Take these four steps to Y2K success

This contingency plan provides a guide for hospitals in four phases.

The Business Continuity and Contingency Planning Approach (BCCP) outline (see box, p. 171.) was developed to help facilities structure an approach to address the continuation of business operations and contingency planning for impending disturbances, says Ginger Campbell, RN, PhD, a consultant in Tampa, FL, who works with a variety of health care organizations. "Its focus is on the implementation of efforts at that facility level."

The BCCP is a compilation of Campbell’s own ideas as well as bits and pieces she has gleaned from other organizations’ public-access contingency plans. "The BCCP is a guide," she says.

"It should be incorporated into the process and tailored to meet the unique needs of the client. Once the plan is developed, it must be kept current, and staff must be educated on a concurrent basis in order to remain prepared." (For more information about contingency planning, see related story, p. 164.)

To facilitate acceptance and implementation of the BCCP and related processes, Campbell addresses the contingency planning process in the following four phases, which should be supported by program and project management activities:

1. initiation;

2. business impact analysis;

3. contingency planning;

4. testing.

Campbell would like to hear from any providers who implement this format. To talk to her about this or to receive a more detailed version of the BCCP, call (602) 674-3299. Or e-mail her at cgcamp@gte.net.


Y2K rules of thumb

Listed here are some rules of thumb for health care providers to keep in mind when preparing Y2K contingency plans. This information is provided by Kerry A. Kearney, in her paper, Y2K Update for Health Care Lawyers,1 and by Alyssia Chapman, JD, BSBA, NMCM, a supervisor with Uniband and contractor with Indian Health Service in Albuquerque, NM. Kearney is partner and co-chair of the year 2000 practice group of the firm Reed Smith Shaw & McClay LLP in Pittsburgh. (For Web resources for contingency plans, see p. 172.)

o Have management involvement. In the event of serious Y2K problems, choices will have to be made about what are the hospital’s most important departments and priorities. These choices cannot be made by technical employees.

o Plan to have a SWAT team of employees on hand at the century date change who can determine what is not working and what can be fixed.

o Have backup phone equipment in case the phone lines are down. Cell phones are essential. In the event that cell phones don’t work, consider using a ham (short-wave) radio.

o Do a department by department inventory of possible failures and determine whether the expected failures are mission-critical and what work-arounds are possible. Plan now for the cost of such work-arounds and consider again which departments are mission-critical and which are not, in light of work-around costs.

o Train employees now that they may be called on to work without reliable power and "essential" biomedical equipment.

o Empower employees to suggest ways to work around expected failures.

o Make arrangements with employment agencies to secure a contingent of qualified nursing and support staff for that time.

o Make sure the backup generator is working and the hospital has a supply of fuel. Consider using alternative energy sources such as solar power or passive wind-generating systems.

o Have on-site portable water sources in case normal sources are not available.

o Consider whether the hospital’s cost-saving "just-in-time" inventory system should be modified in 1999 to stockpile key supplies. Stockpiling three to five times your normal inventory is a good idea.

o Contact blood services to arrange for incremental deliveries throughout the last week of the year.

o Install perimeter security monitoring systems and lock all nonemergency and non-ED doors during this time to minimize unmonitored access.

o Inform the community in 1999 that there may be disruptions in 2000 in the delivery of health care services. Patients should be asked to keep copies of their bills and medical records in the event of Y2K computer glitches.

o Start keeping hard copies of transactions in 1999 in case of computer glitches.

o Determine what the hospital will do if its payment stream is interrupted because Medicare, Medicaid, or private insurers are not paying.

"Find out what kind of financial status you need to be in — in terms of liquid cash and credit — to cover your operational expenses," says Ginger Campbell, RN, PhD, a consultant in Tampa, FL, with a variety of health care organizations. "You will have to continue to maintain operations. What will be your break-even point? What patient volume can you sustain and not get reimbursed?"

o Decide what will trigger aspects of the contingency plan. For example, when will the hospital cut off suppliers if they miss deadlines to disclose their year 2000 plans?

o Expect the hospital’s contingency plan to be the focus of litigation. For example, hospitals could be sued by patients injured because nurses had not been trained to perform manual tasks or by hospital suppliers that are cut off because they are not year 2000 compliant.

If hospitals do not have a contingency plan in place, now is definitely the time. "You need to have the plan on-line at least eight months before the D-day," Campbell says. "You need to have time to test ideas to see if the processes that you built in your contingency initiatives work. If they don’t work, you have to allow yourself room to tweak them and replace them with other processes that do work. It’s a business continuity issue."

Reference

1. Kearney K. Y2K Update for Health Care Lawyers. Pittsburgh: Reed Smith Shaw & McClay LLP; 1998.