a massive toll on a healthcare institution, costing time, money, and staffing support to remedy. This severely affects the number of patients seen for however long it takes to address and fix the damage, which in turn causes the institution’s finances and reputation to suffer.

Healthcare institutions are vulnerable cyber targets, with thousands of patient records to protect and a federal requirement to comply with HIPAA and HITECH. These institutions lack the staffing (and sometimes the awareness) to prevent personal health data from being accessed and held by threat actors. With the constant demand to see and treat patients, cybersecurity hasn’t always been a top priority for these institutions. But it should be.

The call is coming from inside…

According to Verizon’s 2019 Data Breach Investigations Report, for the second consecutive year, the majority of healthcare cybersecurity breaches in 2018 were attributed to internal (rather than external) threat actors—a skew unique to the healthcare industry. These internal threat actors are typically employees working within healthcare institutions (doctors, nurses, etc.). Though these employees are not always acting out of malice, the major concern here is that they have been granted access to systems to carry out their jobs; thus, they do not need to break into those systems to retrieve or expose classified information.

Across sectors, including the healthcare industry, misdelivery (sending data to the wrong recipient) is the most common error type that leads to data breaches. Typically, these errors involve mailing patient paperwork to the incorrect address, or issuing discharge papers or other private records to the wrong person.

The healthcare sector also suffers from the widespread problem of social attacks. Like many industries, healthcare institutions are under the constant threat of phishing emails that bait unsuspecting recipients to enter personal information, such as email credentials, onto fake sites. The stolen login information is then used to access the user’s cloud-based email account, thus compromising any patient data in the user’s inbox, outbox, or other folders.

Required to report

Unlike other sectors, the healthcare industry is required by law to report ransomware attacks as though they were confirmed breaches due to U.S. regulatory requirements. These attacks tend to make headlines as they disrupt an organization’s ability to carry out its primary function—patient care. While some organizations have resorted to paying the ransom demand, this is no guarantee that the criminals behind the attack will provide a valid key to restore an organization’s data—they may just take the money and run.

So how can healthcare institutions immunize themselves from cyberattacks and breaches? There is no magic pill, but there are precautions that industry leaders can put in place to better protect themselves against inside and outside threats.

Prescriptions for protecting your network

  • Locate the problem areas: Practice good security hygiene by examining the current health of the network. Healthcare institution leaders and administrators should know where their major data stores are, limit necessary access for their employees and staff, and keep track of access attempts to pinpoint weak spots. Certain staff may not need complete access to files and records to perform their jobs, and practitioners can enact low-cost process controls to prevent miscellaneous errors that can erode the cybersecurity of an institution.
  • Make it easier for employees to report issues: Minor errors like phishing can be infectious. Industry leaders should make it easy for their staff to report phishing when it occurs (regardless of whether the staff took the bait) so they can nip issues in the bud and prevent an influx of employees from potentially compromising the network. Leaders can incentivize the process by implementing reward-based motivations for employees to report incidents quickly, thereby limiting the people and information affected.
  • Institute checks and checkups: Have a game plan that focuses on mitigating or preventing incidents and breaches, rather than nursing a security system back to health after an attack has occurred. Institutional leaders need to know which processes deliver, dispose of, or publish personal data and put up checks to ensure that a minor mistake made by an employee does not escalate into a breach. By enacting a plan and conducting regular checkups of mobile and network security, healthcare institution leaders will have a standard by which they can regularly measure the pulse of their performance.

As healthcare institutions become increasingly interconnected, leaders need a plan to address the state of mobile and network security before an attack occurs. Reframe cybersecurity as a matter of patient care: Medical devices can be hacked, a breach can cause a misdiagnosis, and personal health information stored on computers can be stolen. Not to mention, the downtime during a breach can put patients in critical danger.

Protect before you have to treat. Industry leaders must take all of the necessary measures to assess and stabilize their institutions’ cybersecurity and better thwart attacks—especially “from the inside.” By putting up safeguards for employees, including doctors and nurses, to protect themselves from accidentally compromising their network, these institutions can lessen or prevent the threat of an incident or breach.

Or you can always seek a second opinion.

Suzanne Widup, senior analyst at Verizon Enterprise Solutions, is a co-author of the Verizon Data Breach Investigations Report, and lead author for the Verizon PHI Data Breach Report. She spends quality time hunting for publicly disclosed data breaches for the VERIS Community Database ( She has 20 years of IT experience, including Unix system administration, information security engineering, and digital forensics in large enterprise environments. She holds a BS in computer information systems and an MS in information assurance. Widup is the author of Computer Forensics and Digital Investigation With EnCase Forensic v.7,published by McGraw-Hill.

Safety Month Showcase: Prevent workplace violence by recognizing threatening acts

By: June 25th, 2018 Email This Post Print This Post

The National Safety Council has designated June as its annual National Safety Month as a way to focus on “reducing leading causes of injury and death at work, on the road, and in our homes and communities.” In accordance with that, HCPro’s safety team will highlight a different healthcare-oriented safety topic each week in the month of June by sharing an excerpt from one of our many books, all available on

The focus this fourth and final week of June is workplace violence. The excerpt is from “Preventing Emergency Department Violence: Tips, Tools, and Advice to Keep Your Facility Safe,” authored by Lisa Pryse Terry, CHPA, CPP.

In her book, Terry provides healthcare personnel and security professionals with guidance for how to deal with violent patients and visitors, active shooters, uncooperative behavioral health patients, and disruptive prisoners. Terry also helps healthcare professionals recognize signs of violence, take steps to defuse tension, and respond appropriately. Plus, she offers real-life examples and training tools and provides sample response protocols and emergency department design ideas to help readers develop plans and make improvements in their facilities.

In this excerpt, Terry writes about recognizing threatening behavior in the ED.

The clock is ticking. The risk of a loved one not being treated quickly enough before her condition worsens causes great anxiety for a family member who begins pacing and becomes increasingly angry (potential risk). Seeing the crowded ED and assuming the staff are too busy to provide immediate attention for his family member triggers the perpetrator to seek immediate medical attention by commandeering staff to assist him (stimulus). An unattended door with a restricted access sign for employees only provides an opportunity for the perpetrator to grab and force a clinician to help now (opportunity to act). Violent behavior erupts, nurses are terrified, and chaos ensues.

The theoretical situation above could have been avoided with proper training and ability to recognize threats early. Understanding how perpetrators behave is key to managing threats. There are some commonalities among individuals who pose a threat. Recognizing threatening behaviors allows resources to intervene at the earliest possible stage.

Most all perpetrators consider, plan, prepare, and then act. This allows intervention at multiple points along the violence spectrum. But effective intervention to decrease threats is dependent on training and experience that enable security officers, public safety, and police officers to fully recognize and identify the early signals. Intervention also relies on nurses and healthcare staff understanding the signs of pending violence.

Nursing by nature requires staff to be physically close to patients who can quickly become agitated or violent. Close contact increases the likelihood that a nurse or other clinician will become the victim of physical violence, especially if the signs of violence are not recognized early. This increases the need for clinical staff training on the violence spectrum as well as related security training, de-escalation techniques, and personal safety training.

A collaborative effort and integrated training for healthcare security staff and clinicians increases safety for everyone. It also helps define roles and responsibilities if an event occurs. Collaboration reinforces what to expect if an event occurs and how resources can be quickly assimilated.

Security and healthcare staff who are able to proactively deal with threats and/or threatening behavior early—detecting threats early, evaluating them, and knowing how to address them—may be the single most important key to preventing and managing violence.

So how do security and healthcare professionals identify the signs to decrease threats?

In Chapter 3, we discussed the impact of the violence spectrum and the importance of managing threats of violence. All staff should be trained on the components of anger and impending violence, which present in three primary ways:

  • Physical reactions—These reactions include an individual’s response to anger, frustration, and potential violence such as an adrenaline rush, increased heart rate and blood pressure, and tightening of muscles for the “fight or flight”
  • Cognitive Experience—This involves how an individual perceives he or she is being treated. If he believes he is being treated unfairly, prejudicially, or in any negative way, the risk of becoming angry and violent escalates.
  • Behavior Changes—Individuals considering a violent action or response will display behavioral changes such as change in demeanor, verbal or voice changes, and nonverbal cues of agitation and frustration such as tapping fingers, rapid eye movement, or pacing.

