¶ … Operations Outline the major risks associated with maintaining continuity of operations in the event of an environmental catastrophe.

The Chief Operating Officer

Berwick Hospital System

Risks Linked to Environmental Disaster

The Berwick Hospital System identified some susceptibilities common to hospitals in Louisiana that experienced the Rita and Katrina calamities. For minimizing the harm, we may suffer in case an environmental disaster strikes, I have encapsulated within this memo a few potential risks linked to environmental calamities, and an operations continuity plan for coping with such a situation.

The Berwick Hospital System represents a healthcare facility/hospital situated in Illinois State's downtown Chicago area. The main division of the organization comprises of medical labs, 5 operation theatres, and 673 hospital beds. The campus also holds seven smaller satellite structures, which include the nursing home, outpatient doctors' offices for outpatient access/visits and hospice.

Federal Emergency Management Agency (FEMA) defines an emergency as any unplanned occurrence that may lead to major injuries or deaths of customers, employees, or the general public; or, is capable of shutting down the organization, damaging the organizational environment or physical assets, disrupting operations, or threatening its public image or financial standing. Prior to preparing an operations continuity plan, we are expected examine the possibilities and kinds of environmental disasters that are likely to occur in Chicago city. While the mayor has recently warned us that the nearby elevated train station was discovered to be targeted by a thwarted plot of foreign terrorists to set off large explosives, the far more likely occurrences in Chicago are environmental disasters.

The list of potential natural hazards/vulnerabilities in Illinois State includes severe storm, harsh winter storm, flood, tornado, earthquake, drought, and extreme heat. This list does not cover calamities like terror attacks and crime. When formulating an operations continuity plan for the hospital system, both external and internal resources have to be taken into account for possible vulnerabilities. IEMA (Illinois Emergency Management Agency) has carried out a research for likely emergencies in the State and rated them based on levels of caution (IEMA, 2016).

Illinois Hazard Rating [3]

-- Severe Storms -- Floods -- Severe Winter -- Drought -- Extreme Heat -- Earth Quake -- Tornado -- Terrorist Attack -- -- -- -- Storms -- -- -- -- -- --

Severe -- High -- Severe -- Guarded -- High -- Guarded -- High -- Elevated -- -- Key -- Low

0-12 -- Guarded

13-24 -- Elevated

25-36 -- High

37-48 -- Severe

49-60 -- --

I recommend giving exclusive attention to every potential hazard that is rated above the elevated range, in our operations continuity plan's first tier, with detailed steps and increased cautions. Then, we ought to include the other potential threats, rated between "Low" and "Guarded" levels, for which moderate precautions will be required.

From the capacity of the hospital, we must expect the hospital system to host population groups such as infirm, aged, limited mobility, and special needs populations, within the hospice and nursing home. These patients might be vulnerable to greater risks in the impending introduction or presence of environmental threat. Based on the catastrophic event encountered, we might also face disease agents that can compound through extensive transmission (e.g., contamination of water supply due to floods). In times of emergency, increased traffic in emergency and outpatient departments is highly likely.

Outline of the Basics of a Continuity Plan to Cope with Such a Scenario

Business continuity represents a practice of sustaining critical systems operations. It aims at optimizing operations and reducing or preventing outage time (Gregg, 2009). The formal definition of the term 'business continuity' is:

"The Management of Business Continuity represents a holistic process of management that detects potential impacts threatening an organization, assures effective response, offers a framework to build resilience, and safeguards key stakeholder interests, its value, reputation, and brand."

Analysis

Several analyses are performed for determining essential functions, threat/risks, and RTO (Recovery Time Aims/Objectives).

Business Impact Analysis or BIA

These analyses help identify and prioritize essential functions, which denote collections of logically-linked tasks or activities that, when carried out in concert, give rise to a definite group of outcomes. Business processes are regarded as critical if they create or possess value for stakeholders of the department. This process's impairment interrupts operations and fails to satisfy customer requirements, mandatory requirements, or regulations, and hinders execution of company mission. For instance, triage is regarded as a key emergency department function. Individual hospital departments ought to carry out an assessment of their existing operations and determine essential functions required for maintaining operations and delivering patient care. Subsequently, essential functions must be prioritized, in order to ensure restoration of essential services and effective resource allocation. RTOs are assigned for every essential function. RTO implies the maximum downtime allowed for any critical process prior to the severity of an impact growing to the extent that patient safety is drastically impaired and/or business services cease to function.

