Research has shown that most individual HCOs possess limited surge supplies, personnel, and equipment, and that vendors or anticipated "backup systems" for these critical assets are often shared among local and regional HCOs.[2][3] This "double counting" of resources diminishes the ability to meet individually projected surge demands across multiple institutions during a medical emergency.[4] To address this, the healthcare coalition (Tier 2) integrates all medical and health assets in a jurisdiction to coordinate their mitigation, preparedness, response, and recovery activities. In this way, HCOs work together to maximize MSCC rather than compete against one another for limited resources.
Much of the benefit gained from the healthcare coalition is evident in participant HCOs' Emergency Management Programs (EMPs) well before a major event occurs. Joint planning and preparedness efforts with geograph-ically related facilities are possible, even though the HCOs may normally be business competitors. Areas of mutual benefit include the following:
- Distributing the mitigation and preparedness workload among facilities, since many of the solutions found during preparedness planning may be applicable to multiple HCOs in a jurisdiction
- Establishing familiarity and trust among HCOs that promote cohesive response actions during an emergency
- Fulfilling regulatory and accreditation requirements for community emergency planning and for establishing and maintaining management systems that integrate into the jurisdiction (Tier 3) response (as required by the Centers for Medicare and Medicaid Services, State survey agencies, the Joint Commission on Accreditation of Healthcare Organizations, and other accreditation organizations)
- Promoting close integration with jurisdictional (Tier 3) authorities for mitigation and preparedness planning, and for pre-planning of scheduled unusual events, such as mass gatherings (e.g., fireworks display) or high-security events (e.g., political demonstrations).
During incident response, coalition participants benefit through cooperative planning, information sharing, and management coordination. As surge demands challenge individual HCOs, the coalition facilitates mutual aid assistance through arrangements with nearby HCOs. Mutual aid is a timely, cost-effective, and reliable method to obtain added surge capacity and capability (via equipment, facilities, supplies, and personnel) that is immediately operational. It distributes health and medical assets to areas of greatest need, thereby enhancing overall jurisdictional MSCC.
- Hospital Preparedness: Most Urban Hospitals Have Emergency Plans but Lack Certain Capacities for Bioterrorism Response. GAO-03-924, August 2003.
- Barbera, JA, Macintyre, AG, and DeAtley CA. "Ambulances to Nowhere: America's Critical Shortfall in Medical Preparedness for Catastrophic Terrorism." Executive Session on Domestic Preparedness, John F. Kennedy School of Government, Harvard University ESDP-2001-07 (October 2001). Updated and reprinted in Countering Terrorism: Dimensions of Preparedness, MIT Press, September 2003.
- The issue of "double counting" also highlights the importance of including members of the HCO supply chain (pharmaceutical companies, equipment vendors, etc.) in preparedness planning.
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