COVID-19 Contingency Planning - Considerations for Health Care Organizations

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COVID-19 is triggering a variety of challenges for health care organizations, regardless of size or medical specialty. Pandemics are not a usual health care crisis or business disruption. The effects of COVID-19 will unfold over many months, possibly years. Contingency planning and appropriate response measures for a pandemic will assist health care organizations to adapt and sustain patient services. Contingency planning includes assessing the business impact of a pandemic (disruption to service delivery); crises escalation procedures; recovery strategies and solution development; and a recovery plan for continuity of operations.

During a pandemic, health care organizations should be using risk management processes to respond and adapt to the impact of unforeseen extraordinary events. Unlike planning for an epidemic, pandemic preparedness requires a sustained health care response for months or years. Health care organizations will benefit from developing unique collaborations and integration across departments, as well as  with other health care providers. All providers should anticipate working outside of their current system to sustain the health care infrastructure of their community. As we have seen in the last week, new information is constantly changing and evolving. Therefore, contingency planning will require enhanced stakeholder collaboration and communication between management, staff, and government regulators.

Pandemic preparation includes the following planning assumptions:

• Simultaneous outbreaks
• Overwhelming number of patients straining resources
• Anticipation of limited ability of federal government support due to an extended pandemic outbreak
• Staffing shortages, even during the recovery stage
• Planning and coordination for effective outpatient care management with home health/urgent care/primary care providers
• Coordination with public/private partners to develop plans for an extended period of self-sustained operations

Business continuity planning should be flexible enough to adapt the plan to changing characteristics of the pandemic and to sustain the organization for a long recovery period. Organizations should use readiness tools to identify gaps in pandemic preparedness and identify what best practices are needed. The risk planning process includes:

• Plan activation
• Leadership/command system
• Identify core services and what is needed to maintain patient services
• Plan for workforce issues (staff shortages, cross-training, succession-planning)
• Mitigate financial risks and implications
• Identify evolving legal and regulatory compliance requirements
• Develop and coordinate communications both externally and internally, including reporting to and from key stakeholders
• Develop supply chain management and control measures  for ethical distribution of scarce resources
• Recovery responsibilities and possibility of recurrent events

Health care organizations should develop long-term pandemic contingency planning for the various levels of pandemic periods:

• “Inter-pandemic Period” - planning preparation or updating current plan and begin workforce training
• “Pandemic Period” - management planning and activate all contingency and business continuity plans
• “Between Waves” - implement recovery operations and adapt plans as needed
• “Post-Pandemic Recovery” - rebuild/reinstate services/recovery operations

A pandemic contingency plan should be viewed as a dynamic document that will be updated frequently to adapt to ever-changing circumstances. Health care organizations should identify challenges and promote effective implementation.

Contingency planning is, at the core, the ability to adapt to a sustained crisis. Health care organizations should implement pandemic planning by leveraging their capabilities and cooperating with other members of the health care community. A sustainable plan for business continuity is driven from the top down. Leadership should develop a culture, and implement mechanisms, that support the adaptive capability to respond to a pandemic. By creating the appropriate contingency plan, health care providers will become resilient during a time of uncertainty.