A DISASTER PLAN IS no longer something that organizations are simply planning. As the health care community combats the coronavirus disease 2019 (COVID-19) pandemic, departments and organizations should consider a review of their disaster plan. As part of this review, practitioners need to determine how the plan covers customers and stakeholders, as well as their expectations, and the impact that COVID-19 has had on the supply network. This crisis is affecting communities, and it calls for an impact analysis of the workforce and the best way to redirect resources to protect the operations most affected while being able to maintain core product or service offerings.

The plan should include the supply chain, the workforce, and other sources of information, including both receivers and senders. Because most employees and businesses rely on technology to complete work assignments, organizations must guarantee the reliability of devices and information sources as a means of providing redundancy systems to meet customer fluctuations in demand for services.

Although COVID-19 is front and center now, a disaster plan should account for a range of potential emergencies based on the region. Potential disasters can relate to security, utilities, and weather and may occur on a local or national level. Also, organizations should now honestly consider whether they have reviewed their plans frequently enough and informed staff of expectations during an emergency. This could be the time to put in place a formal written disaster plan. And once a crisis occurs, organizations must track both what went well and what did not. They must determine how to retain this information as part of organizational knowledge so that any missteps do not recur and designate a chain of command with identified responsibilities and roles.

Communications
Set up a communications plan to identify stakeholders and the frequency of communication necessary for each stakeholder group. This should include the best method of communication for each particular group. Some may require notice via social media or a website, whereas another group may require direct phone contact. Consider not only who will need information but also the most reliable sources. During the pandemic, sources of information have included local and national government agencies, such as the CDC and the FDA, as well as local boards of pharmacy. Set up a chain of resources or sources for the information that affords frequent 2-way communication between these stakeholders and allows the organization to serve as an intermediary.

Furthermore, determine a single point of contact for the communication tree, to facilitate a consistent message meeting at least once a day at the start of a crisis or disaster. Then decrease the frequency as the situation resolves.

Staffing Contingency
Regardless of the type of emergency, organizations should have a single, up-to-date source of contact information for staff. Employees may require training on their prospective roles, depending on the severity and type of event, and management should review this training and these roles on an annual basis. Determine the potential scope of the work and how it might change based on various disaster scenarios that can occur in the region.

Also review the use of agency or as-needed staffing and their areas of expertise. During COVID-19, a major concern has been that as-needed employees may work at multiple locations and could pose a risk of cross-contamination.

In addition, organizations should identify the work that it needs conducted internally and what it can be relocate to an alternate location.

When reviewing alternate locations, consider infrastructure needs, such as computers, along with communications. Also ensure that new locations comply with the Health Insurance Portability and Accountability Act of 1996.

Supply Chain
As pharmacies have moved toward a just-in-time inventory procedure, they have become more vulnerable to supply chain interruptions. These happen under even the best of times, with both the American Society of Health-System Pharmacists and the FDA monitoring for drug shortages. This now requires more skill and time from purchasing agents so they can provide needed pharmaceuticals and supplies. When this is amplified by a supply chain interruption, the strategy of running lean clearly becomes disadvantageous.

Review stock and supply levels to determine current use and anticipate future needs based on expected volume. Set up a plan for alternate methods of supply and resource conservation.

For example, prior to the pandemic, few organizations had considered shortages of hand sanitizer or sterile isopropyl alcohol.

Conclusion
This crisis has helped the entire health care community learn what works and what does not. Although often difficult, try to find a moment at the end of a given day to debrief and note which parts of the plan worked for that day and which did not. Regroup with the disaster planning team, and identify any needed changes. Finally, be sure to keep records of the organization’s findings. This knowledge will be imperative during a review process and even more so when the next crisis hits. 
 
Kenneth Maxik, MBA, MBB, FACHE, is vice president of operations support at CompleteRx in Lexington, Kentucky.