Emergencies Happen:How Prepared is Your Center?By Teresa D. Johnson, BS
Protecting the safety of participants and staff should be your most important and immediate consideration in the event of an emergency. Lack of planning will lead to costly mistakes. Gathering information is an essential part of planning. To provide the best possible protection, take particular care to consult with safety experts when planning emergency procedures. Information in this article is not considered comprehensive, but should serve as a starting point for analyzing and improving your center’s emergency plans and procedures.
Every adult day center is unique in its location, facility, etc. While an organization operating multiple sites might draft standard emergency procedures for all its centers, it is important to research relevant local codes to ensure local compliance. Special attention must be given to local (city and county), state and federal codes, ordinances and standard safety procedures. Examples of entities to contact include the local governing body, planning and code enforcement agencies, local and state Division of Emergency Management, emergency medical services, fire department and law enforcement.¹
A Thorough Plan An emergency plan is only complete if it defines policies, procedures, responsibilities and actions that the facility will take before, during and after any emergency situation. Emergency management planners recommend identifying references to specific codes, rules, ordinances or other materials in the center’s emergency plan.²
Basics about the Center The starting point for reporting an emergency is knowing basic information concerning the facility. Adult day center staff usually have immediate access to current information about the persons served and the personnel in an emergency. But it is also important to have information about the facility itself in case the situation merits it. The following information should be known by all staff and easily accessible in the event of an emergency: à Name of facility, address, telephone number, fax number, emergency contact telephone number à Owner of building in which center is located, address, telephone number à Year facility was built, type of construction and date of any subsequent construction à Name of administrator, address, work/home/alternate telephone number à Number of clients center is certified or licensed to serve à Type of clients served by the facility, e.g. clients with Alzheimer’s Disease, clients requiring special equipment, e.g. oxygen or dialysis.
Analyze vulnerability Identify potential hazards that might threaten the center such as l Fires l Bomb threats l Power failures l Medical emergencies l Safety during violent situations l Missing persons Other hazards may threaten the center as a result of the center’s location, e.g. floodplains, seismic faults, proximity to major transportation routes, airports, nuclear power plants, etc. l Flooding l Hurricanes l Tornadoes l Earthquakes l Terrorism l Hazardous materials spills (based on proximity to a railroad or major transportation artery) l Nuclear power incident (if facility is located within 10-50 miles of the emergency planning zone of a nuclear power plant). Identify specific evacuation zones and routes such as those relevant to hurricanes or flood zones.
Authority Outline the center’s staffing pattern. Define who has the primary authority to make decisions for the facility. Identify at least one alternate in case the primary contact is unavailable to serve in that capacity. State the operational and support roles for all facility staff to ensure timely activation and staffing in emergency situations. Leave nothing to chance.
Notification & Evacuation Procedures must be in place for the center to receive timely information on impending threats and alerting center decision makers, staff and clients of potential emergency conditions. n Define how the facility will receive warnings n Define how staff will be alerted during operating and non-operating hours n Define procedures and policy for staff reporting to work if the emergency occurs during non-operating hours
An emergency plan should not only address an evacuation from the building, such as in a fire drill, but a mutual aid agreement should be entered into for transportation and pre-determined shelter in the event the staff and participants are unable to return to the physical facility. Include a map of the primary and secondary evacuation routes and a description of how families and van drivers get to the receiving facility. Describe procedures for notifying the receiving facilities and transportation systems. Inform families of participants of the notification process for center closings or evacuations in writing at orientation, as updates are made and as potential hazards threaten.
Evacuation Consult with the local fire marshall, fire chief or emergency management planner about the safest and most appropriate primary and secondary evacuation routes for removing people from the building, as well as for relocating to the pre-determined shelter. Post approved fire safety and evacuation plans in every room of the building. In the emergency plan, specify how staff and volunteers should be removed from the facility and where to position participants once outside the building. It is also important to identify exactly what should be taken from the facility. Establish procedures for inspection of the facility to ensure it is structurally sound and who is responsible for authorizing re-entry to the building.
Keep in mind that participants should never be left unattended, even when an emergency evacuation is in place. Ensuring safety is the primary reason the National Standards and Guidelines for Adult Day Services recommend that at least two responsible persons (one a paid staff member) are at the center at all times when there are two or more participants in attendance.³
Recovery and Restoration Preventive measures must be taken routinely to preserve records from damage by fire, water, etc. Photographing or video taping vital equipment before a disaster is a great way to document assets. Thought must be given to alternate locations for relocating participants should the building be destroyed or severely damaged. Damaged goods and equipment must be addressed, as well as who maintains contact with participants, their families and “the public.”
Training Having a plan on paper does not mean everything will run smoothly when emergencies happen. It is critical that thorough preparations be made, that everyone knows his/her role and is trained to carry out his/her responsibilities. Readiness for hazards that pose the highest threat, such as fires, should be tested frequently. Other plans should be tested at least annually at varying times of operation in all locations where the adult day program operates. Establish a training schedule to ensure all portions of the emergency plan and evacuation plans are reviewed and tested at least annually, in addition to training new employees during their initial orientation.
Tests of the emergency plans can be done by giving staff announced or unannounced written tests that detail what should be done in the event of an actual emergency. The results of the testing should be tallied and used for taking corrective actions to improve the knowledge and readiness of staff to respond to an emergency. Ensure that all equipment identified in the emergency plan is available, accessible and in working order, and that staff are comfortable with it. For example, performing regular fire drills is common place, but how many staff have demonstrated competency in using a fire extinguisher? Keep a training log to document every training event.
Emergencies can and will happen. Adult day centers must continuously analyze their procedures to maximize safety and minimize loss of life and property in the event of an emergency.¥
References ¹”Extended Care Facilities Emergency Planning Guide,” NC Division of Emergency Management, Raleigh, NC. ²”Emergency Management Planning Criteria for Adult Day Care Facilities,” FEMA. Chapter 252, Florida Statutes, October 2000. ³Murphy, Mary Brugger & National Adult Day Services Association. Standards and Guidelines for Adult Day Services, March 1997. Washington, DC.
Reprinted from The Information Source for Adult Day Centers®, October 2001 |