Brewing cataclysm’ in emergency response?

JCAHO warns of underfunding, unpreparedness

Responding to the potential for new terrorist attacks in the United States, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has issued a report warning of a "brewing cataclysm" of underfunding, inexperience, and unpreparedness of emergency response capabilities across America.

The report was prepared in consultation with a broad-based expert roundtable which convened on two occasions in 2001 and 2002, and then participated in a national summit on Emergency Preparedness hosted by Joint Commission Resources in Washington, DC, in October 2002.

The 28-member panel included representatives of various federal and state agencies, frontline emergency care providers, emergency preparedness planners, and public health and hospital community leaders, among others.

Noting that virtually all disasters, including intentional terrorist events, will be experienced at the local level, the report emphasizes that many communities will be on their own for the first 24 to 72 hours after a disaster.

The response that must be mobilized will, at a minimum, require the active involvement of emergency medical services, fire, police, hospitals, public health agencies, and municipal and county leaders. This is no task for a single hospital or agency, says Dennis S. O’Leary, MD, Joint Commission president.

"Many of our large metropolitan areas, such as New York City and Washington, DC, are far better prepared to deal with terrorist attacks and other disasters than they were before Sept. 11," O’Leary says. "However, most of America’s communities are at the stage of waiting for someone to call the meeting. Knowing that terrorist strikes will focus on the objective of creating fear, small-town communities and cities of modest size can ill afford complacency today."

To address the problem, the report calls for key community leaders to play a convening role in those communities that lack emergency preparedness programs. These potentially include local emergency management agencies, public health agencies, hospitals, and municipal and county leaders.

The report goes on to detail the critical elements of good emergency management programs, and then calls for the creation of a federal program to evaluate and hold accountable these emergency preparedness programs.

According to a new survey conducted by the American College of Healthcare Executives (ACHE), 84% of hospital CEOs agree that since 9/11, their hospitals have worked more closely with public agencies (e.g., fire, police, and public health departments). Further, 95% of the respondents said their hospitals already have, or within six months will have, a bioterrorism disaster plan in place, developed in coordination with local emergency or health agencies.

Providers have taken to heart their responsibility for responding to terrorist attacks and other disasters, says Thomas C. Dolan, PhD, FACHE, CAE, president and chief executive officer of ACHE.

"In times of crisis and need, health care executives ensure that hospitals and other health care organizations serve as safety nets in their communities by providing emergency and ongoing care, as well as accurate, timely information about public health threats," Dolan says.

In the survey, ACHE asked more than 700 hospital CEOs throughout the country to report on the status of programs related to bioterrorism preparedness. Eighty-five percent of the respondents reported that they already are working with other hospitals or hospital associations to learn about resources available for a response to bioterrorism. Of the hospitals not currently communicating with other organizations, 73% are planning to establish such relationships within the next six months.

[For more information, contact:

Joint Commission on Accreditation of Healthcare Organizations, One Renaissance Blvd., Oakbrook Terrace, IL 60181. Telephone: (630) 792-5000.

Thomas Dolan, American College of Healthcare Executives, One N. Franklin, Suite 1700, Chicago, IL 60606-4425. Telephone: (312) 424-2800.]