Evaluating Hospital Emergency Operations Plans

Carrie Kotecki
Carrie Kotecki, RN, MSN
Director of Emergency Preparedness at || carrie.kotecki@complianceonegroup.com

Carrie Kotecki has taught thousands of healthcare workers on prevention, tactics, and hands-on drill for workplace violence. She is a retired Director of Emergency Services at Bronson Healthcare Group in Kalamazoo Michigan after 38 years. 

Carrie trains nationwide on the topics of workplace violence, healthcare leadership, and frontline staff training, and performs on-site mock surveys as it relates to emergency preparedness to 1) assess the needs of a facility and 2) identify any deficiencies or areas of non-compliance with standards, codes, and laws.  

Hospital emergency operations plans can be overwhelming to produce and maintain. Not only can they be time-consuming to develop, but a challenge is to keep it user-friendly too. This resource must be simple to use to ensure its effectiveness when using it during a disaster.

Most healthcare institutions have limited resources and finances to put towards emergency preparedness plans; however, one disaster of significant impact could destroy your healthcare entity if you do not have the appropriate plans in place.

Here are a few suggestions to use to evaluate your emergency operations plans:

  1. Do you have the recommended emergency operations template for your facility that includes the CMS requirements for emergency preparedness?
  2. Do you have a current Hazardous Vulnerability Assessment (HVA) and is it reviewed/evaluated annually? Does it identify your top five risks based on your history and location?
  3. What does your communication plan entail and does it include downtime procedures?
  4. Do you have all of your response plans in an annex at the back of your emergency operations plan?
  5. Do you have designated Incident Command Staff that have received training (national recommendations) for their designated position? Do you have identified Incident Commanders?
  6. Is there a designated back up for your Incident Command Center if the primary location is compromised?
  7. Are you in compliance with the 96-hour sustainability requirement?
  8. How often do you open the Incident Command Center to ensure ease of use by the team members?

Next week, I will be sharing resources to aid in the development of emergency operations plans. In the meantime, if you would like more information regarding hospital emergency operations plans, please contact me at carrie.kotecki@complianceonegroup.com.