Tornado, Flood, Power Outage?

Thursday, February 7, 2013

Small practices and clinics have to prepare, too.

Faced with Hurricane Sandy, many hospitals were forced to use emergency power, relocate patients or even close their doors. Family medicine practices and specialty clinics may not have the same demands placed on them during an emergency, but it’s still important to be prepared. In fact, risk management policies and procedures are required for all health centers, according to the U.S. Department of Health and Human Services (HHS). Clinic and practice owners must be prepared to show evidence of emergency management planning, collaboration with other providers, information sharing, and keeping up operational and financial stability, even in a crisis.

Besides the obvious difference of most small practices and clinics not having residential patients or providing emergent care, what makes an emergency management plan for the small practice or clinic unique?

‘Generic’ Patients Versus ‘Our’ Patients

Arlo Weltge, M.D., M.P.H., clinical professor of emergency medicine at the University of Texas Medical School, Houston and past council speaker for the American College of Emergency Physicians, distinguishes physicians’ practices from hospitals and emergency centers in terms of emergency preparedness.

“Smaller practices have smaller infrastructure, but they have specialized and personal relationships with their clients,” he observes. “Whereas hospitals accept generic patients, smaller practices have a much closer doctor-patient relationship depending on the individual needs of the patient.”

What does this mean in concrete terms?

While a clinic may not have to house patients 24 hours a day, a larger web of care may link doctors and their patients across a catchment area.

“Some patients use devices, such as home ventilators,” Dr. Weltge says. “Others — oncology patients, for example — rely on compounded or unique medications. While these patients receive treatment at home, they’re complex cases dependent on individual care. Having a doctor who is familiar with the patients’ nuances and complications can cut through a lot of complexity.”

With responsibilities to patients who may be dispersed or homebound, how should small-practice doctors create emergency preparedness plans?

Dr. Weltge emphasizes record-keeping and communications between practices across wide geographic areas. “If patients are displaced, it’s important that they have access and understanding of their records so that another doctor in the receiving community can provide support for them,” he says.

In addition to maintaining awareness of the needs of off-site patients and preparing for them to get care elsewhere, small practices and specialty clinics still need to have plans to provide for the physical security and recovery of the clinic, as well as maintaining staffing during times of crisis, Dr. Weltge says.