How should a hospital best respond to an emergency and which types of crises should it be prepared for? We spoke with Professor Ronald Glasberg at the SRH Hochschule Berlin on this subject.
Professor Glasberg, how should hospitals prepare for crisis situations?
Ronald Glasberg: Let’s take a differentiated view of your question. Of course, there are a number of reference books that define recommended practices and quality specifications. However, these rarely find their way into real life, since every hospital needs to cope with its very own specific challenges. It’s not interesting for associates to learn what they need to do in case of flooding, if their hospital is located on a hill, but it’s important for a hospital that’s located on a river. Each hospital therefore has different circumstances. That’s why it also needs to be prepared for its specific crisis situations. Within the research project titled “Hospital Crisis Management“, we focused on four core areas when identifying the main crisis situations: medicine, personnel, supply (energy) and IT systems. All of the identified crises in these four areas were first analyzed and subsequently evaluated based on ”nature of risk“ and “probability“. In conclusion, specific preventive and response measures were developed for the most important crises scenarios.
Can you give us some examples?
Glasberg: In an overall view, “skills shortage“, “systematic prevalence of poor hygiene“, “acute staff shortage in case of a pandemic“, “reputational damage“ and “fire“ rank among the Top 5 crisis situations. Overall, the subject of personnel is increasingly mentioned as a catalyst for crises. Skills shortage is especially a problem in rural areas, because unlike urban areas, hospitals there barely manage to find adequate talent and fill vacancies. Acute staff shortage due to a pandemic was also identified as a crisis scenario by German hospitals. Participants of expert workshops rate this scenario as particularly important, since a pandemic would lead to a double burden in hospitals. On the one hand, the hospital needs to admit affected patients as part of the critical infrastructure, while the staff itself is potentially threatened by a pandemic disease on the other. In addition, “insufficient communication about reorganization“ also needs to be highlighted. Interdisciplinary and cross-departmental communication with employees is extremely important in this case.
How can the most frequent mistakes be avoided?
Glasberg: Crisis occurrence can only be avoided when the causes have already been identified beforehand and the respective stakeholders are aware of the appropriate preventative and response measures. Once a crisis has occurred, each stakeholder needs to know how to act and what measures need to be taken immediately. A crisis is not the time to check in reference books on what to do. You therefore need to be able to act or respond deliberately. This is why we developed a software-based training tool that playfully teaches hospital staff these types of situations. This can be compared to airplane pilots, who train on a simulator for an emergency before it occurs. The training tool can identify safety related deficits and current levels of maturity in the hospital as well as help in developing text book solutions. In doing so, management is made aware of hospital-specific crises and their causes and is supported in its decisions.