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How well equipped are hospitals and other health facilities to respond to employee sabotage and other crises?

What are the most common types of crises affecting health organisations such as hospitals, medical centres, aged care facilities, pharmacies and dental clinics?

And how well are such organisations equipped to respond to crises such as product recalls, employee sabotage, natural disasters and major lawsuits?

These questions have been investigated by researchers, and the results are more than a touch worrying, reports one of the study’s authors, Dr Deon Canyon from the Disaster Health and Crisis Management Unit at James Cook University in Townsville.

Dr Deon Canyon writes:

Between 2007 and 2008, I was involved in studying various health organisations to determine what types of organisational crises they experience and what they are prepared for.

The reason for doing this research is that an organisation’s preparedness agenda bears a direct relationship to its capacity to respond to and manage crises.

The results were published recently in two papers which can be found here:

The Asia Pacific Journal of Health Management

Journal of Homeland Security and Emergency Management

In brief, this research examined responses from senior decision-makers in 19 hospitals, 11 medical centres, five aged care facilities, five chiropractic practices, eight physiotherapy practices, five podiatry practices, six dental practices, and 18 pharmacies. While the numbers are low, the results merit immediate attention.

Specific mismatches between what was experienced and what was planned for are presented in Table 1 below.

For instance, 60% of hospitals experience product recall crises and they have reasonable capacity in this area. However, 32% of hospitals experience employee sabotage crises and yet they have limited or no capability in this area.

fig

The data suggest that the organisations surveyed have fallen into the pattern of developing capabilities for certain common, expected threats, and extraordinary threats, such as disasters, rather than for what they consider unlikely or what they have not experienced.

The disconnect between what is planned for and what is actually experienced is of considerable concern because it suggests that planners lack sufficient awareness of the actual threats encountered by their organisations.

The policy implications are considerable for accreditation providers. In Australia they are predominantly the Australian Council on Healthcare Standards, the AS/NZS ISO 9000 series of quality standards, and the QIC’s Health and Community Services Standards.

Regardless of the standard adhered to, hospitals fall short in several important areas that are not adequately monitored or assessed.

When the results of this study were presented to the owner of several private hospitals, the response was not ‘Tell me what can I do to become adequately and proactively prepared?” It was, “Talk to the Risk Officer who is in charge of accreditation.” and “Oh dear, this will force the accreditation bodies to address obvious deficiencies” [paraphrased].

The 2006 appointed Australian Commission on Safety and Quality in Health Care is still working to review a new model of national safety and quality accreditation for health service organisations.

In light of the results from this non-comprehensive, cross-sectional study, the standards leave much to be desired and render our health institutions significantly unprepared.

The questions that deserve a response are:

•  “Will the organisations responsible for hospital standards act responsibly now that they know existing standards based on standard risk management processes are flawed?” and

• “Will Australian health managers become proactive and move beyond-compliance in the way that some of their counterparts in business have done to render their organisations more responsible, accountable, sustainable and prepared?”.

PostScript: I just received a response from BW Johnston – CEO of the ACHS (Australian Council on Health Standards) in response to my letter informing him of my results.

He says:

The ACHS accreditation program has over many years provided a focus on the need for preparedness in the event of an emergency (or crisis). The evidence from the evaluations conducted by ACHS is broadly consistent with the findings outlined in your paper. In part, the variation in performance appears to have many explanations including the impact on organisations of restructuring, the effect of staff turnover and the evolving nature of risks. Planning responses in the event of either an internal or external ‘disaster’ are part of a broader risk management program.

Great – for ‘many years’ his evaluations have detected similar gaps.

So why are the gaps still there? These three reasons still do not explain the gaps between what is experienced and what is planned for and our hospitals have clear preparedness deficiencies.

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