Don’t Kick the Can, Make a Plan

Creating a Disaster Preparedness Plan in Ophthalmology by Sam McCommon Kick the Can Don ’t — Make a Plan!

Nobody likes to think about disasters. Whether you’re talking about wildfires, earthquakes, tornadoes, hurricanes or extraterrestrial invasions, our minds have a tendency to relegate such possibilities to some distant, non-real future. After all, who wants to spend time worrying about something you can’t do anything to stop?

Unfortunately, as a medical practitioner, it’s your responsibility to prepare for disasters. Fortunately, on the other hand, you can do plenty to be prepared for such events — even if you lack the power to prevent them in the first place.

A presentation at the American Academy of Ophthalmology annual meeting (AAO 2020 Virtual) by Mrs. Shawn Carter (COE, OCS), held on November 17, 2020, provided valuable insight as to how best to prepare your practice for disasters. While you certainly shouldn’t spend all of your time worrying about and preparing for catastrophe, getting ready for such an eventuality can spare you and your practice significant pain in the long run. As the saying goes, “When disaster strikes, the time to prepare has passed.”

So, let’s dive into the steps laid out — none of which are radical, but all of which are practical.

Do some research

Before you begin, of course, you’ll need to consider your particular circumstances. What natural disasters might affect you? Which ones have occurred recently? Are natural disasters common in your area?

For example, while it would be silly for someone in California to prepare for a tornado or hurricane, making plans for a wildfire or earthquake would be prudent, indeed. And while someone in Florida need not prepare for a devastating blizzard, hurricane preparation is simply a necessity. Each region of the planet comes with its own risks. You get the drift.

There’s plenty to research when it comes to your own practice, too. What are the critical areas or functions you can’t do without? What would you be willing to sacrifice in a disaster? Mrs. Carter recommends conducting a stress test on your business to see just how you’d do afterward: construct a scenario or set of scenarios and see how they play out. This is how the military prepares for all sorts of eventualities.

If you’re in the U.S., ready.gov has some valuable advice for disaster preparedness. Other websites like NOAA Disaster Preparedness can be useful as well. Plenty of others specialize in disaster preparedness. You don’t need to reinvent the wheel.

You should also have plenty of contacts available. Besides the obvious emergency services, think about writing down contact information for utilities, insurance, the local sheriff, and create an employee phone tree.

Map out emergency action plans

Mrs. Carter recommends creating an emergency action team based on

individual skills. For example, assign equipment removal to certain staff members, or delegate patient and staff assistance to others. Keep in mind your staff’s individual skills and knowledge sets and feel free to ask them for suggestions for suitable roles.

You should also create a disaster box, with backups of all sorts of goodies you might find useful: flashlights, batteries, non-perishable food, bottled water and first aid supplies. This could be one short-term expense that you forget about entirely until you actually need it.

Create an evacuation plan that’s up to date, and consider updating it if circumstances have changed. In a single-story building, this can be very simple; in a large complex, less so. Every employee should know the plan and it should probably be rehearsed once a year.

Perhaps most importantly, create a checklist that helps you determine how to act in given circumstances. At what point do you cancel patient appointments? What compels you to call emergency services? When would you continue with business as usual? Who handles emergency liaison with patients and emergency services? Each type of disaster comes with its own set of factors you’ll need to consider when making these decisions. A checklist can greatly help everyone be on the same page.

Protect your practice

Of course, you’ll want to protect your practice and the people in it. While people aren’t replaceable, much as medical equipment is — data isn’t, unless it’s backed up.

Talk to your IT department to ensure you have appropriate backup plans for any valuable data. Similarly, make sure you’re familiar with your insurance policies and that they cover the disaster you’re preparing for. And even if they do, how much are your deductibles?

As mentioned above, make a plan to protect your equipment. Have a plan in place to move it somewhere safe, if possible.

Plan post-disaster recovery steps

Mrs. Carter points out that it’s quite hard to plan for any recovery postdisaster because you’ll have no idea of the effects until it’s over. Perhaps nothing will happen, or perhaps your clinic could be swept away by a tornado and land in Oz. The steps you take afterward will depend on the circumstances, but there are some guidelines to keep in mind. The following steps assume no one has been injured, which should clearly take first priority.

First, make sure to take note of any damage with a notepad, pen and camera. That will be valuable for insurance. Rank the damage in terms of significance and note any financial costs. This can help you get an idea of just how hard you’ve been hit.

Second, reassess your financial position. If you’ve been badly hit, will you need to talk to your bank, the tax office or your accountant? Will you need a loan? Projecting recovery costs can help you determine the amount of work you’ll need to do.

Third, look for help if you need to. Colleagues, family, employees or the community may be willing to pitch in to help. There’s absolutely nothing wrong in asking for help if you need it — especially since you provide both medical care as well as jobs.

Fourth, and related to the third, find a way to get your employees back to work. They’ve got financial obligations and families to feed. Consider telework or a temporary location, and arrange for replacement equipment while making sure your employees’ workspace is safe.

An ounce of prevention…

Physicians of all people understand how important prevention is. With your plan in place and rehearsed, you’ll be ready for the worst. Hopefully, it never comes — but if it does, you don’t want to be caught like a deer in the headlights.

Editor’s Note:

The American Academy of Ophthalmology annual meeting (AAO 2020 Virtual) was held from November 14 to 17, 2020. Reporting for this story took place during the event.