Abstract
Disaster planning is integral component of hospital operations and management, and hospital resiliency is critical to society and health systems following a disaster. Additionally, hospitals, like all public institutions have significant risk of security incidents including terrorism, isolated and mass violence, social unrest, theft and vandalism, natural and human made disasters. Security and disaster planning are cumbersome, expensive and easy to deprioritize. When a hospital disaster is defined as anything that exceeds the limits of the facility to function at baseline, disasters and security incidents are intertwined: disasters create security problems and vice-versa. Hospital resiliency to disasters and security incidents stems from a systems-based approach, departmental and administrative participation, financial investment and flexibility. Significant best practices and lessons learned exist regarding disaster and security planning and ignorance or lack of adoption is tantamount to dereliction of duty on the part of responsible entities. This chapter consists of a review of the concepts of hospital disaster and security planning, response and recovery, as well as hospital specific disaster and security threats (risk) and their associated mitigations strategies. Risks will be presented follow a hazard vulnerability analysis (HVA), a common framework in emergency management, disaster planning and disaster medicine. As such, each element of risk is defined in terms of likelihood and impact of an event. Concepts of disaster medicine that are also addressed, as are administrative concerns, these elements are designed to be applicable to non-experts with an emphasis on cross disciplinary understanding. Additionally, elements are presented using incident and hospital incident command terminology and those not familiar should learn these concepts though free online training on the incident command system provided by several sources including The United States Federal Emergency Management Agency (FEMA), prior to reading.
Highlights
A serious disruption of the functioning of a community or a society at any scale due to hazardous events interacting with conditions of exposure, vulnerability and capacity, leading to one or more of the following: human, material, economic and environmental losses and impacts. -United Nations international strategy for disaster reduction (UNISDR)
Terrorism and acts of violence against healthcare workers and healthcare institutions are common enough to have become a field of study
A major consideration with regards to health system functioning in a disaster, is that the healthcare workforce is affected by the disaster as much as the rest of society
Summary
When the disaster affects multiple social institutions, healthcare’s role in society often expands In such events, for example, hospitals function beyond the provision of healthcare: a refuge for those in need, a gateway to social services, a bellwether for societal wellbeing, a bastion of hope and communal security in the face of disruption. For example, hospitals function beyond the provision of healthcare: a refuge for those in need, a gateway to social services, a bellwether for societal wellbeing, a bastion of hope and communal security in the face of disruption As such the effect of disasters and security incidents on hospitals has an additive physical and psychological effect on the population. The disaster cycle and a healthcare perspective on security
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