Introduction. Background

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2 Introduction On December 27, 2013, the Centers for Medicare & Medicaid Services (CMS) released a federal register regarding emergency preparedness requirements for health care organizations that provide care for Medicare and Medicaid patients. Among the items proposed in the document were four core elements CMS determined are integral to health care facility s emergency management and preparedness activities: 1. Risk assessment/planning 2. Policies and procedures 3. Communication plan 4. Training/testing The purpose of these items is to change the way health care providers prepare for and respond to emergencies. Their proposal was in response to recent challenging natural and man-made disasters, including the 2009 H1N1 influenza pandemic and 2012 Hurricane Sandy, and the response from public health agencies. The proposal would require health care providers and suppliers to integrate emergency management into their daily activities. Any health care provider accepting federal or state funds would be required to establish a program containing those items. Background Based on an analysis of written reports, articles and studies, as well as ongoing discussion with representatives from federal, state and local levels, CMS believes currently, in the event of a disaster, health care providers and suppliers across the nation would not have the necessary planning and preparation in place to adequately protect the health and safety of their patients. Failure to plan can affect a health care organization s ability to connect with staff and patients, extend services and keep up with administrative processes (Routhier, 2006). Hurricane Sandy Hurricane Sandy was a massive and deadly post-tropical cyclone that affected much of the east coast of the United States in 2012, significantly impacting the northeast where fires, floods and power outages left millions of people without adequate medical care. Hospitals faced the evacuation of hundreds of patients. Many health care organizations deployed mobile health clinics, dispatching physicians, nurses and administrative staff to help with vaccinations, medication refills and wellness checks. Hospitals were unable to ensure continuity of operations, which is the hallmark of successful disaster plans (Powell, Hanfling, & Gostin, 2012). Hurricane Sandy and even Katrina highlighted the difficulty in attaining the data and insights needed to make strategic planning and response decisions (2012).

3 H1N1 Pandemic The Centers for Disease Control estimated approximately 60.8 million cases, 274,304 hospitalizations and 12,469 deaths in the United States due to ph1n1 (Centers for Disease Control and Prevention, 2010). During peak months of the infection, some hospitals witnesses a tenth to a quarter more sick hours compared to the prior year, placing additional strain on the labor force during a time of high patient volumes (Bhadelia et al, 2013). This crisis not only tested health care organization s ability to operate during a national health crisis, but also how to ensure the availability of adequate staff. Being able to notify staff, or call in additional staff, can be as critical as the need to treat the patient. Ebola Outbreak Ebola is the current disaster testing the way health care providers communicate with staff and the public. The World Health Organization said Ebola outbreaks can devastate families and communities, but infection can be controlled through protective measures in clinics and hospitals, at community gatherings and at home. However, the ability to reach those at risk with proactive, protective information is vital and timing is key with a disease case fatality of up to 90% (WHO). In August 2014, the World Health Organization said the Ebola epidemic was still accelerating and could afflict more than 20,000 people before it could be brought under control (Cumming-Bruce & Cowell, 2014). New York hospitals had been communicating with staff members about how to handle the potential spread of Ebola even before a patient was admitted to Mount Sinai Hospital with symptoms associated with the virus (Huntsberry, 2014). Montefiore Medical Center in the Bronx ed staff to alert front line health care workers what to look for, who to contact and the types of precautions to take (2014). The hospital indicated the most important thing was to figure out how to get the message to their staff (2014). Putting it into context Within communication planning, the CMS proposal would require hospitals to identify names and contact information for all pertinent employees, physicians, other hospitals and volunteers. Regular communication from a central source combined with a cascade of more localized information has become routine for announcing organizational change, managing crises, or keeping staff informed about what is happening across a large, complex organization (DuHamel, 2009). More and more health care organizations are relying on an integrated approach to their communication plan, a Webbased solution that can be accessed anywhere and at any time. Communication planning for health care facilities must include mitigation, preparedness, response and recovery. Different levels of staff are needed for each, and the calling tree still used by major health care providers is no longer efficient.

4 Solution The SmartNotice staff notification system is a cost-effective and easy answer to the communication plan core element of the CMS proposal. It can and should also be used during the implementation and testing of the other components outlined for emergency preparedness. The SmartNotice system solves each of the issues faced with past and current health care related disasters: ü Hurricane Sandy Continuity of Operations. The SmartNotice system provides Continuity Communications to perform essential notification functions even under the most strenuous of environmental or manmade conditions. The system also provides readily available electronic staff contact records needed to support essential health care functions during a continuity situation. ü H1N1 Pandemic Ensure Availability of Adequate Staff. The SmartNotice system features TeamBuilder, a tool that helps create call-outs and fill schedule quotas, intuitively ending the calling process once staffing needs are met. The on-call scheduler was built specifically for large health care organizations, allowing hospital operators to automatically contact staff who is on call during a pre-determined time frame. ü Ebola Outbreak Getting Message to Staff. Health care administrators can quickly and easily notify groups of physicians and other staff groups/members in a matter of a few mouse clicks, with the ability to deliver phone, text, and desktop notifications. Anticipating use during emergencies, the SmartNotice system is triple redundant and infrastructure is dispersed across the major power grids in the United States, so a health care emergency in one specific geographic location will not impact the system s ability to perform. How the system could benefit your health care organization: Staff contact information A client support representative is happy to load your HR database and staff contact information for you, and import tools allow seamless uploads in real-time Automated severe weather alerts keep disaster preparedness coordinators up to date with the most time critical alerts Unlimited Contact Groups for targeted communications to the correct personnel Staffing/Shift Building feature with real-time response tracking An easy-to-use, Web-based interface gives you access to all personnel within seconds Save time by pre-recording routine communications using an interactive voice recorder.

5 Learn More Emergency Communications Network is here to help your health care organization finalize its communication plan before the CMS ruling. With several certified emergency managers on staff, we are also available for 1-on-1 consulting to help refine or even create your emergency response plan to include your notification system. To learn more about the SmartNotice system and to register for a free system demonstration, visit ecnetwork.com/smartnotice or call

6 Works Cited Bhadelia, MD, N., Sonti, MD, R., McCarthy, MD, J., Vorenkamp, MD, J., Jia, PhD, H., Saiman, MD, L., & Furuya, MD, E. (2013). Impact of the 2009 Influenza A (H1N1) Pandemic on Healthcare Workers at a Tertiary Care Center in New York City. Infection Control and Hospital Epidemiology, 34(8), Centers for Disease Control and Prevention. (2010, May). CDC Novel H1N1 Flu CDC Estimates of 2009 H1N1 Influenza Cases, Hospitalizations and Deaths in the United States, April 2009 January 16, Retrieved from Cumming-Bruce, N., & Cowell, A. (2014, August 28). Ebola Could Eventually Afflict Over 20,000, W.H.O. Says. Retrieved from DuHamel, C. (2009). Using lessons from SARS in tackling swine flu: Looking inward to develop a crisis communication model. Journal Of Communication In Healthcare, 2(4), Huntsberry, W. (2014, Aug 06). Hospitals laid plans for ebola. Wall Street Journal Retrieved from Powell, MD, T., Hanfling, MD, D., & Gostin, JD, L. O. (2012). Emergency Preparedness and Public Health: The Lessons of Hurricane Sandy. The Journal of the American Medical Association, 308(24), Retrieved from Routhier, D. (2006). Crisis communications. Healthcare Informatics, 23(2), 94. Retrieved from U.S. Government Printing Office, (2013). Medicare and Medicaid Programs; Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers; Proposed Rule. [online] Available at: [Accessed 21 Aug. 2014]. WHO Ebola virus disease (EVD). Retrieved from