The emergency management of hospitals is a unique area of specialization within the broader field of emergency management. However, there have been no uniform guidelines established that spell out the specific skills and/or level of education that hospital emergency managers should possess. This deficiency has led not only to the growth of a broad spectrum of disparate capabilities possessed by the nation’s hospital emergency managers but also to considerable confusion and misunderstanding in an era during which uniformity of both knowledge and practice is essential.
In early 2005, the Division of Public Health (DPH) of the Georgia Department of Human Resources set out to create a standardized curriculum for hospital emergency managers. An advisory committee, which included representatives from public health and academia as well as both seasoned and newly assigned hospital emergency managers, was established. The group outlined what its members considered to be the most critical and highest-priority tasks that should be included in the curriculum, and also established the criteria needed for certification as a Hospital Emergency Coordinator – a distinction previously unavailable.
Nine critical areas of study also were identified. They included such interrelated topics as: emergency operations plans (EOPs); overviews of the National Incident Management System (NIMS), the Incident Command System (ICS) and the Hospital Incident Command System (HICS); emergency preparedness training, drills, and exercises; the coordination and integration of disaster plans, hazard vulnerability analyses, regulations, and standards; disaster life support training; and surge capacity. In addition, twenty-seven other high-priority tasks were identified as areas recommended for study. These included such important but ancillary subjects as: budgets and grants; staff and facility safety; administrative support; alert procedures, and the development of external relationships.
Fast Action to Meet an Urgent Need
A development and training grant later was awarded to the Medical College of Georgia (MCG), and the coursework and manuals were completed in late 2007. In January of this year, the course was unveiled in Macon, Georgia, and discussed with an audience that included an estimated 25 percent or so of all of Georgia’s hospital emergency coordinators. (Additional courses are being taught at various venues throughout the state to facilitate attendance by all of Georgia’s hospital emergency coordinators.)
The coursework for certification is divided between room and on-line studies, and includes a mix of previously existing and newly developed courses. It is distinct from, but may serve as a valuable adjunct to, widely available CEM (Certified Emergency Manager) programs of study – but can be pursued independently of the CEM programs. Participants have the opportunity to attain three levels of certification. The only prerequisites needed to begin the certification process are: (a) approval by the Georgia DPH; and (b) completion of the IS 100.HC course or its equivalent – available online through the Federal Emergency Management Agency (FEMA).
When these prerequisites have been met, the student is eligible to enroll in the Certified Hospital Emergency Coordinator (CHEC) Basic Course, which is managed by MCG (with assistance provided by the DPH). Following successful completion of the CHEC Basic Course and the requisite ICS, NIMS, and HICS courses, the student is eligible for CHEC Level I Certification.
Taking It to a Higher Level
If the CHEC student wants to pursue a higher level of certification, he or she may subsequently complete the CHEC Level II course, which is heavily focused on the Emergency Operations Plan and drills and exercises. This room-based interactive course also is managed and taught by MCG, with assistance from the DPH. The prerequisite for enrolling in this course is IS 235 Emergency Planning, also available from FEMA. CHEC Level II certification is available after the student has successfully completed the Level II course.
The final certification is Level III. To be eligible for this advanced certification, the applicant must have at least 12 months of cumulative “on-the-job” hospital emergency manager/coordinator experience. He or she also must have met the requirements specified for the Level I and II certifications, and to have completed the following additional coursework (sponsored by the National Disaster Life Support Foundation): Basic Disaster Life Support (BDLS); Advanced Disaster Life Support (ADLS); and National Disaster Life Support – Decontamination.
The Georgia CHEC training program is the first of its kind, and may serve as a model for similar programs in other states as the nation’s overall preparedness efforts move forward. The coursework mentioned above continues to be updated and could be easily adopted by other states (and/or cities in major metropolitan areas). The key point to remember is that the overarching goal of the program is to develop and ensure the uniformity of the knowledge base and skills required in the training of hospital emergency management professionals. Thanks to the initial and, it is confidently assumed, probable continued success in Georgia, it seems very likely that similar programs will soon be developed and required by Georgia’s sister states throughout the country.
For additional information On the MCG course: please visit www.mcgcom.com and click on the Office of Public Health and Hospital Emergency Management link; On the FEMA coursework available: click on www.training.fema.gov.
Gina Piazza, DO, FACEP, is an assistant professor of emergency medicine at the Medical College of Georgia in Augusta. She also serves as the medical director of operational medicine within the college's Center of Operational Medicine. Previously, she served as the medical director of public health, safety, and wellness for the Erie County Department of Health in Buffalo, N.Y. She is board-certified in emergency medicine and fellowship-trained in emergency medicine services and disaster medicine.