Get Well Soon: 9 Ways to Make Hospital BCM Programs Healthier

Recently, a relative of mine required surgery, which led to my spending long periods of time in a hospital. As a result of that experience, I developed the content of today’s blog: a list of nine ways we can make hospital BCM programs healthier.

Related on BCMMETRICS: How Hospitals Can Heal Their BCM Programs

They say that experience is the best teacher.

That was definitely true for me over the past few weeks when the illness of a close family member required me to spend long stretches of time in one of our city’s hospitals.

NO MARGIN FOR ERROR

Over the years, I’ve visited scores of hospitals all over the country as a consultant coming in to help with business continuity management (BCM) planning.

But the whole subject gets a lot more personal when your loved one is in the vulnerable state of being a patient in that hospital. In that situation, their health and even their survival, potentially, depends on everything at that hospital functioning smoothly, no matter what.

As their relative, you sit there looking around the room thinking, What happens if that device breaks? Or if that computer goes down? Will the doctors and nurses know what to do to compensate?

The experience really brought home to me how unique hospitals are—and what a special responsibility they bear in terms of their resiliency planning.

This was something I understood intellectually before, but having my own family member in that situation really drove home the reality emotionally.

Hospitals have essentially no margin for error when it comes to being able to weather a disruption.

WHEN TECHNOLOGY FAILS

Unfortunately, my observations at this particular hospital, as well as at other hospitals I’ve visited, is that the technology has gotten way out in front of the ability to cross the gap if that technology fails. And sooner or later technology always fails.

As an example, in the course of my family member’s recovery, we ended up in the Emergency Room in the middle of the night. The doctors decided to use a certain machine to perform a key test, but then they found that the battery of that machine had died. No one on duty knew where a replacement battery or another machine could be found. Their Plan B was to telephone certain other staff members at home and hope they picked up. It was an hour before they were able to find another machine.

9 WAYS WE CAN STRENGTHEN HOSPITAL BCM PROGRAMS

This and other experiences from those weeks led to my developing the following list of nine ways hospitals could and should strengthen their BCM preparations.

1. Harden the clinical areas from top to bottom. Ensure clinical downtime procedures are bulletproof, are regularly tested, and are used effectively by ALL work shifts. Too often, only the overnight shift has experience working with downtime procedures, since that is when computer systems are taken down for maintenance and upgrades. All shifts need to be trained in using your alternative procedures. What if the EPIC patient information system goes down? What if the phones go down? Every hospital needs backup procedures for use in situations like these, and all shifts need to be trained to use them.
2. Ensure biomedical device redundancy and resiliency across the network. For an example of why this is important, see my story above about our trip to the Emergency Room.
3. Ensure patient servicing sites have multiple levels of network redundancy back to the primary and backup data centers. At many hospitals, this is the weak link in the chain.
4. Have multiple communication vehicles across the critical sites. Don’t assume your Voice Over IP system will always be up. Build redundancy by also having a plain old telephone system and radios.
5. Develop an IT capability with extraordinarily high availability. Your systems should be up a minimum of 99.99 percent of the time, and ideally 99.999 percent. There should also be a rigorous level of recoverability for the core patient safety and care systems. This is especially important in today’s evolving healthcare technology environment, where healthcare data centers are supporting multiple hospitals, clinics, and outpatient centers.
6. Build sound continuity plans for the shared services functions of the hospital and test them rigorously.  Today’s healthcare environment is a world of regional hospital networks supported by shared services such as IT, patient financial services, accounting/finance, HR, payroll, staff scheduling, and supply chain. The criticality of these systems taken collectively can hardly be overstated. 
7. Harden the supply chain processes. Ensure that your critical suppliers can continue to support you in a disruption. Know the threats to your supply chain and validate the continuity plans of your key suppliers. Inspect what you expect.
8. Establish sound change management processes to address technology and facility changes. This pertains especially to systems that could impact patient care and safety. If preparation is lacking, even simple, routine changes can seriously disrupt critical systems, services and processes.
9. Implement a sound emergency and incident management capability. The system you set up should be capable of managing a multi-facility event if you want to have a truly sound hospital BCM program.

DOING BETTER

Fortunately, my loved one is doing better. My family and I have the hospital and the doctors and nurses to thank for this, as well as all the support staff.

At the same time, I wish hospitals would start doing better in terms of making their systems more resilient and redundant. Their patients are depending on it. Because sooner or later, technology and complex systems always break down.

Based on my observations as a BC professional and anxious relative, the nine items above would be a great place to start.

FURTHER READING

For more information on this and other hot topics in business continuity and IT/disaster recovery, check out these recent posts from BCMMETRICS and MHA Consulting:

• What Service Providers Need to Know About Supply Chain Risk Management
• The Cost of Calamity: How Being Unprepared Can Harm An Organization