Hospital downtime can occur due to various reasons, including scheduled maintenance, IT outages, or natural disasters. Healthcare organizations must be prepared to stay operational during such periods to avoid serious patient care and financial setbacks.
Clinical care resilience is essential to ensure uninterrupted care delivery. It requires active and deeply ingrained planning, rather than just emergency planning kept in a binder or limited to discussions and roleplay.
Clinical Care Resilience Planning
A healthcare CIO once had to take the electronic health record (EHR) system offline for 72 hours for maintenance, which caught the attention of the leadership team. This incident highlighted the need for department-specific approaches to clinical care resilience.
Clinical care resilience starts with a thorough assessment of every clinical and business unit, including primary care, emergency departments, pharmacies, and billing departments. This assessment helps understand downtime in real terms and its impact on nurses, billing specialists, and pharmacists.
Healthcare IT should work seamlessly, like electricity, without much thought. However, with the changing cyberthreat environment and operational uncertainties, organizations must think about what happens when things don’t work as expected.
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A free tool, offered by CDW, is available for healthcare organizations to review their clinical and business units and assess how long each team can provide necessary functions without technology. This tool enables nontechnical conversations to understand downtime’s impact on various departments.
Planning for downtime duration is also important, considering the specific impact of downtime on different departments. For instance, an hour of downtime in the pharmacy department has different implications than four hours of downtime or downtime that occurs across shifts.
Even fractional downtime has its considerations, such as the impact of offline PCs on order fulfillment. Reviewing plans for each department and aligning them with organizational policy can help improve overall resilience.
Realistic simulations, like those used in the aviation industry, can prepare hospital staff for crises. These simulations should go beyond tabletop exercises and introduce a simulated environment to build muscle memory around potential situations.
Training should not be limited to a small sample of scenarios but should include various departments and situations, such as downtime during shift changes or information coordination between teams.
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Dependency mapping is also essential in healthcare for resilience, as it identifies the people, devices, applications, and vendors that each clinical function relies on. This mapping helps organizations understand their safe minimum practice before an emergency.
For example, dependency mapping can help determine what happens when there’s a shortage of nurses due to a hurricane or when a majority of workstations go down on a unit. It can also identify the minimal application set required for care.
Having a system available again after downtime is not enough; recovery validation is key. As cyberthreats continue to evolve and natural disasters become more severe, clinical care resilience is critical for healthcare organizations to build, adapting their downtime procedures to changing expectations.
Clinical care resilience planning should prioritize recovery validation, going beyond system restoration to ensure safe patient care.
