The concept of hospital resilience has changed in light of COVID-19. Despite planning and training for unexpected worst cast scenarios, one key assumption was not consistent with this pandemic response – that not everyone would be affected worldwide. The traditional “essential employees” changed, which left some gaps in filling the new essential roles. Preplanned mutual aid and supply chains were not able to function as planned and exercised. Some agencies focused on the roles within the Incident Command System and lost site of the principles behind it.
Hospitals had a few advantages over other responders, but new challenges as well. For example, being well trained on personal protective equipment (PPE) reduced the amount of just in time training needed for this response. Developing new critical roles, enforcing stricter visitor policies, addressing growing mental health concerns, and ensuring enough (but not too much) information sharing are just a few of the challenges hospitals planned for but did not fully grasp before experiencing this scenario firsthand.
However, the widespread response effort has provided opportunities to learn and grow the industry. Previously siloed sectors have discovered shared priorities with hospitals and other new partners. Complicated supply chains are becoming better understood by those who depend on them. Overlooked and nontraditional stakeholders are organically becoming an integral part of future planning efforts. Telehealth and other online services are expanding exponentially.
To overcome the challenges and embrace the opportunities that COVID has introduced, hospitals and other response agencies need to be flexible and address critical needs internally as well as externally with more community engagement. Effective collaboration and communication would help provide a common operating picture, build situational awareness, and maximize resources in order to recover at a faster pace. This pandemic has and will continue to provide lessons learned. With solid leadership, creative thinking, and a strategic goal, hospitals will be able to face future unexpected disasters with greater confidence in their preparedness, response, and recovery plans.
These topics and more are discussed in this DomPrep webcast.
Craig DeAtley, PA-C, is director of the Institute for Public Health Emergency Readiness at the Washington Hospital Center, the National Capital Region’s largest hospital. He also is the emergency manager for the National Rehabilitation Hospital, and co-executive director of the Center for HICS (Hospital Incident Command System) Education and Training. He previously served, for 28 years, as an associate professor of emergency medicine at The George Washington University. In addition, he has been both a volunteer paramedic with the Fairfax County (Virginia) Fire and Rescue Department and a member of the department’s Urban Search and Rescue Team. An Emergency Department PA at multiple facilities for over 40 years, he also has served, since 1991, as the assistant medical director for the Fairfax County Police Department.
Connor Scott is the acting vice president and chief of staff for security at Johns Hopkins University and Johns Hopkins Medicine in Baltimore, Maryland. He oversees security operations for Johns Hopkins Medicine hospitals and facilities in Maryland, Washington, D.C., and Florida, as well as university campus safety and security worldwide. He was Baltimore’s assistant deputy mayor for operations and deputy director of the Mayor’s Office of Emergency Management. He most recently served Baltimore City as their deputy director of operations in the Department of Transportation. He is an emergency medical technician (EMT) and firefighter.
James Terbush, M.D., MPH, currently serves on multiple boards of directors. He is the president of the El Paso County Board of Health and president of the advisory board for the Peak Military Care Network (veterans affairs). He is active in graduate medical education (Rocky Vista University, University of Colorado), teaching public health and disaster medicine. He was an advisor to the National Academy of Sciences Institute of Medicine Forum on Disaster and Public Health and was president of the American Academy of Disaster Medicine. In more than 30 years of government service, he was the physician to U.S. personnel in more than 80 countries. He is published in scientific journals on influenza and air travel, mass fatalities management, and public health consequences of a cyberattack. His final assignment before retiring from military service in 2014 was with the Science and Technology Directorate at NORAD and USNORTHCOM, where he served as the lead for medical innovations. He received his MD degree from the University of Colorado and a Master’s in Public Health from the University of California, Los Angeles.
W. Craig Vanderwagen
Rear Admiral W. Craig Vanderwagen, M.D., was appointed the Department of Health and Human Services (HHS) Assistant Secretary for Public Health Emergency Preparedness and promoted to the rank of Rear Admiral, Upper Half, U.S. Public Health Service (USPHS) in July 2006. He now serves as the Deputy Assistant Secretary for Preparedness and Response and Chief Preparedness Officer. In this position, he is the HHS Secretary's principal advisor on matters related to bioterrorism and other public health emergencies. The mission of his office is to lead the nation in preventing, responding to, and reducing the adverse health effects of public health emergencies and disasters. Admiral Vanderwagen has significant public health emergency and disaster-response experience. Most recently, he was the deputy secretary's special assistant for preparedness and led the teams that implemented the changes at HHS recommended in the White House Report Katrina Lessons Learned. He also: was the senior federal health official in the response to Hurricanes Katrina and Rita in Louisiana; led the public health team deployed on the hospital ship USNS Mercy to Indonesia to assist in the 2005 tsunami recovery; served as chief of public health for the Coalition Provisional Authority and Ministry of Health in Iraq; and directed some of the health care operations initiated to help Kosovar refugees during the 1999 Balkans conflict.