Realistic Simulations Should be Used To Prepare for Healthcare Crises
In the aviation industry, pilots regularly test emergency scenarios in a physical simulator, working through what happens when autopilot disengages or screens go dark. They can replicate a potential situation and start building a bit of muscle memory around it.
Healthcare organizations should start taking a similar approach, moving away from tabletop exercises that are limited to discussions in a conference room and introducing a simulated environment that will better prepare hospital staff for crises.
And training should not be limited to a small sample of scenarios. What if downtime happens during a shift change? How is information coordinated as one team replaces another? Every department should be tested.
The Importance of Dependency Mapping in Healthcare for Resilience
Modern healthcare organizations not only have their internal teams to oversee, they’re likely working with multiple vendors and relying on a number of outside services, whether it’s third-party payroll applications or a cloud environment. That means a sizeable chunk of their ecosystem is not under their direct control, which is where dependency mapping can help.
Organizations that understand all of the relationships and connecting points that go into clinical workflows will improve their approach to resilience because then they know before an emergency what their safe minimum practice is. Dependency mapping identifies the people, devices, applications and vendors that each clinical function relies on:
- People – What happens when you don’t have the right number of nurses to work a shift because there’s a hurricane? What’s the limit for a lean staff that can still keep a unit safe?
- Devices and applications – If a majority of workstations go down on a unit, could a single operating workstation still meet the demands of care? If an EHR system goes offline for radiology, can imaging still be accessed locally? What is a minimal application set?
- Vendors – If a formulary lookup tool is offline, can a unit still operate safely?
There's a major difference between a hidden dependency during a crisis that an organization wasn’t aware of ahead of time versus a plan for working with that limitation.
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Going Beyond System Restoration and Prioritizing Recovery Validation
One of the most consequential gaps in clinical care resilience planning is treating system restoration as the finish line. Having a system available again is not in itself a clinical release criterion. Recovery validation is just as important to safe patient care, and it’s not as simple as turning to a backup system and continuing work.
For instance, before teams can resume work within an EHR system that was offline, has data been properly reconciled? If medications were noted manually on a scratch pad, was that data moved to the EHR system once it was back up? Is information flowing freely between multiple systems again? Data reconciliation and interface validation are often overlooked processes.
As cyberthreats continue to evolve — especially with the rapid evolution of artificial intelligence — and natural disasters become more severe, clinical care resilience is critical for healthcare organizations to build. Operational disruptions are not only a financial risk but a patient safety one, so organizations must adapt their downtime procedures to changing expectations.
This article is part of HealthTech’s MonITor blog series featuring analysis and recommendations from CDW experts.
