By Hayley Ross, Project Assistant

Building a Community Response to Disaster

There can be no argument that the role of a modern physician encompasses much more than patient care alone. Particularly in the years following 9/11, a new component of this role has been defined: physicians must prepare themselves and their practices to react in the event of a disaster. Practices associated with area hospitals often develop these plans in conjunction with their parent organization. For independent offices already short on time and resources, the task of planning for hazards can be daunting. Still, with planning, these practices, once prepared can serve a vital role in the community in the event of a large-scale disaster.

With this in mind, the El Paso County Medical Society contracted with the Colorado Medical Society to assist area clinics in planning for disaster. The goal of this project is twofold: by participating in this grant project, offices complete disaster planning workshops in an effort to reduce financial loss, interruption of service, and staff and patient injury in the event of a disaster. Additionally, Brian Crawford MD, Director of the Physician Disaster Preparedness Program and Charlotte Schuler RN, Program Coordinator, will assist offices in developing plans to better assist their community should a hazardous event occur.  

With the reality of limited time and resources, it may not always be feasible for a clinic to develop plans for every potential threat. In order to focus efforts, each office participating in the grant project will complete a Hazard Vulnerability Assessment (HVA). The HVA is conducted using a publicly available tool developed by Kaiser Permanente to target weak areas in disaster planning. Potential hazards are grouped into four categories:

• Natural – including tornado, snow fall, and epidemic
• Technological – including electrical failure and communications failure
• Human – including biological terrorism and mass casualty incidents
• Hazardous Materials – including chemical terrorism and internal hazardous spills

The assessment itself is straight forward. Practice managers rank the risk of a potential hazard and their preparedness for such an event on a scale from 0-3. Areas of focus include potential interruption of patient care, disaster plans already in place, and stockpiled office resources. At the end of the survey, the four categories are ranked in terms of their relative threat to the facility. The relative threat is a numerical calculation based on the risk of the occurrence of a particular event, the impact on the facility should such an even occur, and the level of preparedness with respect to this particular event category. Additionally, the tool calculates the probability of an event happening versus the severity to a medical center should a hazard occur. Each clinic is left with a tailored assessment of areas where disaster planning may best be focused.

In the process of disaster planning, the HVA is only the first step. By the end of the grant project, each participating practice manager will have completed an individual emergency operations plan (EOP). The HVA tool helps to prioritize events which are both relatively likely to occur and those with a potential to highly impact the ability of the office to care for patients and conduct business. While a perfect plan would entail detailed preparation for any potential threat, an EOP in concert with the HVA helps a practice manager to develop components of a disaster plan with the maximum benefit to the practice.

At present 10 practices in El Paso County have committed their time and resources to better anticipate hazards and to develop their role in the community in the event of a disaster. The practices are diverse in both their specialties and communities they serve. However, whether the physician sees patients for eye care or neurological concerns, in a downtown loft or a small office building, the results of the HVA are surprisingly similar. Of the seven assessments conducted at the time of this submission, four offices ranked natural hazards as a primary area for disaster planning, while six offices ranked human hazards as a primary or secondary relative threat. Additionally, the HVA overwhelmingly showed that, though a perceived risk may be low for hazards to occur, the severity of impact on a clinic is higher. This discrepancy presents an opportunity to make improvements; with increased planning and small changes, the severity of an event can be significantly reduced.

While the role of physicians in managing disaster risks may be one with which they are not well accustomed, the work of the disaster preparedness project grant demonstrates that small steps can lead to a more informed and adaptable physician community. At the end of July 2008, when the grant is completed, the participating groups will be better prepared to protect their own assets in a disaster, as well as assist others in need.

The EPCMS has been working with the El Paso County Department of Health and Environment (EPCDHE) and other city and regional agencies to assist in emergency response planning.  We are pleased to be working with the EPCDHE in bringing information to our physician community and invite you to join us for a Tabletop Presentation in July.  

Physician Disaster Preparedness Tabletop Presentation

July 19, 2008, 8:00 a.m.-12:00 noon

Colorado College, McHugh Commons

14 E. Cache La Poudre

For more information, contact Charlotte Schuler RN, at 591-2424.