If and when a flu pandemic hits, Canada’s major health facilities won’t be taken by surprise like they were with SARS.
Toronto’s Sunnybrook Health Sciences Centre, for example, says the SARS experience was an excellent test of the IT department’s service model, according to Sarina Giraldi, Sunnybrook’s director of operations and e-health strategies. Giraldi, who has been developing the facility’s IT pandemic plan, said in an e-mail interview the SARS event “definitely triggered fresh discussions with our teams.”
IT needs to not only develop a plan to deal with events of this nature, but to be able to communicate to staff it is providing options to enable the hospital to stay up and running 24/7 and to meet IT’s service expectations, she says.
“No matter what the situation, phones and automated services/tasks will still be required by our clinicians, administration and support staff needed to assist as usual,” she says.
Sunnybrook, which has taken an “all-hazards” approach to its business continuity planning, has made cross training and development a priority since SARS as a means of ensuring available staff in case of staff shortages. Giraldi says help desks and call centres will ensure support services are still in place should the hospital be faced with a crisis and find itself dealing with limited staff or closures. “We have the technology to set up our operation immediately anywhere in the hospital and remotely if required,” she says.
To ensure Sunnybrook’s plan works, the help desk set up a small test pilot that demonstrated a seamless transition with remote access in an emergency.
“A staff member was set up remotely for work as usual for a two-week period. During this time the staff member logged her experience, especially in respect to ease of transition,” she says.
But that it’s not enough to just have a plan, experts warn. Graeme Gordon, a partner in Accenture’s e-government practice, says while it’s possible to prepare for all types of business interruptions under one plan, a pandemic will pose unique challenges.
Accenture, which recently released a brief on pandemic planning, advises organizations to embed business continuity plans in their daily operations.
“What we advocate in terms of preparing for this type of problem is not to take a separate group and launch it as a one-off project,” he says. “The risk assessment, the preparations the planning and the constant reviewing of that plan should be part of ongoing operations, so from a government perspective I believe it should be one of the assigned responsibilities of somebody senior in a particular department.”
There’s a lot of redundancy in place today with disaster and continuity planning that had been done previously, Gordon says, but they have to be looked at in terms of the potential reduction in personnel that many organizations are facing. “From a pandemic standpoint you have to assume that perhaps 25 per cent of the people are going to be incapacitated or just not going to show up for various reasons, and that requires a different type of thinking.”
While it’s comforting to know hospitals are preparing for the worst, it’s perhaps even more important that the provincial governments responsible for health care delivery to Canadians set the standard for internal business continuity planning.
Ontario’s emergency management programs are designed to be flexible enough to meet all threats, says Sam Colalillo, spokesman for the Ministry of Government Services, which is the corporate lead on the province’s BCP.
“They have been refined to help deal with pandemic influenza and they will be refined on an ongoing basis as new threats emerge and develop,” he says. “You’re not going to draft an emergency management plan to a specific situation – nobody knows if anything happens how it will happen.”
Representatives from each ministry participated in a tabletop exercise this past spring, and a number of IT solutions, such as dial-in capability, instant messaging, teleconferencing and access to internal e-mail, have been identified as essential to deal with a pandemic emergency, he says.
Like Sunnybrook, Ontario has developed an IT matrix designed to identify each staff member’s skills, and provide cross-training so employees can be redeployed as necessary.
Alberta has also developed an extensive pandemic flu plan. Mark Dixon, director of public affairs for primary care and public health in one of Alberta’s Capital Health regions, says the province’s Capital Health Link call centre will continue to operate as usual. It will draw resources from other parts of the organization where possible, he said in an e-mail interview, and has planned for a 30 per cent reduction in the number of available staff.
“They are also not saying no to other option,” he says. “For example, if there is a need to use non-nurses to answer some basic non-medical questions, then we will go there.”
At the time of the interview, Alberta Health and Wellness was planning discussions with the health regions to discuss various options, such as working from home. The province has also been having ongoing conversations with Telus about technology options during a pandemic, including the use of geomatics, which would address the need for urgent messaging to large internal and external audiences, says Dixon.
Dixon notes that Alberta is working not only with the other capital health regions in the province, but with other provincial agencies such as Alberta Health and Wellness and Emergency Management Alberta, but with the municipalities and Health Canada as well.
Sunnybrook is also coordinating its efforts with the Toronto Academic Health Sciences Network and working on planning principles and actions for Toronto teaching hospitals in preparation for additional patients and limited resources, says Giraldi.
And that’s key, observes Perrin Beatty, president of Canadian Manufacturers and Exporters. Beatty, who has a long history in the public sector prior to moving to the private sector, says he would like to see greater visibility and leadership from government in terms of sitting down with other organizations such as provinces, municipalities, transit authorities and school boards.
“We should be fairly intensively looking at how our plans interact with each other,” he says. “What about our critical suppliers and the services being provided? We should be sharing a lot of information and trying to get a better understanding of how various plans people have developed interact.
“They may very well make sense on a standalone basis but you have to look at how they mesh with each other and I didn’t get a sense of if there have been extensive simulations and exchanges of information among all the organizations that are going to have to function well together.”
Beatty says while he’s not satisfied each agency in the federal level has its act together in terms of pandemic preparedness, “they’re much better prepared than they were a year ago. I think they take it seriously.”
The CME, which has provided and extensive pandemic planning document for its members, says there have been 75,000 downloads of the document from the site.
“That’s unprecedented in terms of the volume of interest,” he says. “It indicates there’s an awareness there’s something serious here and also that people realize they have a lot of work to do and often they don’t know where to start.”
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