Security and healthcare staff must understand the significance of verbal and nonverbal cues. Key threat management strategies focus as much on nonverbal communication as they do on verbal communication. According to various researchers, body language is thought to account for between 50 to 70% of all communication.

  • In a crowded waiting area, a family member feels claustrophobic and becomes agitated
  • A worried parent continually reaches out for the nurse’s arm in hopes of getting more attention
  • An agitated spouse paces back and forth in front of the doors leading to restricted treatment areas
  • The eyes of a frustrated patient dart back and forth continually.
  • An anxious spouse believes it is taking way too long to get an updated report on his wife, and begins clenching his jaw
  • A forensic patient visually scours the treatment room for a weapon of opportunity

These are all signs of potential violence. Space, touch, body movement, and perception of time are all ways people express their frustration and anxiety. Proactively identifying these particular behaviors of concern can help reduce the risk of violence in the ED and contribute to a better patient experience.

Responding to nonverbal cues may be as simple as providing a brief update on the status of a loved one; giving a person a reassuring smile and greeting; explaining that it’s important to conduct thorough testing to provide the best treatment possible; acknowledging a person’s feelings; or offering to get an anxious parent a cup of water while she waits. Eye contact can also indicate genuine interest and concern for a person and alleviate anxiety. In an overcrowded ED, speaking to the agitated person and offering to help him find a more comfortable place to wait can defuse anger.

Verbal communication is also an important indicator of agitation, frustration, and pending violent actions. Tone of voice, loudness, inflection, intonation, and rapid speech are red flags. Once verbal communication escalates to cursing, threats, and disrespectful language, rapid de-escalation is critical to lessen risks.

Working together, security and healthcare professionals can decrease or minimize threats to safety and block opportunities to act. They can integrate case management into the security management strategy to lessen the threats. Effective threat management strategies incorporate the STEP process.

  • S: De-escalate, contain, or control the subject who may take violent action
  • T: Decrease vulnerabilities of the target
  • E: Modify physical and cultural environment to discourage escalation
  • P: Prepare for precipitating events that trigger adverse reactions

 Utilizing the STEP Process is an effective means of managing threats. Some questions to ask in the process include:

  • What is motivating the individual to become a threat?
  • Has the individual communicated his/her intentions as a threat?
  • Is the individual demonstrating physical actions of threat?
  • Does the individual have access to weapons?
  • Are there unusual objects that could be used as weapons?
  • Are there bystanders to consider and remove from harm’s way?
  • Has the person taken aggressive action (pushing, striking)?
  • Is the person argumentative?
  • Is he/she displaying unwarranted anger?
  • What is the stimulus for action and how can it be removed?

Responding positively to verbal signs of anxiety is extremely important in the ED environment.  Keep your voice calm, repeat what you hear to reassure the person you understand, look the person in the eye when she is speaking, and seek to understand the underlying cause of agitation. People who visit the ED are usually nervous and fearful of a diagnosis or treatment process. Many things in the ED environment can put that fear into overdrive and then violence occurs. Watching for the earliest signs of violence and utilizing strategies to overcome fear and anxiety are an essential part of the healthcare security team’s job.

To purchase “Preventing Emergency Department Violence: Tips, Tools, and Advice to Keep Your Facility Safe,” please click here.

Safety Month showcase: Prep for emergencies by completing a hazard vulnerability analysis

By: June 4th, 2018 Email This Post Print This Post

The National Safety Council has designated June as its annual National Safety Month as a way to focus on “reducing leading causes of injury and death at work, on the road, and in our homes and communities.” In accordance with that, HCPro’s safety team will highlight a different healthcare-oriented safety topic each week in the month of June by sharing an excerpt from one of our many safety books, all available on

The focus this first week is on emergency preparedness.

The excerpt is from The Emergency Management Handbook, authored by Mary Russell, EdD, MSN, CEN, RN. Whether you need to launch a program or revamp your training, this resource provides the step-by-step road map for how to set up a program, obtain buy-in, and train staff. This excerpt focuses on completing a hazard vulnerability analysis.

