"All Hazards" - More than Disaster Preparedness

In the years since 9/11, those in disaster planning,concentration on terrorism and disaster
preparation, education, response and recoverypreparedness.
have concentrated all their effort on convincingThere are a number of advantages to this
private healthcare corporations and non-healthcareexpanded "All Hazards" approach to safety,
corporations alike to adopt an all hazards approachplanning and preparedness. The greatest of these
to adversity and disaster.is the integration of patient safety initiatives and
Perhaps because 9/11 and anthrax were thedisaster preparedness training allowing healthcare
impetus for the funding of this push, corporateprofessionals to practice disaster preparation skills
America has associated this large expense withas part of their daily routine. This has applications
what they believe to be an unlikely threat,in team building, triage, safety reviews, command
terrorism. The 2004 - 2005 hurricane seasonsstructures, patient throughput and literally every
gave the southeastern regions of the Unitedaspect of hospital operations.
States a clear focus for disaster preparedness inThe implications go far beyond the immediate
the forms of hurricanes Charlie, Francis, Ivan,process improvements that come from an "All
Jeanne, Katrina, Rita and Wilma. Unfortunately withHazards" training program. The mind set that is
this focus came a tendency to prepare forinstilled in those trained in an "All Hazards"
hurricanes, certainly not an all hazards approach.approach to daily operations lends to innovations in
The simple fact missed by all but a very few inoperational processes and streamlining of
the disaster community and even fewer in thepreviously entrenched systems.
disaster planning, preparation, education, response"All Hazards" training also creates the "common
and recovery industry is that the word "disaster"safety investment" that the To Err is Human
does not belong in the title. We are not astates is missing from healthcare, but common to
"disaster" community, nor are we in the "disaster"such industries as air travel and railroads (pilots
planning, preparation, education and recoveryand engineers share the same "safety
industry; rather we are the "All Hazards" planning,investment" as passengers). Those who have
preparation, education and recovery community.received "All Hazards" training come to understand
Before you assume this is simply a matter ofand internalize that reality that any risk that exists
semantics, think about what we seek tofor a patient exists for the healthcare professional
accomplish. Our "All Hazards" community does notas well.
just seek to prepare for the possible of aFinally, recognizing patient safety issues and all the
terrorist attack or a natural disaster, we seek toother safety issues in healthcare as hazards under
fundamentally change attitudes and behaviors soan "All Hazards" approach will result in better
that when adversity strikes or disaster loomssuccess in achieving both sets of goals. Patient
large on the horizon, our citizens, our communitiessafety initiatives celebrate their seventh
and our infrastructure are prepared. Our true goalanniversary this year, but even the CEO of the
is to never again see a line at Home Depot or theJoint Commission for the Accreditation of
grocery store the day before or the day after aHealthcare Organizations (JCAHO) admits that
disaster.medication error and wrong site surgery have
This is not a new concept. The practice ofgrown exponentially in that time. Despite a
vulnerability analysis and risk assessment is wellvirtually limitless budget and the best efforts of
established in many safety sensitive industries andthe best minds in patient safety, healthcare has
in the military. The Institutes of Medicine firstnot gotten better, it has gotten more dangerous.
applied this practice to the healthcare industry inAt the same time, the past five years has seen
the 1999 To Err Is Human report. Far from ahospital and healthcare disaster preparedness
treatise on disaster preparation, To Err is Humanchange only marginally. The 2006 Institute of
was the warning siren that brought the issues ofMedicine reports severely criticizes healthcare for
patient safety and medication errors to the publicfailing to invest in "All Hazards" preparedness
forum.despite the fact that it has been proven effective
Although voluminous, the main thrust of To Err isnot only in increasing security, but increasing surge
Human was to review the lack of reportingcapacity, safety and efficiency. For "All Hazards"
systems and fail safes in the healthcare systempreparedness, the problem is not having the
as a whole and to correlate the current state ofbudget to apply a proven and effective solution.
safety in healthcare to that of other industries. ToDealing with patient risks, medication errors and
Err is Human goes to great lengths to detailsurgical mishaps as another category of hazards
"public-private" safety efforts, but overall theunder an all encompassing "All Hazards" approach
report proposes the groundwork and apromises to solve the problems for both
justification for governmental intervention andprograms. Patient safety will benefit from the
federal regulation of healthcare safety and byproven efficacy of an "All Hazards" approach
implication, healthcare quality/certification.designed specifically to mitigate multifactorial risk
If this sounds a lot like the trio of 2006 Institutewhile "All Hazards" training programs will finally
of Medicine reports on the state of Emergencyhave the budget priority and funding needed to
Medicine and disaster preparedness, it is veryensure system wide implementation.
similar. The 2006 reports when combined with theThe only question remaining is whether those who
1999 To Err is Human report demonstrate thehave made their careers in patient safety as it
similarity between community wide disasters andhas been practiced for the past seven years are
patient centered disasters. A true "All Hazards"prepared to adopt a broader view of the world
approach to preparedness thus should includeand whether the "All Hazards" community is ready
patient safety, medication safety, fire safety andto be truly "All Hazards" in their approach.
personal safety in addition to the current