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• Focus your efforts on a general "all-hazards" plan that provides an adaptable framework for crisis situations. The terrorist attacks have revealed that the unimaginable can become reality.
• Upgrade your disaster plan. The attacks have dramatically altered the potential range of disasters communities may face. Be sure that your plan includes components for mass-casualty terrorism, including the potential for chemical or biological incidents.
• Connect with your community’s emergency response agencies. This is a good time to integrate your plan with your community’s rescue squad and police and fire departments. Specifically, make sure you have the latest contact numbers for key agencies, and that they, in turn, have an up-to-date list of your hospital’s key contacts.
• Develop a plan to support the families of staff members. Staff members want and need assurances that their families are protected and cared for, especially if the incident involves chemical or biological exposure. This is likely to involve agencies and resources from the broader community.
• Develop a simplified patient registration procedure in the event of a very large number of casualties.
• Review your backup communications capabilities. Traditional telecommunications mechanisms can become overwhelmed. Pay special attention to backup communications mechanisms, such as Internet-based communication tools and even couriers.
• Ensure that essential hospital information systems and data storage have off-site storage and recovery capabilities. In the event of a large-scale incident, you may have to rely on resources outside your own community.
• Be prepared to talk with your community and its leaders, lawmakers, and others about how your hospital would deal with a mass-casualty event, especially an incident with large numbers of survivors. Also be prepared to provide a medical advisory to the mayor and other public officials who may be the primary focus of the media.
• Review your supply and inventory strategy. Many hospitals have moved to "just-in-time" supply schedules, which keep enough supplies on hand to care for expected patients. While state and federal resources will become available, communities may be on their own for at least 24-48 hours. Include the possibility that traditional transportation systems could be disabled.
• With the nation on heightened alert, examine how to protect the physical security of your hospital by limiting access to the facility.
• If your hospital is part of the National Disaster Medical System, review who the contact is within your organization, and who the federal coordinator is in your area. If located in an urban area, determine if there is a Metropolitan Medical Response System (MMRS) plan in your community and know how it can complement the hospital’s own plan.
• Ensure that the hospital and its medical staff report unexpected illness patterns to the public health department and, if appropriate, the Centers for Disease Control and Prevention.
• Finally, with the armed services calling up reserves and the possibility that Department of Health and Human Services’ Office of Emergency Preparedness may need to call up response teams (Disaster Medical Assistance Teams, Disaster Mortuary Team, and MMRS), take time to inventory who on your staff, including medical staff, could get called, what your policies are for job retention and benefit continuation, and how activation might affect your operations.
Source: Disaster Readiness Advisory, Sept. 21, 2001, American Hospital Association, Washington, DC.