In the years since September 11, those planning, preparing, training, responding and rebuilding disasters have focused all their efforts on convincing private healthcare companies and non-health corporations to embrace all dangerous approaches to disasters and disasters.
Perhaps because 9/11 and anthrax have become an incentive to finance this push, corporate America has linked these high costs to what they see as an unlikely threat of terrorism. The 2004-2005 hurricane season gave the southeastern regions of the United States a clear focus on disaster preparedness in the form of hurricanes Charlie, Francis, Ivan, Jeanne, Katrina, Rita and Wilma. Unfortunately, in this focus a tendency has appeared to prepare for hurricanes, of course, not to any dangerous approach.
The simple fact that everyone but a very few people missed in a disaster community and even less in the planning, training, education, disaster response and disaster areas is that the word “disaster” does not belong to the name. We are not a “disaster” community, and we are not engaged in the planning, training, education and disaster recovery industry; rather, we are a “All Hazards” planning, preparing, training and restoring community.
Before you assume it is just a matter of semantics, think about what we are striving to achieve. Our “All Hazards” community does not just strive to prepare for a possible terrorist attack or natural disaster, we strive to radically change attitudes and behavior so that when adversity or disaster looms on the horizon, our citizens, our communities and our infrastructure are prepared. Our real goal is to never see the line again at Home Depot or the grocery store the day before or after the disaster.
This is not a new concept. The practice of vulnerability analysis and risk assessment has worked well in many areas of security and in the armed forces. Medical institutes for the first time applied this practice to the health care industry in a 1999 report, Err Is Human. Unlike the disaster preparedness treatise, “Err” is a human alarm siren that brought to the public forum the problems with patient safety and drugs.
Despite the fact that the main problem for Err is that it was important for “Man” to analyze the lack of reporting systems and failures in the health care system as a whole and to compare the current state of health security with other sectors. For Err Human, the “public-private” efforts to ensure safety fit the details, but the report generally suggests the basis and justification for government intervention and federal regulation of health safety and, accordingly, quality / certification of health care.
If this sounds like the 2006 trio of the Institute of Medicine reports on the state of emergency medicine and disaster preparedness, it is very similar. The 2006 reports, in conjunction with the “Man until 1999” report in 1999, demonstrate the similarities between community-wide disasters and patient-related disasters. Thus, the “All Hazards” approach to preparedness should include patient safety, drug safety, fire safety and personal safety, in addition to the current focus on terrorism and disaster preparedness.
There are a number of advantages to this enhanced All Hazards approach to safety, planning and preparedness. The greatest of these is the integration of patient safety initiatives and preparation for disaster education, which allows health professionals to practice their skills in preparing for natural disasters as part of their daily lives. It has applications in team building, sorting, safety reviews, team structures, patient capacity and literally every aspect of hospital operations.
The consequences go far beyond the immediate process improvements that emanate from the “All Hazards” training program. The mind set, which is introduced into those who are trained in the “All Hazards” method for everyday operations, adds innovations in operational processes and the rationalization of previously ingrained systems.
Learning All Hazards also creates “total security investments”, in which “To Err” are human states that are lacking in healthcare, but common to industries such as air transportation and railways (pilots and engineers use some and the same “safety investments” as passengers). Those who have received the “All Hazards” training understand and assimilate this reality that any risk that exists for the patient also exists for the medical professional.
Finally, the recognition of patient safety problems and all other health safety problems, since the dangers within the “All Hazards” approach will lead to better success in achieving both sets of goals. This year, patient safety initiatives mark their seventh anniversary, but even the director general of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) admits that drug error and improper site surgery have increased exponentially at this time. Despite the almost unlimited budget and the best efforts of the best minds in the field of patient safety, health care has not improved, it has become more dangerous.
At the same time, over the past five years, the health situation in the hospital and health care has changed only slightly. In 2006, the Institute of Medicine reported serious criticism of public health for not being able to invest in the preparation of “All Hazards”, despite the fact that it was effective not only in improving safety, but also in increasing throughput, safety and efficiency. For “All Hazards” preparedness, the problem is not that the budget applies a proven and effective solution.
Fighting risks to patients, medication errors and surgical failures as a different hazard category within the All Hazards all-encompassing approach promise to solve problems for both programs. Patient safety will benefit from the proven effectiveness of the “All Hazards” approach, designed specifically to mitigate multi-factor risk, while the “All Hazards” training programs will finally have budget priority and funding necessary to ensure widespread adoption of the system.
The only question that remains is whether those who have made their careers in patient safety, as practiced over the past seven years, are ready to take a broader view of the world and whether the “All Dangers” community is ready to be “all” Danger "in their approach.