One of the most valuable tools in your emergency planning repertoire is the risk assessment process. A hazard vulnerability analysis (HVA) is a tool designed to help you become familiar with hazards that your facility may face and to help you prioritize your planning, training, exercises, and corrective action improvements for your facility based on the likelihood of an event occurring.

Hospitals need to complete an HVA for their facility that identifies actual or potential events that can result in a demand for medical services or can affect the ability of the hospital to provide services. Your hospital’s HVA must consist of an assessment of each facility on its campus and any satellite outpatient centers it considers part of the hospital complex. The focus is to identify vulnerabilities that could affect the safety of patients, visitors, or employees during an emergency. It should also identify hazards within the larger community setting inclusive of the hospital’s campus. In this way, the HVA can uncover valuable opportunities for planning and mitigation to reduce vulnerabilities to specific threats. The HVA process will also identify scenarios that are a priority for your hospital to exercise.

Hospitals are part of a community’s critical infrastructure because of their role in providing medical care and services for the ill and injured. Because of this role, however, there are inherent vulnerabilities in terms of daily operations. These include the following:

  • Twenty-four-hour-a-day operational needs
  • Critical power dependence due to lifesaving equipment and procedures that hospitals offer
  • An essential need for effective communication both within the hospital and externally to physician providers, other hospitals, EMS, and other partners
  • Utilities support, including electric, water, waste disposal, IT, and communication support
  • A high density of persons on-site at any one time, including inpatients, outpatients, employees, the medical staff, volunteers, visitors, students, vendors, service personnel, and others
  • Inpatients with high acuity levels, including a high percentage that could be non-ambulatory (the vast majority will require some level of assistance if an evacuation is necessary, as most persons are tethered to some form of equipment)
  • Hazardous materials in the form of pharmaceuticals, antineoplastic drugs, anesthetic gases, lab specimen solvents, formaldehyde, radiological materials, xylene, compressed gases, bulk liquid oxygen, biohazardous waste, on-site fuel, cleaning materials, and others
  • Structural aspects of hospitals (e.g., many small rooms) that can make evacuation difficult, especially in older structures that include dead-end corridors and added-on wings

Hospitals that proactively take steps to reduce their vulnerabilities for one hazard will benefit from doing so by providing a level of reduced risk for other hazards. For example, hospitals that use shuttering and window protection systems to shield from hurricane winds know that such systems also offer security protection during any other hazard. The same concept goes for perimeter fencing around a facility as a mechanism to restrict access and manage crowd control, regardless of the scenario.

The hospital should review their HVA annually with key community partners as well as with the hospital’s emergency management team and Environment of Care Committee. The review should also assess the hospital’s capability to respond to various threats, advance mitigation strategies, inventory resources and assets to manage an incident, and plan exercises to trend progress in meeting objectives.

The HVA is a living document. Some things will not change, such as your hospital’s geographic location and its major transportation routes. Other things, such as local businesses and industries, can change from year to year. Agencies that can assist you with the development or annual review of your HVA include, but are not limited to, the following:

  • Local fire-rescue services can be a great resource to update you on any new environmental threats in your area as fire inspectors become aware of new hazards in the community during business inspections and as part of their ongoing risk surveillance
  • Police are aware of crime statistics, substance abuse issues, and potential terrorist threats, including persons of interest or groups such as gangs and activists
  • Local, county, or regional emergency managers can be consulted to ensure that your HVA encompasses proximity to area hazards in which your facility may not be in the immediate impact zone but could be a receiving facility for casualties who flee the scene
  • Local utility companies for electricity, water, and communications can detail risk and their mitigation strategies that are proposed or already in place for the grid location of your hospital complex
  • Local chamber of commerce, which maintains an updated listing of population demographics, businesses, seasonal events, and other resource information
  • Your local healthcare coalition includes additional key community partners beyond those listed above that can contribute both threat and hazard information and knowledge of existing resources to a local or regional HVA that is also applicable to an individual hospital HVA

The following are five steps you can take to complete your HVA.

Step 1: Complete your HVA community profile

Completing a community profile will help you understand the surrounding community and give you a context within which your hospital will consider its priorities (e.g., social, economic, political, and legal realities). A profile contains details related to your geographic location; demographics of the community; resident, seasonal, and tourist populations; top employers; weather and climate; economic status of residents; educational levels; multimodal transportation systems; and other considerations.

Step 2: Identify all hazards in your community risk profile

Insert all known community and area hazards into a hazard vulnerability matrix to create a community risk profile. Request the assistance of your community partners to ensure that your list is complete. These stakeholders can help you determine the probability that the hazards you identify will occur, and your facility’s vulnerability to them. Hospitals can also identify hazards in a visual way using community maps or a summary PowerPoint slide. Provide clear detail on top-ranked hazards so that your hospital’s emergency management team, Environment of Care team, and HICS team can all clearly articulate each risk and what they are doing to prepare for such potential occurrences to the organization.

Step 3: Assess the hazard’s risk

The risk of a hazard is a product of its likelihood, and the impact or consequences of the hazard on the community, and how it would affect the hospital’s ability to manage such an event. Determine risk by estimating the potential number and types of casualties your facility could expect from a given hazard; in most cases, you should base your estimation on your community’s population.

The risk of a hazard occurring can be assigned a score based on expert judgment or actual intelligence, or it can be assigned to a category of risk—for example, low, medium, or high. Some hazards may not be applicable due to a hospital’s geographic location. Factors that influence ranking of hazards include history of prior occurrences, vulnerability of population and property, and probability for the hazard to occur, based on both short-term and long-term predictions.

Step 4: Analyze the vulnerability to each hazard

Analyze each hazard separately to determine the likelihood of it affecting your hospital in terms of susceptibility, impact, and consequences to the organization. Impact can be determined in terms of the human impact (patient or staff injury, workforce availability), property impact (damage to facility, flooding, equipment damage, debris), and operational impact (disruption of services, utility failure).

Step 5: Prioritize the vulnerabilities for hazards and identify risk interventions

It is not enough to fill out an HVA for your hospital simply to identify hazards and rank them. The next critical step is to look at the hazards you have identified to find common vulnerabilities across different scenarios and establish shared mitigation measures. A subsequent exercise can determine whether the mitigation was successful for a specific scenario; however, such interventions will reduce vulnerability for other threats too. The severity of a hazard can be identified by the magnitude of the incident as measured by potential human, property, or business impacts but mitigated by preparedness (preplanning, training, exercises), internal response (initiating an efficient and effective response and mobilizing resources), and an external (community or mutual aid) response.

The highest-priority vulnerability is for patient and staff safety concerns—that is, those hazards that can result in illness or death or other health risks. Another high-ranking concern is business continuity, which translates into minimizing service disruption or failure and maintaining the trust of the community.

Local residents expect that hospitals will do all they can to protect the facility from harm and to prepare both the facility and its staff for threats. Hazards that result in property damage are also important, as they can affect access to the facility and can cause disruption in services.

To purchase The Emergency Management Handbook, please click here. And, as we highlight Safety Month, check back next Monday for another free HCPro book excerpt that focuses on a different healthcare safety topic.

NFPA unveils new standard to help with response to active-shooter incidents

By: May 1st, 2018 Email This Post Print This Post

Early this year, the NFPA promised to fast-track a new standard to help first responders, healthcare providers, facility managers, and others prepare for an active-shooter incident, and they have delivered, complete with its own acronym.

NFPA 3000, a Standard for an Active Shooter/Hostile Event Response (ASHER), is now available in paperback for $52, or, as with other NFPA codes and standards, it is also available on the National Fire Protection Association’s website for free in a read-only format. The format cannot be printed, searched, or copied. But it is a quick read at only 48 pages.

Designed as a roadmap for the multidisciplinary response needed in the aftermath of an active-shooter incident, there is a separate chapter for “Hospital Preparedness and Response for Out-of-Hospital ASHER Incidents.”

