The official 2026 hurricane season began on June 1st offering an opportunity to review mitigation and preparation activities for summertime emergencies. These emergencies may include effects of hurricanes, lightning, flooding and extreme heat, resulting in power outages, loss of HVAC, water and IT systems.
Consider these proactive planning assessments to promote a safe environment for occupants:
- Conduct re-education of the Emergency Operations Plan and HVA for the Incident Command team, with special consideration for new IC members up to and including evacuation plans
- Review high risk population treatment areas
- Establish succession planning for anticipated longer-term emergencies
- Identify the party responsible for communicating with state and community officials and the media
- Review possible impacts on critical, non-critical and offsite services
- Evaluate the ability for providers and staff to provide uninterrupted patient care
- Schedule adequate security throughout the emergency
- Re-educate providers and employees of their department’s roles, protocols and shelter plans
- Review the 96-hour plan and confirm with department leaders that supplies are adequate, in good condition and have not expired
- Confirm contracts and Memorandums of Understanding are current for transfer agreements, vendors, utilities and critical services, e.g., oxygen and dialysis
- Current vendor licensure, credentials and education of hospital policies and procedures should be on file
- Establish communications with the local emergency coalition, emergency services and AHJs
- Charge battery operated medical equipment and utilize red outlets for critical equipment
- Confirm PBX staffing, department phone trees, radio availability, mass notification system operability and website communication capabilities for patients and visitors
- Plan for staff inability to access the hospital due to weather/road closures
- Distribute the hospital’s inclement weather policy
- Confirm back up emergency power for electrical systems, HVAC, water and refrigeration
- Confirm quick connects are available for temporary utilities such as generators and cooling towers
- Conduct Plant Operations inspections including hospital grounds for existing conditions including infrequently occupied areas
- Ensure outdoor construction areas are properly secured
Response activities during an emergency are critical to managing occupant safety. Consider the following actions:
- Establish Incident Command with all pertinent staff including leadership, all clinical services representation, infection control and plant operations
- Draft and maintain a formal risk assessment that includes areas to monitor and staff education
- Maintain an accurate timeline of events
- Evaluate the ability to continue surgical services/instrument sterilization
- If the hospital stops accepting admissions, consider having ambulance(s) at the emergency department and security staff available to safely re-direct emergencies to a confirmed alternative location
- Re-allocate floor staff to the emergency department if needed
- During loss of HVAC in the summer, maintain an adequate number of spot coolers and dehumidification units
- If these units are part of the hospital’s inventory, the manufacturer’s instructions for use should be followed and documented in the work order system
- Maintain an MOU with vendors for deployment when necessary
- An ALSM/ILSM should be completed for equipment deployed, especially in patient care areas
- Document education for the staff responsible for safety rounding including the hazards the temporary units may present
- Document ALSM/ILSM staff education
- Regular documented rounding should occur on the fire panels and confirm the life safety, critical and equipment branches are functioning
- If temporary equipment is placed on the grounds, implement ALSM/ILSM and notify the AHJ; placement should not obstruct emergency connections or exits
- Document water intrusion including an ICRA with staff education
- Ensure all temperature and humidity readings are readily available for all required areas including the ORs, sterile supply storage areas, scope cleaning room, pharmacy, laboratory, interventional radiology, ICU, airborne isolation rooms, IT closets (consult the state’s adopted FGI guidelines for the full list of areas)
- Relocate sterile supplies, medications, food and other perishables and document monitoring activities
- Evaluate refrigeration, hot water and ice machine capability in the kitchen and on the units
- Transition to disposables for patient meals if hot water is impacted
- Security should monitor the hospital perimeter and round regularly in the emergency department, cafeteria, lobbies and other areas where visitors and other members of the community may be occupying
Steps to recover from an emergency and resume the hospital’s regular activities include:
- Conduct a facility-wide assessment in and outside of the hospital and its offsites
- Close out ICRAs, ALSMs/ILSMs and risk assessments upon confirming restoration of normal conditions
- Engage fire system, utility and industrial hygiene vendors as needed
- Complete terminal cleaning
- Confirm utilities are functioning to capacity
- Ensure medical equipment is in working order
- Incident Command should debrief with the IC within 72 hours after the event to evaluate the hospital’s response
- Include providers and front-line staff in the evaluation of opportunities for improvement
- Keep all improvement activities as open agenda items until formally closed
- Amend the EOP based on lessons learned, if applicable
- Re-educate providers and staff on the updated EOP
Most importantly, formally thank providers, staff and vendors for their commitment and expertise!
Planning for emergencies is a complex, multidisciplinary process requiring the “all hazards” approach. These proactive suggestions are meant to provide a starting point to develop a comprehensive organization-specific emergency preparedness checklist.
Resources on the CMS Emergency Preparedness rule may be found on the ASPR TRACIE website: https://asprtracie.hhs.gov/cmsrule.
Please contact us for questions or more information at 704-573-4535 or info@courtemanche-assocs.com.
Courtemanche & Associates specializes in Healthcare Accreditation and Regulatory Compliance Consulting Services. With over 30 years of being in business and 100+ years of healthcare experience amongst our consulting team, we are ready to assist with your accreditation and regulatory compliance needs.
