[This is the sixth of seven articles from the premier issue of Prospective Risk Management In Healthcare. It is not available online. All usual disclaimers apply.]

Emphasize The ED In Y2K Contingency/Disaster Planning

Risk managers whose hospitals aren't beefing up existing disaster plans to deal with any contingencies Year 2000 (Y2K) may throw their emergency department's (ED) way could be in for a rude surprise.

One of the biggest Year 2000 risks for a healthcare organization will be its ability to respond to a potential increase in ED visits from communitywide failures, in addition to the "regular" heavy patient load that might be expected on the New Year's Eve of a new millennium, said Lori Iwan, Esq., the partner in charge of the Y2K practice at Williams & Montgomery in Chicago.

Emergency departments likely will bear the brunt of Year 2000-related failures throughout society, suggested Stephen Frew, JD, president of Rockford, Ill.-based Frew Consulting Group (http://www.medlaw.com). "When things go bad in a community, it will be the emergency department that will be expected to deal with it. Any disaster plan may end up being the coordinating factor for the entire hospital."

Potential problems such as pacemaker failures and injuries related to traffic light malfunctions or power outages could result in an influx of patients. "Even if a bunch of people code in the hospital, the ED crew is the code blue team in most hospitals," added Frew. And if telephone service is interrupted, the ED's radio unit could become the communication point for the hospital.

Most emergency departments have not been involved in Y2K planning and are ill-prepared to deal with potential problems, said Frew. Risk managers should push to have emergency departments "operate on a parallel back-up mode to what's going on in the general Y2K efforts."

The medical director and nursing director of the ED need to lead departmental planning, with the risk manager providing the framework and the access to necessary information, Frew advised. "They've got to be given a priority status from administration."

Operating in parallel back-up mode means the ED, separately from the rest of the hospital, must address how to operate in the event of worst-case infrastructure washouts, as well as how to identify and handle equipment failures and potential shortages of critical drugs and disposable medical supplies.

ED managers also need to evaluate what types of problems they are most likely to see and prepare for those eventualities. For example, some prognosticators believe there will be numerous pacemaker failures. EDs that haven't dealt with many pacemaker failures need to do some in-servicing "in case from midnight to 3 a.m. on Jan. 1, we have 70 people come in with pacemaker failure," said Frew.

Editor's note: At press time, Frew was scheduled to release the workbook, Plan B: Contingency Planning for Hospital Emergency Departments. Call (815)654-2123 for information.

[End of article. My note: My understanding is that pacemakers will be fine. The monitoring equipment, on the other hand, may not be. This article seems to contradict that. Anyone with definitive info?]

-- Steve Hartsman (hartsman@ticon.net), February 19, 1999

Answers

Wow, this is terrific of you to post these, Steve: THANKS!

These are achived under "Health/Medicine Threads."

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-- Leska (allaha@earthlink.net), February 19, 1999.