Emergency preparedness was once more of an afterthought than a major priority among healthcare providers. But much has changed since the turn of the century when terrorist attacks on New York and Washington, D.C., and a string of natural disasters stretched hospitals beyond their capacities and capabilities.
“It really came to a tipping point I think with 9/11 and Hurricane Katrina,” said Meg Femino, senior director of emergency management at Beth Israel Deaconess Medical Center in Boston. Femino also oversees emergency management for several other hospitals within the Beth Israel Lahey Health system.
“We saw the fallout of what happens when you are not prepared,” Femino said.
Indeed, the terrorist attacks on Sept. 11, 2001, caused healthcare providers to bolster their focus on emergency preparedness that included adding more safeguards in the event of an extended power loss.
Such focus was backed by the federal government. In 2002, Congress passed the Public Health Security and Bioterrorism Preparedness and Response Act, creating the Hospital Preparedness Program that provides grants to healthcare providers specifically to fund their readiness efforts.
At its height in 2003 and 2004, the preparedness program provided hospitals with more than $500 million in grant awards, but over the years the level of funding has steadily decreased. In 2019, funding was set at $254.5 million.
But Femino said a lot has changed over the past 10 years, with hospitals developing better contingencies in the event of a blackout. She said the number of emergency preparedness standards for hospitals from federal and state regulators as well as accrediting organizations such as the Joint Commission and the National Fire Protection Association has grown over the past decade from just a few to more than 120 currently.
In 2017, the CMS finalized updates to its Emergency Preparedness Rule to establish national standards for how healthcare providers handle natural disasters and terrorist threats. Under the rule, hospitals are required to have generators that can power critical care areas where life support equipment is used and kick in to supply power within 10 seconds after a power outage occurs.
Following the CMS rule, the Joint Commission also updated its own emergency management standards, which include requiring hospitals to perform regular testing of their emergency generators every month for at least 30 continuous minutes and store enough fuel on-site to keep generators running for up to four days.