Top 10 actions to take for medical emergency preparedness

Once a virus such as the swine flu becomes widespread in the United States, medical practices should consider implementing their emergency response plan. Here's what you should do to keep yourself, your practice and your patients safe during such an event.

1. Create a monitoring system.
   As the group's administrator, you must assign responsibility for monitoring the flu outbreak and updating appropriate staff on a regular basis. Establish a planning committee comprising physicians, nurses and key administrative staff.
   
   For monitoring outbreaks such as the swine flu, the Centers for Disease Control and Prevention (CDC) provides a weekly flu report online and are tracking recently diagnosed swine flu cases in the United States.


2. Set protocols for flu patients.
   Begin with phone triage when patients call: Provide a checklist for your receptionist to follow if a patient may have flu. Consider separate waiting areas, appointment times, exam rooms and even a dedicated flu staff. To segregate potential flu patients from at-risk patients you may need to limit medically unnecessary visits.


3. Investigate resources for treating flu patients.
   Know the agencies to turn to in your community and state for assistance. The United States Department of Health and Human Services (HHS) and the CDC list helpful resources by state, such as pandemic planning information, health and wildlife contact information and federal assistance available to your medical practice.


4. Establish a reporting system to appropriate health authorities.
   Maintain a current, easily accessible list of agencies to which you should report suspected or confirmed flu cases. The CDC provides this information for clinicians.


5. Educate and train staff about flu and its control measures.
   Educating employees can help reduce their risk of infection and maintain the work force. The CDC has training resources such as posters, handouts and podcasts in different languages for you to share with staff. Education should include infection control procedures to mitigate the spread of influenza. Emphasize that all employees should have an individual or family pandemic plan to minimize risk of exposure.


6. Establish respiratory hygiene/cough etiquette for patients and staff.
   To reduce the risk of disease transmission, plan for an ample supply of tissues, appropriate disposal receptacles, regular removal of waste tissue and regular disinfection of virus-exposed surfaces. The CDC has plenty of resources for proper respiratory hygiene, and recommends coughing into a tissue or your sleeve, not your hand, and being diligent about hand washing. Symptomatic patients may have to wear masks, so be sure to have an extra supply on hand.


7. Compile information on obtaining antiviral drugs and vaccines and inventory other medical supplies.
   Your medical practice may need antiviral drugs and vaccines, if available, for staff as well as patients. Inventory important medical supplies such as gloves, masks, and gowns that need rotation to ensure readiness and minimize loss from theft, expiration or spoilage. Consider whether supplies have special storage requirements and whether you have adequate storage space. Identify alternate suppliers if normal vendors can’t meet your practice's needs.


8. Establish a sick-leave policy for staff with influenza.
   This policy should address what to do when employees become sick at work, when they should return to work, when they are symptomatic but well enough to work and when they must tend to ill family members. Severe pandemics may call for counseling services.


9. Anticipate staff absence.
   Figure the minimum number and mix of employees necessary to operate your practice. If absences take your group below that minimum, you'll have to decide whether to close the office or call on alternative, pre-arranged personnel. Be sure to communicate how employees will be paid if the office closes.


10. Evaluate information technology resources.
    Evaluate the IT strengths and weaknesses of your organization. What would cause the practice to lose the use of its computers? Can the practice function without computers? Can nonclinical employees work from home? Can your staff and physicians have remote access to the practice's information systems?
    
    You could minimize staff exposure to the flu while maintaining productivity by developing remote access or virtual private network connections for essential nonclinical employees. Transcription, insurance filing, account posting, appointment scheduling, various accounts receivable activities, report functions, purchasing and payroll can all be performed remotely. This level of staff functionality will most likely require additional software and greater server capacity. Employees must have home computers of sufficient quality, speed and capacity, in addition to a broadband Internet connection. Such a system calls for occasional testing to eliminate potential problems with work-from-home logistics.

This article is from The Medical Group Management Association (MGMA) website