SEPTEMBER / OCTOBER 2005

FEATURE

Acibadem hospitals focus on enhancing disaster management capabilities

Around the world, HMI and its hospital partners are collaborating to raise the standards of care and help ensure patient safety and satisfaction. While these efforts are focused largely on the routine provision of care, there is increasing attention being paid to instituting emergency preparedness plans that enable hospitals to manage patient care when disaster strikes. Hospitals must be prepared not only to care for those injured by natural or man-made disasters, but also to mitigate the effects of these events on the facility itself.

Acibadem Healthcare Group, which has partnered with HMI since 2003 for a broad range of educational activities, has made significant investments in its physical plant, equipment, and human resources with this challenge in mind. The organization has assembled a high-energy emergency management committee with representation from its three acute care hospitals. In June, Kadiköy Hospital in Istanbul was the site of Acibadem’s first disaster drill to evaluate current emergency preparedness efforts.

Acibadem staff tend to “patients” during the disaster drill.

The drill was the centerpiece of a three-day HMI-Acibadem program on emergency preparedness and disaster management led by Philip Anderson, MD and Robert Freitas, MHA, both of the Division of International Disaster and Emergency Medicine in the Department of Emergency Medicine at Harvard Medical Faculty Physicians. In addition to the drill and extensive internal discussions and workshops involving the HMI faculty and Acibadem’s leadership team, the program included a symposium for the external emergency management community.

“ Acibadem’s leaders demonstrate vision and commitment to the process of emergency management. Individuals from all levels of the organization are dedicated and possess a great work ethic and enthusiasm for increasing the degree of preparation for disaster and crisis,” said Anderson, who stressed the importance of the program by adding that a single large disaster could “wipe out all that has been accomplished throughout the Acibadem system in fourteen years of hard work.”

Prior to the site visit, the HMI team collaborated with leadership at Acibadem to develop the key objectives of the program: help educate the staff in disaster management, assess the current capacity to respond to a disaster, and evaluate the disaster management plan currently in place. The disaster drill was designed to put the hospital’s existing plan and its staff to the test, and help HMI and Acibadem identify opportunities for improving the plan and enhancing the hospital’s readiness for a disaster.

In addition, the drill would help the leadership team to evaluate the communications processes associated with disaster response, including alert mechanisms, contact with outside agencies and hospital leadership, and media relations. It was also important, as the HMI faculty pointed out, to gauge the Acibadem staff’s understanding of their specific disaster management roles, and to look at the processes in place to handle triage and shifting care priorities.

A wide range of personnel from the Acibadem hospital network participated in the drill, which took place as normal hospital activities continued.

The disaster drill
The disaster scenario for the drill consisted of an earthquake occurring in the vicinity of Istanbul, with significant damage to residential and business neighborhoods surrounding the Kadiköy Hospital, but not to the hospital itself. A wide range of personnel from the Acibadem hospital network participated in the drill, which took place as normal hospital activities continued. A cast of patient actors were given detailed instructions about their roles.

Following the disaster drill, the team conducted a debriefing session with all participants. After the debriefing session, the emergency management committee met again to review the initial analysis of the drill and discuss next steps. The team gathered observations and input from all the parties involved, leading to the development of a comprehensive report and recommendations for future action.

“ This first drill was a worthwhile learning experience for all involved. It demonstrated that the Acibadem staff have many of the core clinical competencies already and primarily need to refine command, control, and communications skills,” said Anderson.

Michael Kavanagh of HMI was on hand to help coordinate the three-day program, and to observe the drill. He said, “In recent years, people in Istanbul have seen firsthand the impact that large-scale disasters can have on the health care delivery system. Acibadem’s commitment to an objective assessment of their plan and of the staff’s capabilities was clear.”

Elizabeth Brown, RN, MSN, MBA, HMI director of clinical services, added, “At HMI we have been very impressed with the way that Acibadem has driven this initiative and involved the community in order to help build the local capacity to deal with disasters.”

Practice is key
Acibadem is well positioned to move forward on improvements to its current disaster management plan and capabilities. An emergency management committee has already been organized, meets regularly, and understands the challenges. In addition, the organization’s facilities are new, allowing for the most modern technologies, building materials, and adherence to up-to-date building codes, thereby making protection of the infrastructure markedly easier.

The HMI faculty emphasized that Acibadem should conduct regular emergency management exercises in order to reinforce the necessary competencies required to perform when a real emergency strikes. “This helps improve communication, decision-making, and self-confidence for the clinicians, managers, and support personnel involved,” said Freitas, adding that the
Joint Commission on Accreditation of Healthcare Organizations requires two drills annually, one of which should be part of a community-wide exercise. Joint Commission International, the international accreditor of hospitals, is expected to strengthen its mandates regarding emergency management planning in the near future.

Copyright 2006 Harvard Medical International