Environmental Emergency Preparedness for Healthcare Practices

October 11, 2022

Reading time: 5 minutes

Environmental emergencies — such as tornadoes, hurricanes, floods, blizzards, fires, chemical spills, radiation exposure, etc. — can have short-term or long-term consequences that might range from minor issues or disturbances to severe damage.

For healthcare practices, preparation and planning are essential components of emergency preparedness, and these activities should take into account what steps should take place if an environmental disaster compromises staff, infrastructure, or technology.

Major areas of consideration in contingency planning include communication, utilities, technology, emergency equipment/supplies, sheltering/evacuation, and relocation. This checklist includes fundamental questions in each of these categories and is intended to help healthcare practices develop, evaluate, or update emergency response plans.

Has your practice identified primary and secondary methods for communicating with staff and patients during an environmental emergency (e.g., phone, email, text, website, social media, etc.)?
Does your communication plan take into account potential loss of critical services, such as internet or phone service?
Does your emergency response plan specify who is responsible for internal and external communication activities, and are staff members aware of their responsibilities and the steps they should take?
Does your practice post and maintain:
  • An up-to-date staff contact list with home, mobile, and emergency contact information for all personnel? 
  • A current list of local and regional emergency contacts (e.g., the local fire department, hospital, and emergency management agency)?
Are contact lists maintained onsite and offsite?
Does your practice have a dedicated emergency phone number and/or an emergency email account?
Does your practice have contingency plans for managing loss of power and other utilities?
Does your office have emergency lighting that will activate during a power outage, or does the office have ample natural light to ensure visibility during an outage?
Does your practice have an emergency generator to supply power during outages?
Is the generator located in the safest area possible (e.g., a cool, dry location that won’t be at risk for flooding)?
Will your emergency generator power all of your systems or only critical systems?
Have you identified which systems should remain available during a power outage?
If applicable, does your practice have a protocol for the transfer, handling, and storage of products that require cold storage if emergency backup systems cannot maintain them?
Do you have protocols for managing other types of utility failures or hazards, such as natural gas leaks, sewage backups, loss of heating or air-conditioning, and water contamination?
Does your emergency response plan stipulate the need to document all actions taken in relation to utility failures, including notification times, who was contacted, and response times?
Has your practice developed protocols for managing computer system failures, loss of internet connectivity, and loss of phone services?
Has your practice assessed all of its information technology (IT) applications, services, and data to identify the most critical?
Is onsite IT equipment (e.g., servers, laptops, etc.) kept in the safest place possible within your practice?
Are safeguards, such as surge protectors, in place to maintain and/or protect critical systems?
Is a contingency plan in place for the continued provision of care, even if IT systems (such as electronic health records) are not available?
Does your practice have a protocol for shutting down all systems or moving IT equipment offsite prior to an impending disaster?
Does your practice consistently and frequently back up its data?
Is backup data stored offsite or in multiple locations to prevent loss or destruction if the office is damaged?
Does your practice maintain documentation for critical IT hardware and software (e.g., serial numbers, versions/models, lease information, suppliers, etc.)?
Do your practice’s IT vendors have emergency response plans? Do they offer emergency services as part of their contracts?
Emergency Equipment and SuppliesYesNo
Have you considered the types of emergency equipment and supplies your practice should maintain based on the most probable emergency scenarios?
Does your practice have basic emergency supplies onsite, such as weather-related supplies (e.g., salt or sandbags), basic tools, flashlights, a first aid kit, fire extinguishers, a portable radio, extra batteries, water, and nonperishable food?
Does your office have working fire alarms and an automatic sprinkler system?
Does your emergency response plan specify the need for periodic auditing of emergency supplies and routine testing of emergency equipment?
Does your practice have clear policies for sheltering in place or evacuation based on the type of emergency?                                                        
Have you identified a safe location to shelter in place? (Note: The safest place to seek shelter may vary based on the type of emergency.)
Is clear signage in place to indicate the shelter location and all available routes to the location, including preferable routes for people who have limited mobility?
Is the shelter location conducive to communication (e.g., can you get television, radio, and/or internet reception?)
Is the shelter stocked with adequate emergency supplies, water, and food? (Note: The Federal Emergency Management Agency recommends planning for at least 3 days.)
Have you considered your facility’s layout and accessibility when planning evacuation routes?
Has a location been identified where evacuees should congregate for safety and a head count?
Are emergency exit routes posted in visible locations throughout the practice? Do exit signs clearly indicate evacuation routes?
Are staff members familiar with emergency exits and evacuation routes so they can direct patients and visitors?
Does your practice have a contingency plan for relocating if the office is damaged or inaccessible?
Does the plan specify what equipment, records, and files need to be moved, how they will be transported, and who is responsible for moving them?
Does the practice have a secondary mailing address and contact information?
Is a protocol in place for communicating information about the relocation to staff and patients?


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This document should not be construed as medical or legal advice and should not be construed as rules or establishing a standard of care. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may differ, please contact your attorney or other professional advisors if you have any questions related to your legal or medical obligations or rights, state or federal laws, contract interpretation, or other legal questions.

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