Issue link: https://nebusinessmedia.uberflip.com/i/840658
Healthcare providers prep for new emergency preparedness rule Healthcare Operations By Scott Aronson W ith a November implementation deadline fast approaching, healthcare providers are tasked with ensuring they are compliant with the Centers for Medicare & Medicaid Services (CMS) Emergency Preparedness Rule. e rule focuses on core elements of emergency preparedness, from risk assessments to training exercises It will impact 17 types of providers and suppliers, including hospitals, long-term care, surgical centers and community mental health centers. In recent years, Connecticut experienced a tropical storm and hurricane, the Halloween storm of 2011, active shooter events and other disasters. With the escalation of disasters throughout the nation, the existing regulations provided baseline guidance, but little beyond that. e emergency preparedness rule aims to beef up those guidelines. ey include several aspects. Risk assessments and planning Risk assessments are vital to maximizing patient safety when facilities are faced with threats. By requiring providers to conduct a Hazard Vulnerability Assessment (HVA), CMS aims to ensure facilities have assessed their perceived risk for incidents such as loss of power, fire, tornado, and electronic health records failures, among other potential threats. Findings from the HVA help facilities make informed decisions on procedures, equipment needs, drills and exercises. Creating a communications plan e fast pace at which disasters and emergency situations unfold requires healthcare facilities to have a comprehensive and actionable plan in place for communications. Facilities need to ensure timely communications to local responders, media and others. For nursing homes, a new targeting requirement is the need to communicate effectively with patients and their families, not only during an event, but also ahead of time. is helps to control the spread of misinformation and demonstrate the facility's conscientious response to a potential situation. Managing evacuations or high vol- umes of incoming patients Emergency situations may pose two high impact scenarios to healthcare facilities — the need to evacuate a portion or all of the building, or the need to receive a high volume of patients simultaneously (a mass casualty incident or "surge"). To effectively respond to either of these scenarios, healthcare facilities need to have practiced their response prior to the actual incident occurring. Hartford area healthcare facilities have taken a coordinated approach to preparing for these scenarios. More than 120 facilities in this region use a common platform and have planned and practiced how they will support one another in an emergency. Education and training While facilities have been required to conduct exercises twice per year, the new CMS rule stipulates that one of these exercises must be a full-scale, boots-on-the-ground exercise with a provider's emergency partners. e other drill remains the facility's choice, using a high-impact threat to test their response. Connecticut is a national leader in this area, with nursing homes and assisted-living communities running full-scale disaster exercises since 2009. With the new CMS rule requiring facilities to take a more prescriptive approach to maximizing patient safety, it is critical for facilities to prioritize how they will ensure compliance. Healthcare leaders and staff of across Connecticut are working diligently to meet these challenges. Scott Aronson is principal of Russell Phillips & Associates, an emergency management consulting firm with a regional office in Plainville. In health care, outdoor settings matter Health Environment By Kristin Schwab and Claudia Dinep A growing body of research shows that exposure to outdoor green spaces improves cognitive, mental and physical health. Healthcare facilities in Connecticut and beyond are taking advantage of even limited outdoor space to extend their mission of healing and wellness into the outdoors. is trend offers opportunities for local providers to tap the hidden potential of roof tops, entry ways, streetscapes, and even parking lots to better serve their patients. Supporting this trend is research presented at a recent conference at Yale called "Health of Place," organized by the Northeast Summit for a Sustainable Built Environment. ere, public health researchers from Harvard University reported important links between well-being and the design of specific aspects of the landscape including aesthetics, accessibility and connectivity. While technical advances in health care have eclipsed these ideas, the intuitive connection between healing and nature appears to be regaining ground in part due to the emergence of evidence-based design. One recent Connecticut example is a new neonatal intensive care roof garden at Danbury Hospital designed with lush planted areas to feel like a park setting. Seating areas as well as contemplative areas were developed using textures and colors found in nature, which create an immersive natural experience. Two avenues exist for healthcare facilities to take advantage of landscape design to better the health of their patients. One is the familiar concept of the healing garden, where therapeutic benefits are tailored to address specialized physical or mental health conditions or populations. e other provides a broader stress-busting effect in promoting health in the larger context. Many opportunities to improve wellbeing through nature also have environmental benefits. In addition to critical health benefits, living landscape spaces manage stormwater, moderate heating and cooling needs, and improve air quality. With increasing build-out of hospitals on limited campus space, sometimes the challenge is finding room for these natural landscapes. Booming healthcare construction over the last decade has increased parking needs and reduced open spaces. However, the way patients arrive to campus, find parking and navigate to the front door all play an important part in how welcoming a facility is to visitors. Research has shown that much of the stress of a doctor's visit is not the visit itself but the anxiety felt in the waiting room. Ultimately, when you think expansively about healthcare campuses and the patient experience, it is the sidewalks, parking lots and walkways that are the first waiting rooms. So how can we best leverage the outdoors at a hospital campus to improve patient well-being? Examples include adding roof gardens, activated garden walls and extensive planting beds. Further strategies for creating value within the landscape to attract patients and promote human health include: • Balancing "green to grey" ratios by maximizing green space and minimizing pavement; • Converting underutilized rooops and vertical surfaces to green space and features; • Creating accessible space for a wide spectrum of users, from strollers, to wheelchairs, to the elderly; • Providing varied seating options within green outdoor spaces; • Making it as easy as possible to get from the parking lot to the front door of a hospital or medical facility; • Utilizing a participatory process to develop the overall "environment of care" so all needs are considered. Kristin Schwab and Claudia Dinep are principals of landscape architecture firm Dinep + Schwab in West Hartford. H H GREATER HARTFORD HEALTH • Summer 2017 21