The chapter outlines minimum expectations for hospitals in preparing for, reacting to, and receiving patients from an active-shooter event in the area. Among other things, it says hospitals should:
• plan and drill regularly with other local authorities having jurisdiction (AHJs)
• have at least two ways to communicate with public safety officials about how patients are being distributed to health care sites, and to test communications at least once a month
• expect spontaneous arrivals of injured patients and those looking for them
• have a way to identify victims and reunite children with their families
• and have a security plan to restrict access as needed, and to search the facility for devices and weapons if that becomes a concern

Other chapters detail expectations for the variety of first responders, government agencies, and other organizations who might be involved in an ASHER response to prepare, plan, and recover from an incident.

The publication marks only the second time the NFPA has fast-tracked a provisional standard.

While most standards or codes can take years of planning, the ASHER standard was born of an urgency brought by the request of Otto Drozd, the chief of Orange County Fire and Rescue in Florida, three months after the June 2016 shooting at the Pulse nightclub in Orlando.

In that attack, 49 people died and more than four dozen others were shot, with many of the injured walking to nearby hospitals or in some cases physically carried by friends or others down several blocks. Since then, hospitals nationwide have responded to mass shooting incidents at a church, a concert, and a high school, among others.

At the time of Drozd’s request for a standard, there was an abundance of guidance material available but “there was no consensus standard for the components of a multidisciplinary response for preparedness, response, and recovery to active shooter and/or hostile events,” notes the NFPA in the opening to NFPA 3000.

A committee of 46 experts from law enforcement, fire services, emergency medical services, hospitals, physicians’ groups, and others was formed to receive technical, expert, and public comments and arrive at a consensus of standards.

The fast-tracked standard will now move into the normal biennial review and update process for other NFPA publications, according to the NFPA.

Editor’s note: This blog post was written by A.J. Plunkett, our colleague over at DecisionHealth.

New report on emergency preparedness says U.S. healthcare system is improving

By: April 18th, 2018 Email This Post Print This Post

We recently published online an article from the upcoming edition of our Healthcare Life Safety Compliance newsletter about a recent report by the Johns Hopkins Center for Health Security that examined how the U.S. healthcare system has fared while responding to emergencies both large and small.

Their conclusion? The bigger the emergency, the less prepared healthcare facilities are for handling the crush of patients that come through their doors.

“Although the healthcare system is undoubtedly better prepared for disasters than it was before the events of 9/11, it is not well prepared for a large-scale or catastrophic disaster,” the authors wrote in the report, which was released in late February. “Just as important, other segments of society that support or interact with the healthcare system and that are needed for creating disaster-resilient communities are not sufficiently prepared for disasters.”

Their research, however, spanned from 2010 to 2015, meaning that responses to recent emergencies such as Hurricane Harvey, the wildfires that torched California, the harrowing mass shootings at a country music concert in Las Vegas and at Stoneman Douglas High School in Florida were not examined.

Now a new report has come out, this one concluding that hospital readiness for managing health emergencies has improved over the last five years.

From our colleagues at Patient Safety & Quality Healthcare:

The Robert Wood Johnson Foundation (RWJF) this week released the 2018 National Health Security Preparedness Index, which found that the U.S. scored a 7.1 out of 10 for preparedness, up 3% over the last year and almost 11% since the Index was begun in 2013.

The assessment found improvements in most states, but also noted serious inequities in health security across the country, according to a RWJF release. Maryland was the highest scoring state, 25% higher than the lowest-ranked states, Alaska and Nevada. The report found that states in the Deep South and Mountain West scored poorly compared to those in the Northeast and Pacific Coast.

“Five years of continuous gains in health security nationally is remarkable progress,” said Glen Mays, PhD, MPH, who led the University of Kentucky research team that developed the index, in the release. “But achieving equal protection across the U.S. population remains a critical unmet priority.”

The index found that 18 states had preparedness levels exceeding the national average, while 21 states fell below the average. Thirty-eight states and the District of Columbia increased their overall health security last year, with eight remaining steady and four declining.

So, while this new RWJF report suggests that the response of the U.S. healthcare system to emergencies has generally improved in recent years, a lot of work still needs to be done, which aligns with what the authors of the report from the Johns Hopkins Center for Health Security wrote a couple of months ago.

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