Center for Improvement in Healthcare Quality Newsletter
November 2021

CIHQ-ARS Blog

Things to Consider After a Disaster

By: Don Roush
If you are involved in an actual disaster, recovery from the disaster may feel like an overwhelming task. Have you taken the time to look back over all the damage that your hospital experienced from water, fire, smoke, or wind? In many situations, water may have been present in the hospital for an extended period, or the facility experienced some form of structural damage both internally and externally. These conditions most likely will translate into equipment and supplies becoming contaminated and requiring some form of clean-up procedure.
Emergency planning considers many things that could adversely affect hospital operations. What is not often realized during these discussions is that disasters do not mysteriously appear and disappear. What is unique about them is that through your planning and training you can establish strategies to mitigate potential disasters, respond to them and finally, how to recover from them. However, when you are dealing with the recovery phase of a disaster, you may soon realize that recovering from a disaster can be more challenging than the disaster itself.
Throughout a natural disaster, hospitals may experience a myriad of damages, including water and wind damage. Flooding that has occurred can lead to standing water being present for a long period of time. The standing water can affect the integrity of the building structure, contaminate patient care and hospital equipment, or severely damage building operating systems such as electrical transformers and other electric components. Before reopening or continuing operations of the hospital, you must first assess the damage and determine if it can be restored, repaired, or placed out of service. Once the decision is made to repair and reoccupy the areas affected by the disaster, determine what structural damage must be repaired and what materials and equipment are salvageable. Reusable equipment must be gone through and disinfected before use. The restoration of a hospital to full function is a complex, multidisciplinary task, and the assistance of engineers, professionals trained in building remediation, and manufacturers of healthcare equipment will likely be necessary to complete the job.
When working through the recovery phase of reopening operations of your hospital, the following information can assist you in this effort. By considering these processes, you will be better prepared to comply with state and local certification requirements, and successfully meet the terms of building and fire inspection(s) along with other relevant state and local regulations.
First, and foremost, you must be conscious of the safety of personnel involved in the disaster relief and cleanup. They need to be protected from infectious diseases, electrical shock, exposure to hazardous chemicals, radiation, and potential for fire hazards. Building integrity must be assessed. Essentially, the hospital must first undergo a building and life safety evaluation to determine if the structure is safe to enter and if there is sufficient safe electrical power to assist clean-up operations. Once it has been determined that the hospital is safe to continue recovery efforts, a plan needs to be developed to guide the process. For example; if the hospital has sustained significant damage from water you will need to consider the following:
  • Ascertain that the hospital has working electrical, sewage and water systems
  • Fire protective systems within the hospital must be evaluated and repaired if needed. A local fire department should be consulted if fire safety systems cannot be fully restored prior to beginning remediation work
  • Certify that HVAC systems are operational and can maintain sufficient ventilation
  • Establish how to remove contaminated or damaged items such as walls, ceiling, insulation, furniture, and carpets
Unfortunately, this is just the beginning of recovering from water, fire, smoke, or wind damage. If your hospital has experienced such an event, additional assessments should be conducted before resuming normal operations. One of the primary assessments is to determine if the clean-up can be accomplished by hospital staff or if you will need outside assistance. For instance, mold remediation or structural repairs may require specialty companies. Such companies have extensive experience in dealing with water damage, remediation, and recovery work. This needs to be accomplished by professionally trained staff that can safely restore the areas.
What you need to be aware of is that the recovery phase will begin immediately after the threat to human life has subsided. Your objective is to restore a form of normalcy back to the organization. Recovery efforts will continue until all phases of the recovery have been completed. Periodic inspection of the remediated structure will be necessary to identify mold growth and initiate removal and control measures. Also, clinical and laboratory-based surveillances of your hospital for unusual groups of infectious diseases due to pathogens in the environment will also be essential. This mitigation effort will reduce loss of life and property and lessen the impact of the disaster.
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