Threat and Risk Analysis

By understanding likely events, the hospital can plan and eliminate or mitigate these events' impacts.
Staffing Needs

The number of personnel needed in case of emergency, for performing essential functions will be governed mainly by priority emergencies determined through the hospital's HVA, in addition to reporting relationships within the hospital's Control and Command operations. Departments should determine which staff members are needed for specific operational periods and whether they can simply telecommunicate directions or whether their physical presence is needed on site.

Information Technology Applications

Information technology continuity planning refers to a coordinated company strategy that involves procedures, technical measures, and plans, that facilitate IT systems, data, and operations recovery following a disruption. Normally, contingency planning involves at least one approach to restoration of disrupted information technology services:

Restoration of IT processes at some alternative location;

Recovery of IT operations through the use of alternate equipment/tools; and/or

Performance of all or some disturbed business processes by using the operations manual (i.e., non-IT) means (usually acceptable only in case of short-term interruptions).

Critical Equipment and/or Resources

A healthcare facility maintains a general equipment and supplies inventory, required for performing essential functions, on an everyday basis. It is imperative for necessary resources or equipment to be identified, for ensuring critical processes remain functional within a given period of operations.

Vital Records

These constitute a critical resource and have to be dealt with in departmental continuity plans. Such records can be paper-based or computerized records, regarded as vital to business continuation after a disruptive event. Recorded data categories that are typically deemed vital can include:

Birth records, vital statistics, and court records

Patient medical records, clinical trial results and administration of controlled drugs

Agreements or contracts that prove equipment and property ownership

Operational records like architectural drawings, accounting records, software licenses, maintenance contracts, and shipment delivery records

Current client account information and files

Legal documents including correspondence and tax records or any other papers forming part of an ongoing lawsuit

Intellectual property, e.g., source code, schematics, standard operational procedures, and formulae.

Department Dependencies

Other departments provided a variety of services that are required for ensuring working of essential functions. These departments can be internal secondary services like the laboratory or imaging. External dependencies can exist too (e.g., mobile dialysis services or courier service).

Specifications for Drive-Away Kits

"Drive-away kits" (sometimes called "go-kits") must be readied by people who are expected to be deployed in times of emergency to some alternate location in times of emergency. These kits must contain items that team members regard as important to supporting organizational operations at the alternate location. Every kit can be unique, but they must mostly include such items as:

Important contact lists (i.e., names, addresses, cellphone/landline numbers, etc.)

Continuity checklists

Alternate site maps

Files that are specific to personnel's positions, which will prove crucial to effective response capacity

Tools utilized routinely by personnel (CHA, 2014).

Maintaining Continuity Readiness (Execution)

The team responsible for continuity oversight must create a hospital-wide program for operational continuity testing. This program must:

Include testing strategies for addressing BIA and risk assessment results;

Identify key responsibilities and roles; and Set up minimum organizational operations continuity testing requirements, including baseline scope, frequency, and test result reporting requirements.

At the minimum, testing objectives and scope must:

Not put routine business operations at risk;

Gradually increase participation level, complexity, physical sites involved, and functions;

Demonstrate various response and management skills under simulated conditions of crises, and progressively involve more participants and resources; and Reveal inadequacies to allow revision of testing procedures.

Requesting your kind advice about implementation of the mentioned measures and actions,

Thanking you

Best regards

Chief Continuity Manager

Berwick Hospital Systems.

Bibliography

CHA. (2014). Hospital Continuity Planning Toolkit. California Hospital Association.Retrieved from: http://ddcache1.net/calhospital.s1017.SU/sites/main/files/file-attachments/hcp_toolkit_1.pdf

Gregg, M. (2009, June 8). CISSP Exam Cram: Business Continuity and Disaster Recovery

Planning. Retrieved April 12, 2016, from Pearson: http://www.pearsonitcertification.com/articles/article.aspx?p=1329710&seqNum=3

IEMA. (2016). Illinois Disaster Plans. Retrieved April 12, 2016, from Illinois Emergency

Management Agency: http://www.illinois.gov/iema/Preparedness/Pages/DisasterPlans.aspx#operations