Emergency Management Healthcare

Establishing Stronger Resilience in Long-Term Care Facilities

Organizations, to have any longevity, have to build organizational resilience for the unexpected.

In the past few decades, that resilience has come together through emergency management and business continuity programs. The understanding emergency managers, continuity planners, and other professionals hold of program must-haves has also changed over time in response to new environmental, political, and regulatory landscapes.

The deep Texan freeze caused by Winter Storm Uri in February 2021 shifted the thought process again, and especially so for long term care. What does it mean to be fully prepared as an LTC or LTAC and how can organizations meet the new standard practitioners are now forging?

This post is sourced from a recent Veoci webinar: Reframing Resilience for Long Term Care Facilities. If you’d like to see the webinar recording, click here.

Legislation: Texas SB1614

While Texas SB1614 and HB2325 have failed their respective journeys through the Texas state legislature, it doesn’t mean the bills lack lessons for LTCs. Lance Lynch, Account Executive at Veoci and a participant in the Reframing Resilience for Long Term Care Facilities webinar, covers the impact of the two bills in this blog post.

If there’s any one takeaway from the past year and half, Lance said during the webinar, is that there’s no excuse to be prepared. There is no saying “it can’t happen here.” And that attitude needs to spill over to LTCs, both for the benefit of the facilities and their surrounding healthcare systems.

The MAP LTC Task Force

Doni Green, MS, Director of Aging Programs at the North Central Texas Council of Governments, established a task force in the North Central Texas Regional Advisory Council in 2020. The Mobilizing Action Planning for Long-Term Care Facilities Task Force, or MAP LTC Task Force for short, is a group of professionals actively identifying emergency planning needs and gaps of LTCs; the group also sets out smart preparedness goals for LTCs to meet. The overarching goal of the group is to assist in the emergency planning process of LTCs and develop more resilience within the region’s healthcare system.

With this larger goal in mind, Doni and the other professionals on the task force laid out more specific goals. Those goals were the following:

  1. Increase long-term care representation in the healthcare preparedness community of the region.
  2. Help LTCs develop all hazards plans in accordance with CMS guidelines.
  3. Improve inspection control and management within LTCs.
  4. Ensure facilities know their emergency managers and who can assist in procuring resources during disasters.

Doni and the MAP LTC Task Force used surveys to develop these goals. In doing so, Doni and the group found only 26 of 98 survey participants knew their city’s emergency manager and path for requesting resources. The survey not only found a specific issue to resolve, but revealed the need to strengthen the overall resilience of LTCs.

Another survey Doni and the task force sent out showed that getting participation might not too difficult. There’s a willingness among the leaders of LTCs to involve their facilities in the resilience operations of the region. 93% of the survey’s respondents expressed a desire to participate in drills going forward.

Hospitals within Hospitals

John O’Hearn, FACHE, MHA, Chief Executive Office at Select Specialty Hospitals-Dallas, noted that preparedness within LTCs shapes depending on the approach. For a long time, LTCs and other acute care facilities have used a “free-standing” model for preparedness. As time passes and new events force these facilities to respond, however, these facilities’ leaders are taking a second look. As more and more LTCs and LTACs join local healthcare RACs and coalitions, opportunities arise for facilities to take a “hospital within a hospital” approach.

Resilience for the LTCs and LTACs following this model means ensuring communication within the system (i.e., local hospitals and other care facilities). Building relationships and starting initiatives will allow the professionals on each side to be ready when something happens so quality of care and operations will take a minimal hit. Facilities should go as far as having regular exercises with their partner care providers as well.

Internally, facilities practicing “hospital within a hospital” need to have two sets of plans and policies. One plan should handle scenarios without the region’s helping hands. The other set should set rules and standards for the times the facility reaches out for aid. This set up should minimize internal and external miscommunication and keep all stakeholders on the same page.

What Preparedness for LTCs Means Going Forward

As cultures of preparedness slowly take hold in the operations of LTCs and LTACs, these facilities will still need to bridge some gaps in operations.

Drills and exercises are an essential piece in the emergency management and continuity programs of all organizations across all industries. As coalitions, RACs, and regions build their drills, LTCs and LTACs need to guarantee their own involvement. Not only will the exercise stress-test their preparedness, but it will help build the relationships and understanding needed to thrive in the heat of an emergency.

Additionally, staff and administrative turnover is relatively high in the LTC space. The lessons and knowledge from exercises and other preparedness functions can follow staff out the door. What LTCs and LTACs need to do is capture that institutional knowledge throughout their processes and usher it between new personnel and administrators. Preparedness coordinators may even want to consider assigning predetermined emails to positions so critical emergency and regulatory information doesn’t fall into a dead email inbox.

The failure to prepare sets a grim outlook. LTCs and LTACs put the lives of patients and residents at risk by being unprepared. Even on the lighter side, being unprepared means possibly putting additional strain on the local healthcare system, reducing the quality of care hospitals and other facilities can give to their patients.

So what can LTCs do?

Their call-to-action is to bake preparedness into operations. This means securing critical contact information, understanding the landscape of any emergency in the region, letting all staff know their roles throughout an emergency or disaster situation, and having communicable and actionable all hazards plans. LTCs and LTACs should bring this strategy to the larger community as well by building lines of communications and spaces for collaboration with other facilities.

The success of a healthcare system through a disaster depends on the success of the response of its LTCs and LTACs. Recent events have exposed the importance of emergency and continuity planning in this space, and the cost of being caught off-guard is too high. Many are probably just a few steps away from reaching the threshold for resilience, and now have the checklists needed to get there.

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