Healthcare service continuity

Blackout taken place in Fundación Jimenez Diaz hospital , last 16th of October in Madrid is a good example to realize that there is not necessary great disasters or disruption  to activate Business Continuity Plans.
Although we have not too much information about this incident, it can be clearely indenfied two tradicional continuity measures:

• Power generators activation, to support critical systems
• Redirection of new admissions to other hospitals, in this case the Hospital Clínico.

When we are talking about a hospital, such as I discuss in my previous post components supporting business, this service is so critical that  availability of all components supporting the service has to be granted, that is, facilities, suppliers, medical staff or information technology. Impact caused by lack of service is simply unaffordable because the life of patients is in play.

However, the incident occurred in Jimenez Diaz Hospital must make us think about if our health system is really prepared for emergency situation or disasters when hospitals are affected. 2004 terrorist attacks in Madrid realized that the emergency agency are prepared to deal with such a great disaster, but What would happen if the own hospitals were affected by the disaster?

In a hospital there are a lot of diverse healthcare services, with different criticalities: emergencies, maternity, hospitalization, operating rooms, doctor appointments, radiology,.... Strategies must be different depending on this criticality. For example, a pediatric appointment could be delayed or redirected to other hospital, but a serious patient that has to go through surgery or with dependation of ventilation can no be unattended and any delay can be fatal.

Having a look abroad, for example to United States, hospitals has a global framework since lasts 80s, called HICS (Hospital Incident Command System). This framework identifies different issues to be taken into account to assure healthcare service. HICS was born as a emergency specific framework (HEICS), but it nowadays is a system for use in both emergency and non-emergency situations. George W Bush govern created in 2003 a global framework to manage incidentes (NICS) and this caused a new revision or HICS which is the last version (version V).

About content, HICS identifies five management functions hat has to be defined in the hospital to manage incidentes:

• Incident Command, set by different responsibles of safety, liaison and public information officers and the global responsible
• Operations section concuct ths tactical operations.
• Logistics Section: provides required resources to achived operational objectives.
• Planning Section: Collects information about the incident, maintain resource status and infomration for reports and prepares documents, such as incident plan.
• Finance and Administration Section: Monitors costs related to the incident and provides accounting, procurement, time recording, and cost analyses

The most important advantange of HICS is provides a common terminology and position titles to enhance standardization among agencies and responders

In Spain, with healthcare service tranferred to Autonomous Comunities and with the actual economic crisis it seems that this kind of initiatives are not a priority, altough from my point of view is an interesting tasks for CNPIC. At the end of the day hospitals should be considered critical infrastructure.