Hospitals are required by The Joint Commission to monitor performance and evaluate each exercise or actual event using a multidisciplinary process that involves licensed independent practitioners. During an exercise, individuals are to be designated to observe performance and document opportunities for improvement.
The Homeland Security Exercise and Evaluation Program (HSEEP)is a capabilities and performance-based exercise program which provides a standardized policy, methodology, and terminology for exercise design, development, conduct, evaluation, and improvement planning.
The EMTALA requirement is based on federal law and cannot be waived by the Governor. However, the Governor may request that the Health and Human Services Secretary waive the EMTALA requirements under 42 USC Section 1320b-5.
Federal statutes and regulations cannot be waived or suspended by the Governor. However, during a catastrophic disaster, the Governor may make a request to the federal Secretary of Health and Human Services requesting waiver of specific federal statutes and regulations. The following provisions could be waived.
The Recovery phase begins when hospital incident command determines that the event is de-escalating or over and that some or all de-mobilization and recovery activities can be initiated.
The After Action Report (AAR) captures observations of an exercise and makes recommendations for post-exercise improvements. The AAR then is used to develop Improvement Plans (IP). HSEEP AAR examples can be found on the HSEEP website.
The Emergency Management Program (EMP) implements the mission, vision, goals and objectives of the organization as related to Emergency Management. The EMP utilizes organized analysis, planning, decision making and assignment of available resources to mitigate, prepare for, respond to, and recover from all-hazards. (Emergency Management Principals and Practices for Healthcare Systems, Department of Veterans Affairs, 2006).
AHRQ has released a model to help federal, state, and local emergency planners estimate the vehicles, drivers, road capacity and other resources they will need to evacuate patients and others from health care facilities in disaster areas.
This guide is designed to help organize the initial assessment of a hospital upon return after an evacuation/closure due to an emergency event. The specific assessments are meant to be conducted by hospital staff to assess the level and locations of damage sustained by the hospital, and provide information that will be needed to create the full recovery plan. This guide will be particularly useful for assessing a hospital that has sustained significant or widespread damage.
This Hospital Evacuation Decision Guide was developed by AHRQ, the lead Federal agency charged with supporting research designed to improve the quality of health care, reduce its cost, address patient safety and medical errors, and broaden access to essential services.