Is your health care facility prepared to overcome a catastrophe? Q&A with Lindsey and Joshua Brackett

Thursday, January 24, 2019
Image: surgeons running through a hallway

If faced with an emergency situation, how equipped is your facility team to overcome it? ASHE recently interviewed Lindsey Brackett and Joshua Brackett, PE, CHFM, experts in health care facility management and operations training, to discuss emergency preparedness. Lindsey and Joshua are the founders of Legacy FM, a health care facility management training organization, and have experienced catastrophic events firsthand.

Q: What does it mean to be prepared in a health care setting?
A: (L. Brackett) Being prepared means being agile and quick on your feet. It also means knowing what to do in the wake of failure. When everything seems to be going wrong, being prepared means having a plan B and a plan C in place.

(J. Brackett) Most hospitals are prepared for the expected. For example, any health care system in Tornado Alley knows what to do when a tornado touches down. However, being truly prepared means being ready for the unexpected. When there isn’t a predicted natural disaster or an expected power outage and it’s just a regular day and catastrophe strikes, does your team know how to react?

Q: From an operations and maintenance standpoint, what are a few catastrophic events a team should be prepared for?
A: (J. Brackett) Some of the top concerns include

  1. Fire protection/plumbing malfunctions,
  2. Electrical power outages,
  3. Data system/phone system loss, and
  4. Critical equipment failures.

For example, if a sprinkler system is accidentally set off and water is rapidly gushing out of it, staff must know where the system control valve is located and how to turn it off.

If a facility has a catastrophic power failure, life-saving equipment needs to be addressed. Items such as pneumatic-operated NICU ventilators, which require medical gas to operate, are often overlooked until they fail.

If a health care facility experiences data loss and can’t adequately document patient records, they need to be prepared to go back to pen and paper.

Q: Oftentimes, when a new hospital comes online or equipment is installed, facility management teams receive a PowerPoint presentation, video, or canned training material. What needs to change?
A: (L. Brackett) So many hospitals think “this is never going to happen to me” and believe the canned training material will be sufficient. However, the reality is that things do happen. Catastrophic events, both expected and unexpected, do occur. Every staff member, working any shift, needs to be put through the proper hands-on training and testing procedures.

A: (J. Brackett) Once you have plans in place and procedures and equipment that help you enact those plans, hands-on training needs to occur. Staff members need to be taught with interactive training how to work devices during emergencies. Examples include hands-on practice using a real fire extinguisher on a supervised fire or using fire sprinkler shut-off devices on a sprinkler head connected to a garden hose to simulate a sprinkler head going off.

Second and third shift teams are smaller and therefore less prepared to handle emergency situations. There needs to be more focus on adequately training all shift workers.

Q: What can designers, architects, and construction teams do differently in terms of emergency preparedness?
A: (J. Brackett) Emergency preparedness needs to be incorporated into the design of a facility at the forefront of the process. Designers must understand the operations and maintenance side, recognizing what could go wrong and designing in a way that not only mitigates risks but allows staff to easily shut equipment and systems down if needed.

A: (L. Brackett) Throughout the process, the operations and maintenance teams at the hospital should be involved in the performance testing of equipment and systems. These are the teams that are going to need to spring into action if an emergency situation occurs. The more often they can see the testing sequences, the better.

Q: How often should emergency preparedness training be addressed?
A: (L. Brackett) In terms of emergency preparedness, you really can’t be too prepared. Even a training once per month is not overkill.

A: (J. Brackett) Continuously. The facility supervisor at one of the hospitals in our system will walk up to staff members and flicker his flashlight on and off until someone asks what he is doing. He responds by saying, “You just discovered a fire. What do you do next?” Having the team perform as if there is a real emergency is the best way to ensure they are going to properly react when it’s not a drill.

Q: What can attendees expect from your 2019 PDC Summit session, “Management Team Prepared to Overcome a Catastrophic Event
A: (J. Brackett) We will be presenting as part of a panel that includes individuals who have experienced emergency situations in the health care field, including a general contractor, a powerhouse operator, and a facility manager. Through case studies and an interactive discussion, attendees will leave understanding the importance of equipment training and will gain insight into the tools and tactics needed to keep facility teams properly trained.