CHFM CHFM - Certified Healthcare Facility Manager Emergency Management Preparedness 2 — Questions and Answers
Question 1: The four phases of emergency management that guide healthcare facility planning are:
- Mitigation, preparedness, response, and recovery (Correct answer)
- Prevention, detection, containment, and eradication
- Alert, mobilize, execute, and demobilize
- Plan, train, exercise, and evaluate
Correct answer: Mitigation, preparedness, response, and recovery
The four phases of emergency management are: mitigation (reducing risk before a disaster), preparedness (planning and training), response (actions taken during an emergency), and recovery (restoring normal operations afterward).
Healthcare facility emergency management programs must address all four phases. Mitigation includes hazard vulnerability analysis and structural hardening. Preparedness involves writing plans and conducting drills. Response requires activating HICS. Recovery focuses on restoring normal patient care operations and documenting lessons learned.
Question 2: Under CMS emergency preparedness requirements for hospitals, how often must a full-scale exercise be conducted?
- At least annually, with one exercise being a community-based exercise or an actual emergency (Correct answer)
- Every six months
- Every two years, alternating between tabletop and full-scale
- Quarterly, with at least one full-scale exercise annually
Correct answer: At least annually, with one exercise being a community-based exercise or an actual emergency
CMS requires hospitals to conduct at least two exercises per year: one must be a full-scale exercise (community-based or include an actual emergency) and one must be an internal, facility-based functional exercise.
The 2016 CMS Emergency Preparedness Rule (42 CFR 482.15) requires annual risk assessment-based planning, policies and procedures, a communications plan, and training and testing through exercises. An actual emergency can substitute for a required exercise if an after-action report is completed.
Question 3: In the Hospital Incident Command System (HICS), who holds overall accountability for the hospital's response to an emergency?
- Incident Commander (Correct answer)
- Operations Section Chief
- Safety Officer
- Medical Staff Director
Correct answer: Incident Commander
The Incident Commander holds overall authority and accountability for the management of an incident, including strategic direction, resource allocation, and communications with external agencies.
HICS is structured around the ICS principle of unified command with clear span of control. The Incident Commander activates sections as needed. For the facility manager, the role is typically in the Logistics or Operations section, responsible for maintaining utilities, infrastructure, and critical systems during the emergency.
Question 4: A hospital's hazard vulnerability analysis (HVA) rates risks based on which three factors?
- Probability, severity (human impact), and preparedness (risk) (Correct answer)
- Location, cost, and frequency
- Population affected, response time, and legal liability
- Likelihood, mitigation history, and insurer rating
Correct answer: Probability, severity (human impact), and preparedness (risk)
The Kaiser HVA model rates each hazard on probability (likelihood of occurrence), severity (impact on people, property, and systems), and preparedness (current level of mitigation), then calculates an overall risk score.
The HVA helps facilities prioritize emergency planning resources. A hazard with moderate probability but high severity and low preparedness scores high risk and warrants priority attention. The HVA should be reviewed and updated annually and after significant incidents or major facility modifications.
Question 5: During a mass casualty incident (MCI), a hospital activates its emergency operations plan and surges patient capacity. Which action is part of a 'surge capacity' strategy?
- Discharging stable patients, canceling elective procedures, and opening alternate care spaces (Correct answer)
- Immediately requesting mutual aid from other hospitals
- Activating a full community evacuation plan
- Reducing staffing ratios to serve more patients with fewer staff
Correct answer: Discharging stable patients, canceling elective procedures, and opening alternate care spaces
Surge capacity involves expanding the ability to manage a sudden increase in patient volume by discharging stable patients to free beds, canceling elective cases, converting conference rooms or corridors, and calling in off-duty staff.
Healthcare coalitions define three levels of surge: conventional, contingency, and crisis standards of care. Facility managers play a critical role by rapidly converting spaces, ensuring utility support for temporary clinical areas, and coordinating with engineering staff to address infrastructure needs.
Question 6: What does a continuity of operations plan (COOP) address that a basic emergency response plan does not?
- Sustaining essential functions over an extended disruption lasting days to weeks (Correct answer)
- The immediate life safety response in the first 30 minutes of an incident
- The annual exercise and drill schedule
- Compliance with CMS emergency preparedness conditions of participation
Correct answer: Sustaining essential functions over an extended disruption lasting days to weeks
A COOP focuses on sustaining essential functions such as patient care, utilities, supply chain, and payroll over extended periods when normal operations are disrupted, going beyond the immediate response of an emergency operations plan.
For healthcare facilities, COOP planning includes identifying mission-critical functions, alternate operating locations, succession of key leadership roles, vital records protection, and supply chain continuity. The facility manager's role includes maintaining emergency fuel supplies, arranging generator servicing, and ensuring alternate utility connections are available.
CHFM CHFM - Certified Healthcare Facility Manager Emergency Management Preparedness 2
The four phases of emergency management that guide healthcare facility planning are: