Emergency response and employee health ultimately boils down to a paradoxical paradigm: “Know what you don’t know,” says Cathy Floyd, MS, BSN, RN, DPA, COHN-S, regional manager of occupational health at Memorial Hermann Health System in Houston.
“In all fairness, there is much more to it than that,” she says. “But, we do try to do just that.”
As this issue went to press, Floyd was slated for a talk on emergency preparedness at the annual meeting of the Association for Occupational Health Professionals in Healthcare. (AOHP). She agreed to field a few questions on this important topic for Hospital Employee Health.
HEH: When a natural disaster strikes, what are some of the first important measures that should be taken to ensure staff safety and the well-being of healthcare workers and their families so they can continue to work or safely leave work?
Floyd: As natural disasters unfold, prepare to work your plan, and hopefully you will have one with plenty of supplies stocked up. Some of the first important measures include the following and should be included in your plan:
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If your employees are responding to a disaster, be supportive and ensure they have access to plenty of food; clean water; dry or protective clothing, depending on the disaster; shelter, especially for rest and sleeping; ample supplies of hand sanitizer; and rubber or leather gloves (again, depending on the disaster and environment), dust respirators, goggles, hearing protection. You get the picture.
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Double-check immunizations with Tdap or tetanus. If employees have previously placed current prescription medications, inhalers, and/or other medical supplies in the clinic or worksite infirmary for safekeeping, ensure they have immediate access to their personal items. You will also need on hand several copies of injury reports in case workers are injured during event response and recovery.
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Additionally, once you have taken care of physical needs, don’t forget the mental and emotional aspects of working disaster scenes. Make certain you have a good supply of mental health recommendations on hand in case referrals are needed.
HEH: In addition to the obvious moral duty, you note that there is a regulatory aspect to emergency planning as required under the OSHA General Duty Clause. Do some employee health professionals and their colleagues face resistance as they try to plan and drill for things that may not be seen as a high priority in the day-to-day operations of a hospital?
Floyd: Absolutely. In most organizations, employee health is not a profit center, or profit-generating department. But, we are still responsible for helping to maintain a safe and healthy work environment. So for the most part, we are an employee benefit. And although employees may very well be an employer’s “greatest asset,” we cannot escape the bare minimum fact that in the business world there are, as we often refer to it, “competing priorities.” For some organizations, that means, “Do we meet payroll this week, or do we purchase equipment and bulk supplies for disaster preparations — hurricane, tornado, earthquake, flood, etc.?”
Yet, under those conditions the resourceful, resilient employee health professional will often network effectively with others tasked with disaster management responsibilities, either locally or in their communities. These individuals may include internal environmental health and safety teams or with disaster response neighbors in our communities such as public health, federal agencies, employee assistance programs (EAP), and mental health entities.
Law enforcement and community agencies can also help identify organizations in the community which supply disaster recovery resources and advisement for discounted prices, and even pro bono services and supplies. More often than not, all one needs to do is look.
HEH: Can you describe a couple of strategies in creating and testing response plans? Should they be “all-hazard,” or tailored for different contingencies?
Floyd: Both are good. Remember, the key is to know what you don’t know; that’s how we learn. One strategy is to determine what risks, whether internal or external, your facility may be exposed to. Does the local fire department know where your most hazardous chemicals are stored in case they respond to a fire? There are laws requiring that they be aware. Or, do you have a team of highly trained professionals if “active shooters” or workplace violence may be a possibility? A lot depends on how you identify your risks in order to prepare a more complete and thorough plan. Another strategy is to test your response plans with local team players, corporate teams, and/or local responders. It’s great fun, and you can learn so much from your peers in the community and throughout your organization.
HEH: What are some of the worksite departments employee health should partner with in developing a disaster response program?
Floyd: A lot depends on what you currently have on hand. Is it a well-established disaster preparedness team, or are you just starting out? If you are joining a well-established team, ask a few questions to get started. What can you do to better support the team and be a resource? Develop the employee health portion of the response. If you are truly just starting out, work with your human resources person, company legal resource, and security. Find out what their response plans are and what they have available, and who they network with in the community and build on that. From there you will want to know if they participate in community drills, or establish resources such as EAP, risk management, etc.
HEH: You mention the importance of having an Emergency Response Team (ERT). What kind of preparations should a healthcare facility’s ERT have?
Floyd: A well-organized ERT will have local expertise in routine emergency first aid. I was on a team once where we contracted — for a minimal fee — with our local fire department paramedics to come out and train us on emergency procedures: bandaging, splinting, observation, evacuation, oxygen administration. It was an awesome team and our local fire department seemed to enjoy the opportunity to come to the worksite and familiarize themselves with our setup. An incredible partnership.
The ERT should also be up to date on their hepatitis B, tetanus, and seasonal flu immunizations. Beyond that, maintain current CPR and first aid certifications, and continuing education if employers are fortunate enough to have volunteer or moonlighting EMTs and firemen on their team. They often require continuing education units to recertify. So many people now work two jobs, so it’s a real treat when an employer can score an ER team member who does double duty as after-hours EMT, fire responder, or law enforcement officer.
