“Seeking Evidence-Based Covid-19 Preparedness: A FEMA Framework for Clinic Management” – The New England Journal of Medicine


IN FACT, there are guidelines. As the author of this article in the New England Journal of Medicine discovered:

“ICS (The National Incident Command System) is a standardized approach to emergency management. Its goal is a coordinated response with common processes and resource management. It was initially used to manage wildfires in California; now I use it to manage Covid-19 in St. Louis, Missouri. As a leader, having a framework makes the unknown seem more manageable. Being able to share a plan has brought comfort to my clinical team, both providers and staff. Creating a ‘Plan B’ for possible threats assuaged anxiety, and enacting aspects of this plan on day 2 of preparation (more on that below) resulted in calm, efficient actions, rather than panic and chaos. While not all aspects of ICS were applicable to our clinic’s response, we utilized the principles as the foundation of our new plan.”

The All Hazards ICS approach to managing incidents is not new. It’s not even new in the healthcare industry; it uses the Hospital Incident Command System. In nursing homes, there’s the Nursing Home Incident Command System.

Pandemic? Sure pandemic has been a scenario that all hospitals, nursing homes and municipalities SHOULD HAVE KNOWN about and exercised (and trained for) since 2005.

“An independent, not-for-profit organization, The Joint Commission is the nation’s oldest and largest standards-setting and accrediting body in health care.” And while The Joint Commission has “no standard that specifically addresses educational requirements for organizations that use the National Incident Management System (NIMS) as an incident command structure. If the organization is required to use NIMS by their state or local controlling authority, then per standard LD.04.01.01, the requirements of that controlling authority with regard to NIMS implementation and educational requirements must be followed,” it does “require healthcare organizations to develop and maintain an emergency’s management program so that patient care can be continued effectively in the event of emergency or disastrous situations.”

While this nation’s not walked down this pandemic road in a while, the roadmap has been produced — it seems few people really bother referring to it until the doo-doo gets deep.

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