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U.S. Department of Health and Human Services

5.2 Establishing the Healthcare Coalition Emergency Management Program (EMP)

When establishing processes to sustain and enhance the Coalition’s response capability, it is important to consider the need to address recurring issues, such as training staff and evaluating performance. The Healthcare Coalition’s Emergency Management Program (EMP) provides the structure and guidance for preparedness activities.

5.2.1 Defining the Healthcare Coalition EMP

One of the most important concepts in Comprehensive Emergency Management is organizing the EMP by the four phases of emergency management: mitigation, preparedness, response, and recovery. These phases are summarized below.[6]

  • Mitigation: Activities that are performed to reduce or eliminate the probability of a hazard occurrence or to eliminate or reduce the impact from a hazard if it should occur. Mitigation activities are generally performed prior to an imminent or actual hazard impact.
  • Preparedness: Actions that are designed to build organizational resiliency and/or foster capacity and capabilities for response to and recovery from disasters and emergencies.
  • Response: Activities performed to address the immediate and short-term effects of the emergency. It includes activities immediately before (for an imminent threat), during, and after a hazard impact.
  • Recovery: Activities and programs implemented during and after response to return the organization to its usual state or to a “new normal.” For response organizations, this includes return-to-readiness status and resumption of baseline operations.

The Hazard Vulnerability Assessment (HVA) provides the basis for informed planning in all phases of emergency management. The HVA process is described in relation to the Healthcare Coalition at the end of this chapter.

5.2.2 Establishing the Healthcare Coalition Emergency Management Committee (EMC)

A coordinating or organizing body should be created to conduct the Healthcare Coalition’s preparedness and mitigation activities (Chapter 6). Maintaining consistency with emergency management terminology, this can be addressed through an Emergency Management Committee (EMC). The EMC assures a fair and balanced process for Coalition preparedness and mitigation activities among all member organizations. For this to occur, the following requirements must be in place:

  • There should be balanced representation of Coalition members on the EMC. Similar types of healthcare organizations should have the same level of representation on the EMC if desired by the organizations. While ceding control or influence to one or several organizations may seem like the fastest way to establish the Coalition, this approach can lead to future problems.
  • Decision-making by the Coalition must be transparent. Processes used for making decisions should be pre-established and conveyed to Coalition organizations. It may necessitate that minutes are taken during meetings and that preparedness meetings are open to all Coalition participants. Moreover, the Coalition may draft and adopt a Charter and Bylaws for the EMC.
  • There may be situations in which individual organizations cannot agree to a majority decision that has been made by the EMC. This should be expected and opt-out policies for the individual organizations should be established.
  • Actual or perceived conflicts of interest should be recognized and addressed. An example might be the award of a large grant or appropriation earmarked “for the Coalition” but used to primarily benefit only a few partners. This could create distrust among the Coalition members and compromise the effectiveness of the Coalition.

The desired construct of the EMC includes representation from each organization in the Coalition. In very large or complex Coalitions, this may not always be feasible and the actual composition may reflect a fair and balanced representation of the different types of organizations. To ensure fairness, a process to rotate EMC participation should be designed into the Coalition’s EMP.

The participants on the EMC should have the delegated authority to represent their respective organizations. This does not mean that they can make all decisions on behalf of the organization, especially decisions with major financial or legal implications. But it does mean that they can speak for their institution within defined parameters and are responsible for communicating information related to Coalition preparedness activities back to the leadership of their respective organization. It is up to the organization to establish the level of decision-making authority that its representative has on the EMC.

Representatives on the EMC should also have some level of expertise in healthcare system emergency management. The ideal representative is knowledgeable of emergency management principles and practices, including NIMS and ICS, and understands the organization that they are representing.

How the EMC operates is another area to address during the initial development of the Coalition. The following concepts may be helpful in establishing the EMC:

  • Strategic planning: One way to focus the EMC’s efforts is to define strategic guidance, including goals and objectives, for the EMC itself. Objectives should be constructed with a specific, measurable end-point and a timeframe.
  • Leadership: A Committee Chair is usually elected by Coalition participants to lead the EMC’s efforts. To promote a sense of fairness, the Committee Chair may be determined on a rotating schedule. This can also help enhance the long-term sustainability of the EMC.
  • Conduct of the EMC: Pre-established rules for the EMC should address issues such as voting on initiatives and how meeting minutes will be preserved. Rules that promote response-oriented procedures can be beneficial. For example, conduct of meetings using protocols established for response teleconferences can promote familiarity with these processes and keep the meetings efficient.
  • Structure: The EMC forms the core structure for EMP activities outside of emergency response. Subcommittees or work groups may be established to address specific issues, such as on-going exercises for the Coalition or ad hoc subcommittees stood up to coordinate the purchasing of a specific item.
  • Document control: An agreed upon process for managing the EMC’s documents (e.g., Coalition’s EOP, training plan) is essential. These documents should be stored so they are easily accessible.
  • Corrective action process: A corrective action process for the Healthcare Coalition response organization is described in Chapter 6. Similarly, the EMC itself should undergo periodic evaluation to ensure it is meeting its goals and objectives.

5.2.3 Establishing Executive Oversight to the EMC

It may be beneficial to establish some level of executive oversight to the EMC. An executive committee can be established that is composed of executive administrators or their designees from Coalition organizations. This committee can review the development of Coalition elements as they evolve, provide strategic input into the EMC, and approve major financial commitments. While meetings to address these tasks are expected to be less frequent than EMC meetings (e.g., bi-annually), they require significant preparation to efficiently inform the representatives.



  1. Barbera JA, Macintyre AG, Shaw G, et al, Emergency Management Principles and Practices for Healthcare Systems (2006); Available at:  www1.va.gov/emshg/page.cfm?pg=122.

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  • This page last reviewed: February 14, 2012