JCAHO Update for Infection Control: Lucky 13: Key steps to small-town readiness

JCAHO Update for Infection Control

Lucky 13: Key steps to small-town readiness

A recently published planning document by the Joint Commission on Accreditation of Healthcare Organizations outlines 13 essential components of an effective community-based emergency management planning.¹ Components include:

1. Define the community

• Identify key stakeholders in defining the community.
• Consider geopolitical and other definitional factors.
• Consider impact of federal definitions.

2. Identify and establish the emergency management preparedness and response team

• Build on existing relationships.
• Identify appropriate planning partners.
• Consider start-up logistics.

3. Determine the risks and hazards the community faces

• Use an "all-hazards approach."
• Acknowledge the potential for a catastrophic event.
• Compile a list of potential hazards.
• Recognize the problems inherent in hazard lists.
• Assess and prioritize the listed hazards.
• Fine-tune list by conducting a "gap analysis"

4. Set goals for preparedness, response planning

• Ensure that planning covers basic societal functions.
• Make the planning process as doable as possible.
• Address the four phases of emergency management.
• Address human resources requirements.
• Plan for convergent responders.
• Involve the public in community preparedness efforts.
• Enable people to care for themselves.
• Plan for layered preparedness and response.

5. Determine current capacities and capabilities

• Use federal government asset categories and target capabilities as a guide.
• Specifically consider the public as an asset category.
• Consider other groups not yet represented at the planning table.
• Identify geographic features and vulnerabilities that may affect capabilities.
• Consider surge capacity and consult surge planning resources.
• Consider all community health resources.
• Define critical capacities for each health entity and link to state databases.
• Know the federal government's definition of required surge capacity.
• Consider the issues involved with standards of care during mass casualty events.
• Identify dual uses for existing or merging capabilities.
• Identify alternative care and shelter facilities.
• Identify federal resources in the community.
• Identify gaps in community assets.

6. Develop the integrated plan

• Maintain a collaborative effort; broaden planning partnerships where necessary.
• Choose an approach to developing the plan.
• Use available guidance and resources.
• Determine how the plan is to be drafted and the expected time frame.
• Agree on meeting frequency.
• Review existing plans, laws, and mutual aid agreements.
• Commit to the use of simple language.
• Clearly delineate roles and responsibilities.
• Determine how the plan will be organized.
• Address all types of events and cover all defined goals.
• Specifically address health and medical facility emergency planning.
• Specifically address how to meet needs for pharmaceuticals and medical suppliers.
• Identify and address hazards and resources that cross jurisdictions.
• Identify how preparedness and response success will be measured.
• Consider the lessons learned from 9/11.

7. Ensure thorough communication planning

• Understand how communication is transmitted.
• Plan for alternative and backup communications links and systems.
• Plan and provide for emergency backup power to communications systems.
• Ensure interoperability of communications systems.
• Use available communications planning resources.
• Review and build on existing communications planning initiatives.
• Obtain/prepare information for crisis communications.
• Define emergency communications protocols or procedures.
• Establish communications credibility with the public.
• Recognize and plan for the critical role played by media.
• Identify how every community member can be reached in an emergency.
• Plan to provide decisional support.
• Ensure culturally sensitive communication.
• Use publicly available communications materials.
• Ensure integration of the local health care organization's communications plans.

8. Ensure thorough mental health planning

• Use available mental health disaster planning resources.
• Link to pastoral care resources.
• Consider organizing self-help groups.
• Link to and know how to access federal and state disaster mental health plans/resources.
• Recognize and plan for the emotional effect of crises on rescue and health care workers

9. Ensure thorough planning related to vulnerable populations

• Identify special-needs populations to support effective communication, outreach, and planning.
• Include a cross section of partners in planning and response efforts related to vulnerable populations.
• Consider the unique needs of children.
• Involve the school nurse in emergency preparedness and response.

10. Identify, cultivate, and sustain funding sources

• Proactively pursue funding.
• Include all planning partners in the funding requests.
• Consider revenue-raising opportunities.
• Seek funding collaboratively and regionally.
• Consider the impact of funding reductions.

11. Train, exercise, and drill collaboratively

• Identify who should be trained and the training needs for each.
• Ensure competency-based training programs.
• Identify cross-training opportunities.
• Consider offering the CERT program.
• Access other training programs offered through the federal government.
• Ensure incident command training for appropriate personnel.
• Recognize drills or exercises as a critical element of the emergency preparedness process.
• Involve all players in exercises and drills.
• Be sure to include local businesses in training, exercises, and drills.
• Access available resources.
• Practice with other communities.
• Identify performance measures for drills and exercises.
• Ensure the realism of drills and exercises.
• Include alternative care sites, shelters in disaster drills.
• Activate the emergency plan.

12. Critique and improve the integrated community plan

• Conduct periodic review and reprioritization of possible emergency incidents.
• Review emergency management plan on an annual basis.
• Base review on analysis of performance.
• Discuss post-test problems and assign remedial actions.
• Consider obtaining external feedback.
• Review the planning process.

13. Sustain collaboration, communication, and coordination

• Ensure proper documentation and dissemination of plans and supporting information.
• Establish mechanisms for receiving and reviewing regional, state, and federal plans.
• Collect and disseminate information about effective models, practices, and lessons learned.
• Build multilayered relationships and prepare for transitions.
• Ensure ongoing communication with the public.

Reference

1. Joint Commission on Accreditation of Healthcare Organizations. Standing Together: An Emergency Planning Guide for America's Communities, Chicago: JCAHO: 2005