To account for Children’s Surgery Center of Malvern’s young patient pop- ulation, Smith says the ASC devel- oped a system to account for all family members in the event of an evacuation. “Patients and family members receive an identification band at check-in and are required to list the number of people with them on the day of the surgery. Our front desk is responsible for grabbing the schedule and list so we know who was likely in the building at that time.” A preparedness plan should be a

living document, Dorr says. “It is a constant work in progress based on what is going on in the world. We have a safety committee that meets monthly to examine different aspects of the plan. They are currently working on what we used to call the ‘irate patient policy.’ That is morphing into a policy for responding to a disruptive patient becoming an active shooter.” She continues, “Our governing

board reviews the plan annually and offers suggestions that our safety com- mittee takes into consideration when updating the plan.”

Test Effectiveness There is no way to accurately gauge the effectiveness of a preparedness plan unless you test it, Smith says. “Drills make you think differently about how you would respond to an emergency,” she says. “We practice at least one type of disaster drill every year, such as how to respond to an armed intruder and if a bomb threat is called in.” Dorr says her ASC also performs one disaster drill per year, noting that doing so is required by CMS. This year, at the recommendation of its con- sulting pharmacist, the ASC drilled an active shooter scenario. “The Portland Police Department came in to help us,” she says. “We learned a lot from the experience. It was very emotional for the staff because it is such a current issue. Our staff were pleased to know we were thinking

Drill Video

Watch the OA Centers for Orthopaedics in Portland, Maine, conduct a trial run of an emergency evacuation of its facility in a drill designed to respond to water, smoke and fire damage caused by malfunctioning equipment located immediately above its operating rooms at

[A preparedness plan] is a constant work in progress based on what is going on in the world. We have a safety committee that meets monthly to examine different aspects of the plan.”

—Laurie Dorr, RN, OA Centers for Orthopaedics

about such a scenario, and it got them thinking about what they would do in the event it actually happens.” To maximize the education of her

ASC’s quarterly fire drills, Smith says she tries to create different scenarios. “We have needed to come up with creative ways to get patients out of the building if they could not exit in a particular direction while making sure we have the proper supplies needed to evacuate children out of our ORs.”

Work with the Community While ASCs must know how to take care of their own staff and patients in the event of a disaster, they can also play a critical role in community assistance, Haddix says. “The fed- eral government is encouraging ASCs to determine what role they can play in assisting state agencies and other health care entities in the event of a disaster and to participate in commu- nity emergency drills.” Dorr says her ASC is part of the

Southern Maine Regional Resource Center, a group of businesses that meet regularly to hold drills. “They know about our capabilities to assist in disas- ter response, such as how many beds we can provide. There are ways we can be a valued participant in community disaster response.”

Smith says her preparedness plan identifies how the ASC could assist in a community disaster. “There are train tracks behind us. If there were an acci- dent involving mass casualties, we can triage, treat to the best of our ability and transport out. We can provide lim- ited first aid.” An ASC might encounter road-

blocks in its efforts to become more involved in community disaster response planning, Haddix notes. “It is not unusual for an ASC to be told by a health department, hospital or emer- gency management agency that its involvement is not needed.” Do not give up on your efforts to become more involved if you ini- tially fail to gain traction, she advises. “There are hospitals, emergency man- agement agencies and state depart- ments of health receiving federal grant funds to build health care coali- tions. ASCs can and should be a part of these coalitions. In fact, surveyors are asking more about ASC involve- ment in community exercises. “It is no longer acceptable for ASCs to do nothing when a disaster strikes a community, Haddix adds. “ASCs are untapped resources that are so valuable to a community response. We have seen ASCs help respond to disasters, and in those communities, they played a pivotal role.”


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