Time and time again natural and man-made disasters are affecting hospitals and laboratories throughout the country. In just the past few years news headlines have been littered with tragic hospital scenarios. Some examples include Superstorm Sandy in New York City, devastating tornadoes in Tuscaloosa, Alabama and Joplin, Missouri, a major flood in Cedar Rapids, Iowa, and damaging hurricanes such as Charley in Florida, and Katrina in Louisiana. Each of these calamities created multiple challenges for the laboratories affected. The development and use of their emergency management plans played a critical role in how those labs navigated successfully through those disasters.

Creating or revising a comprehensive laboratory emergency management plan is a multi-step process, but a necessary one. Avoid creating separate disaster plans for every possible type of situation as that can be very difficult to create and maintain, and it will be difficult for lab staff to grasp quickly. Include all areas of the laboratory when developing the plan, and communicate it with other areas in the hospital so that disaster facility coordination can be achieved. Obtain approval of the lab plan from the facility emergency management committee if applicable.

In December of 2013, the Centers for Medicare & Medicaid Services (CMS) put forth a proposed rule on emergency preparedness planning that will affect how patient care facilities will handle disaster management. The proposed rule contains four essential elements:

  • Risk Assessment: The facility must conduct a risk assessment to determine its capabilities during a full spectrum of emergencies or disasters.
  • Policies/Procedures: The facility must develop and implement policies and procedures based on the risk assessment and emergency operations plan.
  • Communication: The facility must develop and utilize a comprehensive communications plan in order to preserve patient and staff safety in an emergency situation.
  • Training/Testing: The facility must develop an emergency operations training plan for all employees and establish a testing process for the plan as well. Initial and annual training should occur as well as drills and exercises.

These elements are beneficial for creating a process laboratories can use to develop an updated emergency operations and evacuation plan.

Once the lab emergency operations procedure is complete, it is important to test the plan for flaws or needed improvements. One thorough method of testing includes the use of a table-top drill or exercise. Present a step-wise disaster scenario to key lab stakeholders and discuss possible responses as the imagined situation unfolds. Be sure to discuss items such as staffing, supplies, communications, and relocation of testing.

In most parts of the country, a wide variety of realistic disaster scenarios can occur which will have a direct impact on laboratory operations. Is your emergency operations plan up to date? Does your staff know how to use it? Has it been tested? If not, it is time to begin the process of establishing that comprehensive plan for the benefit of your lab, the lab staff, and the patients served.

1. CMS Proposed rule: http://www.gpo.gov/fdsys/pkg/FR-2013-12-27/pdf/2013-30724.pdf
2. Examples of table-top disaster exercises: http://www.fema.gov/emergency-planning-exercises