An emergency operations plan (EOP) provides the structure and processes that a healthcare facility and its security and safety operation use to respond to and initially recover from an event. The EOP is therefore the response and recovery component of an emergency management program.

The Joint Commission Emergency Management Standards are very specific to the requirements of the hospital EOP; however it should be noted that some of these requirements cross over to mitigation and preparedness activities.

The need for planning, training and ongoing exercises was highlighted by the impact of Superstorm Sandy in the northeast. As of late November, four New York City hospitals remained closed for inpatients, leaving thousands scrambling to find other medical centers to treat everything from broken bones to brain cancer. The closures of NYU Langone Medical Center, Bellevue Hospital Center, the Manhattan VA Medical Center and Coney Island Hospital have meant more business for some nearby hospitals and an unwelcomed cost for others.

Dennis Manley can identify the challenges.

His St. John’s Regional Medical Center was devastated by an EF5 tornado when it tore through Joplin, Mo. Despite the odds, the hospital continued to provide care and save patients’ lives because its staff had successfully tested and implemented effective emergency preparedness and disaster management plans. In early 2012, Manley, the director of quality and risk management at St. John’s, was a featured presenter at The Joint Commission and Joint Commission Resources’ (JCR) eighth annual emergency preparedness conference, discussing impact of the damage on the hospital caused by the tornado, how it was managed and what lessons were learned in the process.

More recently The Joint Commission has standards revisions addressing hospital leadership for emergency management (EM). Among issues addressed:

• The hospital identifies an individual to oversee emergency management.
• The individual with EM authority oversees the following -- Planning across the four phases of emergency management: mitigation, preparedness, response, and recovery.
• Identifying and collaborating with community response partners.
• The individual with EM authority oversees planning across the six critical areas -- communications, resources and assets, safety and security, staff responsibilities, utilities and patient clinical support activities.
• The individual with EM authority oversees annual reporting of the evaluations of emergency response exercises and responses to actual emergencies to the integrated patient safety program.
• Based on all monitoring activities and observations, the hospital evaluates all emergency response exercises and all responses to actual emergencies using a multidisciplinary process. This evaluation includes licensed independent practitioners, and staff from all levels affected by the event or exercise.