Bringing the Future into the Present: Disaster Planning for the Oncology Office

Every medical practice is at risk for a natural or man-made disaster. Future events cannot be predicted, but re­sponses to such events can be. Any medical professional who has worked through a disaster can tell you either how glad they are that the practice had a disaster plan in place, or how they regret the practice was not prepared for such a risk. A serious crisis—fire, weather event, health crisis, or something else—disrupts your business. It threatens income streams, company data, jobs, personal safety, and patient care. Who do you think employees and patients will turn to in an emergency? You, the practice manager. You are the one who your team members expect to have a plan. If you have a good one, then you can help guide your company through a rough spot and get the organization back on its feet. Since you never know when a crisis may strike, the best time to prepare is now.

It is our hope that this article will serve as a guide to inspire you to start writing your plan, or to update or continue to add to the plan you have already developed. The authors will guide you through content to consider and provide checklists and tools to make preparation easier. The article will also focus on the coordination and communication necessary among staff and associates. For a jumpstart to planning, it may also be helpful to visit www.open-central.net to download a free disaster plan checklist.

Getting Started
In 2004, Florida endured 4 hurricanes in a single season, and in 2005, Hurricane Katrina resulted in the displacement of large numbers of hematology/oncology patients, as well as medical practices. A great deal of time and resources were needed to help patients locate hematology/oncology physicians for continuity of care. Some patients had treatments delayed, or did not receive their treatments at all. Unfortunately, this scenario has been repeated throughout numerous disaster events across the country since 2005.
While we cannot control or predict the future, we can plan for it, and we are even required to do so by the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Few people would argue that disaster planning is a waste of time, or that it is not important for maintaining patient safety and continuity of care. It is clearly good business practice to have a plan in place to ensure the financial stability of a practice, even—and especially—in the event of a disaster.

Although it is recognized as important, seen as a sound business practice, and even mandated by federal law, how many oncology practices make disaster planning a priority? It seems to be one of those tasks that gets pushed to the back burner in favor of more immediate, more pressing needs in the office: those with high visibility that confront us daily, those that cannot be set on a back burner. Unfortunately, when a disaster strikes and its fallout is suddenly confronting and challenging us, it is too late to come up with a viable plan to get through.

The most effective plan is developed by a team so that it does not depend solely on 1 person. It will help to designate someone as the disaster plan coordinator to lead the team. Other members to consider are the office manager, information technology manager, human resources manager, and accounts payable/bookkeeper. The makeup of your team may vary depending on the size of your practice. Regardless of the titles assumed by those staff members, you will want to make sure that attention is given to the specific tasks discussed below.

The disaster plan coordinator will lead the team. Determine that person’s responsibilities, including oversight, to ensure each of the other team members maintains his or her assignments. Better yet, determine responsibilities with the person to gain buy-in and ownership in developing the plan. Then assign a backup disaster plan coordinator so that not everything is lost if the coordinator becomes unavailable in the event of an emergency.

Before Disaster Hits
Below is an outline to guide your planning. Do not let the 10 steps overwhelm you, as you do not need to do them all at once or in order. Pick and choose where to start, divide them among staff and do some simultaneously, or commit to a set number of hours you will work on the plan each week. Before you know it, you will be checking tasks off your list and feeling good about it.

Ten steps to take before disaster strikes:

1. Collect and organize emergency supplies (Table).

2. Maintain hard copy and electronic lists of important contact information. Keep copies in a secure place offsite. Lists may include business contacts such as your bank, chemotherapy supplier, biohazard waste disposal agency, office supplier, certified public accountant, or attorney. Include the name of the contact person, alternate contact person, product/service, telephone number, fax number, e-mail address. The list should also comprise staff, including name, job description, home address, home telephone number, cell phone number, alternate telephone number, e-mail address, alternate e-mail address, emergency contact person, evacuation zone, initial notification, and subsequent notification.


Table

3. Video and/or photograph your offices, equipment, and furniture inventory. Update it annually, and prior to any anticipated disaster (those with a 24-hour warning or more). Maintain copies both onsite and offsite.

4. Back up computer files on a regular basis (ie, financial records, patient clinical records, patient demographic information, business and staff contact information, insurance documents, and accounts payable records). Maintain them onsite and offsite.

5. Prepare a script for your office telephone “on hold” message. This can be e-mailed or faxed to a vendor that can update the script for incoming phone calls as needed.

6. Establish a central phone number for patients to call, as well as an alternate phone number offsite.

7. Identify alternate physicians and hospitals for patient referral in the event of a disaster (ie, contact county, state, and national medical societies for recommendations on who to include).

8. Determine availability and ability to administer vaccinations for diseases such as polio, tetanus, hepatitis B, and hepatitis C.

9. Train staff. Once you have a written plan, keep a copy of it in a specific place in your office, as well as an electronic copy that is accessible through your website. Then, most importantly, make the plan available to all staff members. Conduct training to ensure everyone knows their roles and responsibilities in the event of a disaster. If appropriate, create an organization chart to show the chain of command in the event of a disaster. Update it annually through orientations, training sessions, and/or emergency drills. The executive director of the practice should review and document the training at least once a year to ensure the plan is current and updated as needed.

10. Enroll in the Oncology Patient Emergency Network (OPEN) to ensure continuity of patient care.

These are 10 valuable steps to take to prepare for a potential disaster. Remember to involve staff in preparations and preparedness. Keeping team members informed will facilitate efforts should a disaster strike. The first in a 2-part series, this article has addressed the importance of disaster planning and how to work with staff members to begin developing a disaster plan.
Watch for the final article in this series, which provides guidance on how to engage patients, with an emphasis on patients sharing responsibility for their care. It will also address what to do when a disaster is imminent and when a disaster strikes.

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