The Challenge Healthcare Professionals Face
When an emergency event occurs, the normal process and patterns of our day are interrupted. Things that we take for granted such as inventory supply, patient flow, nursing assignments, and resource allocation are dramatically changed. How we react to that change will determine how we deliver on the mission of healthcare within our community: patient care.
However, such events do not always occur with the same frequency throughout the country. And so, healthcare facilities in areas that do not experience devastating events with regularity must learn from after action reports generated by those facilities that do experience such events.
I pulled these quotes from a 2015 report, Operational Lessons Learned in Disaster Response, published by the US Fire Administration that illustrate the problem:
“Learning the lessons learned and turning that into actionable behavior requires real effort at the individual level and for the organization.”
“We know the cause and effect of operational errors and omissions, the critiques/reviews that follow report similar issues in disaster after disaster, and the lessons learned are so identified in the evaluations. As long as we fail to implement the knowledge of disaster response into training and operations, lessons learned will not be much more than a catch phrase. The best evidence for our failure to learn from past experience and lessons and the lessons of others comes in the testimony from after action reviews conducted after devastating events.”
“Honest self-evaluation by the organization is the most important first step, getting to the facts and recognizing what may be learned from the event. From evaluation flows the lessons learned. Now comes the critical piece: Will lessons learned be shelved or will they lead to organizational learning? That is the question. Implementation of lessons learned into organizational training and operations comes down to a question of leadership.”
Leadership is Key
We need leaders at all levels that have the courage to think “outside of the box” and can embrace such organizational learning. They should also have an all-hazards perspective in order for their staff to maintain a heightened level of preparedness.
Next Generation Emergency Core Competencies: Behavioral Anchors for Measures and Objectives, a report published by FEMA in 2017, identified the following behavioral anchors for leadership:
- Inspires a shared vision
- Communicates clearly how people can contribute to achieve the vision, so that mutual adjustments can be made in concert with others
- Creates an empowering environment
- Identifies and negotiates constraints to enable others in the organization to successfully pursue its vision
- Resolves conflict
- Resolves conflict that may emerge within the organization or between the organization and the community it serves
- Promotes a vision of shared outcome and facilitates agreement by constructively resolving differences of opinion
- Uses strategic decision making that influences others towards change
- Develops strategic plans created through participatory process within and between organizations
Interlaced throughout these anchors is the common theme of communications both within the organization and between different agencies. What makes communication successful is a shared language amongst the stakeholders.
Bake-in the Change
So how does communications get the treatment it deserves? Last year, the American Nurse Credentialing Center (ANCC) rolled out a way to assess the required knowledge amongst the different disciplines that might respond to a healthcare disaster.
In May 2017, the ANCC unveiled the National Healthcare Disaster certification. This was not a national certification just for nurses. It was an interdisciplinary certification directed towards registered nurses, physicians, nurse practitioners, physician assistants, pharmacists, paramedics, emergency medical technicians, respiratory therapists, behavioral health professionals, emergency managers, and public health professionals.
The test itself is broken down into the four pillars of emergency management: mitigation, preparedness, response, and recovery. The certification pulled healthcare into the federal, state, and local disaster response framework as an active participant. For hospitals and healthcare organizations to integrate this active participation, emergency management concepts must be fully integrated throughout the organization; from administration to bedside staff. In addition, regular training for staff must incorporate the lessons learned by those facilities that have experienced a low probability/high impact event.
Is this certification the solution healthcare professionals need to address the communications gap in facing disasters? I am encouraged to see attempts to address the problem and am curious if you think this approach goes far enough to prepare healthcare professionals for their next challenge.
References
American Nurses Credentialing Center (n.d.). National Healthcare Disaster Certification. Retrieved from http://www.nursecredentialing.org/NHDC on January 15, 2018.
Feldmann-Jensen, S., Jensen, S., & Smith, S. M. (2017). The Next Generation Core Competencies for Emergency Management Professionals: Handbook of Behavioral Anchors and Key Actions for Measurement. FEMA Emergency Management Institute. pp. 5-7, 91-95.
United States Fire Administration (2015). Operational Lessons Learned in Disaster Response. Emmitsburg, MD: Author. pp. 22, 35-36.
Guest Post by: Michael J. Curran BSN, RN, EMT-P, NHDP-BC
michael.curran69@outlook.com | www.crisisdiscussions.com
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Read more about Michael Curran here.
I appreciate your comments surrounding the pillars of emergency management: mitigation, preparedness, response, and recovery. I sometime see that Healthcare organizations become silos and only have enough resources to achieve minimum levels of preparedness. From what I read in your post it looks like the National Healthcare Preparedness certification challenges organizations to push the envelope in healthcare preparedness. Unfortunately, most in the Healthcare industry who are responsible for preparedness within their organizations are over tasked. We often read lessons learned from other healthcare organizations where disasters occur but quickly go on with our routine. Healthcare preparedness should be kept as a top priority.
I believe Healthcare Coalitions can still challenge organizations to raise the bar in preparedness and convince our stakeholders they don’t need to walk this path alone. Once this is done our responses within disasters will have better outcomes to restore essential services and keep doors open to these organizations.
“I believe Healthcare Coalitions can still challenge organizations to raise the bar in preparedness and convince our stakeholders they don’t need to walk this path alone. Once this is done our responses within disasters will have better outcomes to restore essential services and keep doors open to these organizations.”
A preparedness mindset is essential throughout the organization. It must be encouraged and promoted even amongst the staff that reaches the patient’s bedside.
We just witnessed the Super Bowl last weekend. Just imagine the quality of play if only the coaching staff and maybe a few “key” players on the field knew what play was being called and what the assignments were. How on earth would the defenses on each team be able to “effectively respond” to the opponent’s play call on offense? How could each team be able to insert appropriate substitutions to overcome noted weaknesses/shortcomings?
I think it is safe to say that, with the athletic skill on the field, the players would be able “adapt to the conditions present”. However, for much of the Super Bowl, wouldn’t it look like a sloppy pick-up game in a neighborhood park? Isn’t that we are being asked to do everyday when preparedness, at the bedside, is an afterthought.
We are capable of so much more!