6th Edition In-Depth: Structural Integrity of Patient Care Environments in the Event of a Disaster
Standard FMS.6: The hospital develops, maintains, and tests an emergency management program to respond to emergencies and natural or other disasters that have the potential of occurring within the community.
An important element of disaster planning is determining the impact on the structure of the patient care environment if a disaster were to occur. A new requirement was added to the Facility Management and Safety (FMS) chapter related to the need for organizations to determine “the structural integrity of existing patient care environments” in the event of a disaster. This requirement was added as letter b to the intent and addressed in ME 3 of FMS.6, requiring the hospital to establish and implement a disaster program that identifies its response to likely disasters (including items a through h in the intent).
The organization must first perform a hazard vulnerability analysis by identifying the likelihood and consequences of hazards, threats, and events. For example, is the organization in a location that is at risk for geological phenomena, such as earthquakes, landslides, or tsunami? Or is it in an area at risk for chemical or other technological phenomena such as explosions or hazardous material spills? Is the organization at risk for environmental emergencies such as infectious disease epidemics or system contaminations (for example, bacterial contamination in the water system)?
Once the types and likelihood of emergencies are identified, the organization should determine the structural integrity of the building(s) where patient care is provided based on the most common types of disasters. For example, if the organization is in an area where hurricanes are likely, are the roof and windows capable of withstanding the storm surge generated by extremely high winds? Are there mechanisms in place to manage the flooding that is likely to occur as a result of the heavy rains that follow a hurricane?
If earthquakes are likely, is the building seismically sound? If utilities such as power and water are disrupted from the earthquake, is there an adequate emergency power system and an alternative water supply? (See also FMS.9.2 and FMS.9.2.1.) As part of the facility analysis, if there is a high probability of an airborne pandemic, are the facilities capable of isolating patients to prevent further spread of the airborne illness? (See also PCI.8.1 and PCI.8.2.)
There are tools and websites to help organizations with their planning to meet this requirement. Some examples are:
- The World Health Organization’s (WHO’s) website dedicated to emergency planning and information (www.paho.org/en/health-emergencies)
- The European Commission (ec.europa.eu/info/law/law-making-process/planning-and-proposing-law/better-regulation-why-and-how/better-regulation-guidelines-and-toolbox_en)
- The California Hospital Association (www.calhospitalprepare.org/post/hazard-vulnerability-analysis-tool)
- U.S. Federal Emergency Management Agency (https://www.fema.gov/sites/default/files/2020-08/fema577_design_guide_improving_hospital_safety_2007.pdf)