This project explores emergency management and preparedness in nursing homes, assisted living facilities, and hospice — using interactive, nonlinear stories to understand the past and prepare for the future.
Purpose.
The conditions of a declared emergency, which require either sheltering in place or evacuation, call for additional preparation. This is especially true for skilled nursing facilities that serve patients in hospice care. The attention to the failures in Hurricane Katrina initiated a nationwide discussion on preparedness, sheltering, and evacuation in healthcare facilities. On November 2017 the Center for Medicare and Medicaid Services (CMS) enacted the Emergency Preparedness Rule for healthcare facilities.
Method.
This study begins by presenting background information on healthcare facilities providing hospice care and their response to emergencies and disasters. In summary, we offer findings, based on case studies, and the primary and secondary research questions.
Results.
Ensuring continuity of care and reducing risks to patients in skilled nursing facilities offering hospice care begins in steady state. It requires cooperation and commitments. Most importantly, it requires that these facilities have a plan that is well-understood, well-resourced, well-rehearsed. Once established, emergency plans need updating based on changed conditions and observations from exercises and surveys.
Discussion.
Incorporating elements of the plan into everyday operations is the best predictor of success, a seamless transition to disaster operations. The entire community must be included in the dialogue; patients, families, staff, administrators, insurance providers, emergency management officials, and police, fire, and EMS. The effort needs to be both comprehensive and continuous; woven into the entire community’s organizational framework.
Intention is to examine these 2 questions:
1. Have skilled nursing facilities (SNF) achieved the Centers for Medicare & Medicaid Services (CMS) preparedness goals of increasing patient safety and establishing more coordinated responses to declared emergencies in skilled nursing facilities (SNF) providing hospice care?
2. When faced with a declared emergency, what actions do care providers and administrators of skilled nursing facilities (SNF), together with local emergency managers, need to take to assure continuity of care for patients in hospice?
This will be accomplished by addressing the following 5 points via interactive, non-linear stories based on real-world events.
1) Decision support criteria and decision points.
2) Situational awareness and adequately heeding warnings.
3) Exercising preparedness plans and conducting individual and collective training.
4) Ethical obligations and "duty to prepare" when charged with safeguarding the lives of those in need.
5) Communications and the understanding of preparedness policies, plans, and procedures.