The One Best Step to Mazimize Your Disaster Plan

There are as many ways to write an after actionFollowing the disaster or disaster drill, when it is
report as there are hospitals that are nowtime to perform the after action review the index
required to perform disaster drills and write aftercards will be collected and taken to the review
action reports analyzing the performance of thecommittee. The hospital now has thousands of
institution following a disaster or a disastereyes that have critiqued hospital operations.
exercise. Since there are 5,756 licensed hospitalsWhen the committee meets, they will perform
in the United States, there are 5,756 differenttheir usual analysis of those things that went well
ways that are currently employed to write theand those areas of failure. They will still perform
after action review. At most institutions, aftertheir usual root cause analysis attempting to
action reviews are written by a committeeidentify the reasons for all failures. Then they will
between 12 and 18 individuals, managers andturn to the index cards.
supervisors who in addition to their regular duties,If the committee is very, very lucky, on the
have been charged with analyzing thefront of the index cards, they will find that the
performance of their departments during anemployees saw the same successes as the
adverse event or disaster exercise.committee identified. The committee now knows,
When these individuals meet, they review thewith certainty, what items to keep as part of the
disaster plan and the performance of each divisiondisaster plan.
of the organization seeking to identify those areasIn review, those areas where the employees saw
where they enjoyed success. This list ofthe plan fail; they will find that the committee's list
successes will represent what the committee willof critical failures matches the observations of
keep as part of all future plans.those who worked during the disaster or disaster
The committee will then review performance todrill. The committee now knows that their analysis
determine where the plan failed. From this list ofis valid. They identified the same failures as the
failures, they will perform a "root cause analysis"employees.
seeking to determine why the failure occurred atIf the committee is very, very, very lucky, there
each of these critical locations. This list of failures,will be one index card that identifies the early
along with the list of root causes, will become thecritical failure that started the domino-like cascade
list of those items to be changed in the next plan.that ultimately led to the failure of the hospital's
In the last year, however, a newdisaster plan. When the committee fixes this early
recommendation for a more effective afterfailure, the hospital's disaster plan will be that much
action review process has come to light. Thecloser to a perfect plan.
recommendation does involve spending a smallUnfortunately, there are no absolutely perfect
amount of money. The one best technique fordisaster plans. However, a "near perfect" plan can
maximizing your disaster plan is to buy indexbe achieved. The "near perfect" is that disaster
cards.plan that continues to function until one second
During a disaster or a disaster exercise, everyafter the last emergency room patient resulting
individual involved in the operation of the hospital,from the disaster is moved from the emergency
regardless of their role or job, receives an indexroom gurney into a regular hospital bed. Because,
card. On the front of the index card, theseif a plan can last until one second after the last
employees will write the one thing that they sawemergency room patient resulting from that
that went extremely well during the disaster ordisaster leaves the emergency room, then the
disaster drill. On the back of the card, theseplan has lasted until recovery has begun.
employees will write the one key failure that theyTake this one best step and maximize your
saw during the course of the disaster operationdisaster plan.
or disaster exercise.