Coordination amid chaos: emergency planning key to ongoing delivery of health care in emergencies
By Terry Skipper
Winnipeg Regional Health Authority
Published Tuesday, June 15, 2021
Manitoba is no stranger to emergency situations or to mobilizing a response to rapidly changing circumstances. Within the health system, whether a flood, forest fire, pandemic or any other potential threat, the details of any emergency response will vary to ensure ongoing access and availability of health services. What will not vary, however, is the coordination, the collaboration and the "calm" brought to each situation by the skilled professionals responsible for emergency and continuity management who "shepherd" the health system's response to any and all emergencies. .
Shared Health's Emergency and Continuity Management Service is a vital part of the provincial Emergency Response Service, providing guidance, structure and support to emergency situations, helping to ensure healthcare sites, programs, and services are prepared to respond to a wide range of potential scenarios, including extraordinary events or disasters. This includes supporting all health regions across the province, to ensure that Manitobans continue to have access to the health-care supports they rely upon, even in an emergency.
The success of a response generally comes down to planning. Just as you would not wait for the smoke alarm to sound in order to plan your family's escape route, the health system cannot risk waiting for disaster to strike before springing into action.
The importance of planning was evident last month when forest fires forced the simultaneous evacuation of the Misipawistik Cree, Little Saskatchewan, Pinaymootang, Dauphin River and Lake St. Martin First Nation communities.
The health system's response began with a fire coordination meeting with health partners including Shared Health, the Winnipeg Regional Health Authority, the Canadian Red Cross, Indigenous Services Canada, Manitoba Emergency Measures Organization, Manitoba Wildfire Service as well as other relevant stakeholders.
With Winnipeg as the point of destination for many evacuees, the Winnipeg Regional Health Authority was identified as the anticipated provider of health services for evacuees.
Working with Public Health, evacuees that were unable to go directly to a hotel were directed to an Alternate Isolation Accommodation (AIA), established as part of the COVID-19 pandemic response to ensure evacuees who needed to isolate were able to do so safely even once evacuated from their home community.
Moving people out of the path of an emergency and finding them a place to stay is only one part of the health response. When people move, their health-care needs move with them. These can include meeting both acute and long-term care needs, such as ongoing care for pre-existing conditions such as diabetes, the provision of treatments such as dialysis and mental health supports. In response to the evacuation, WRHA mobilized supports to both assess and respond to the needs of evacuees.
While complicated by the ongoing COVID-19 pandemic, the mass evacuation involved partnerships and planning that are long-standing and which have been refined and improved over many similar events. The result, was a successful evacuation, in the most unprecedented of circumstances, with the evacuees ultimately able to be returned home.
These situations - even when they involve unprecedented challenges like those posed by COVID-19 - are able to be effectively managed because of planning, practice and partnerships.
In collaboration with health regions across Manitoba, the Emergency and Continuity Management Program within Shared Health supports the development of plans for any possible circumstance, including those with the potential of compromising the health system itself, e.g. a hazardous chemical spill, power outage, lost air conditioning or water damage.
From the mundane to the major, planning for events can ensure the impact to services - and to patients - are limited.
Once planned, responses are practiced, and refined. Table-top exercises, dry-runs and similar dress rehearsals are an important component of process improvement, with learnings both identified and included in the next phase of a plan.
It is often said that you must "plan for the unexpected" and this is absolutely accurate when anticipating disaster scenarios. While it's not possible to plan for every possible occurrence, the existence of strong and effective emergency and continuity management structures - and the partnerships that make them work well – are invaluable.
One of the secret ingredients in a strong health system emergency response are the relationships that exist between health regions, health-care facilities and the many other agencies and stakeholders. Knowing and understanding roles and responsibilities allow for an effective management of a disaster, even when the emergency itself is new - or different.
Manitoba's health-care system is sophisticated and complex, with many moving parts, but when an emergency occurs, the relationships, skills and capacity that exists within the system means it is capable of incredible things.
Terry Skipper is Provincial Health Operations and Recovery Lead for Shared Health's Emergency and Continuity Management Program.