1. Hader, Richard RN, CHE, CPHQ, NE-BC, PhD, FAAN

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Panic!! The definition of this word needs to be expanded to describe the overwhelming feeling of despair when your computer has malfunctioned. Disaster!! The result when hundreds of hours of hard work can't be recovered from a hard drive following an unexplained system crash. Reliance on mobile devices, laptops, networks, and a wireless infrastructure have changed the way we think, write, communicate, and work. Our economic, intellectual, functional, and social structures are built on blind faith that our information systems will never fail. Is your organization prepared if the cyber world suddenly collapses and you're forced to quickly revert to a manual system?

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Many healthcare organizations have become increasingly dependent on information technology to provide safe and efficient patient care. Valuable information, such as physician orders, diagnostic results, assessments, medication records, and patient planning and educational needs are most likely retrievable only through computer access. Failure of the information system could cause organizational chaos, resulting in sustained patient injury or even death.


What challenges would your organization encounter if its computer systems were disconnected for a prolonged period of time? Are there precautionary mechanisms in place to ensure that patients will continue to receive the same quality of care without modern information technology? Leaders need to ask themselves these important questions and if the answers aren't readily available, preparation for a system failure needs to begin immediately. Prudent leaders will conduct a failure mode and effects analysis-a performance improvement tool used to determine weaknesses in the system. This process helps leaders and staff members study the consequences of system failures and identify critical components necessary to maintain quality operations. An action plan must be developed to address identified frailties.


Just as organizations are held accountable for environmental or community disaster preparation, they must also spend equal time and resources preparing for a computer system outage. Leaders need to be proactive, making sure that a well-developed plan is in place. Staff members must be educated regarding their responsibility to take swift and appropriate action. A manual infrastructure must be developed and readily accessible to ensure the efficiency and safety of patient care.


Nursing, business, and ancillary departments must develop strategies to quickly revert to a manual system for results reporting and clinical documentation. Policies and procedures for this process need to be available in hard copy within each department and easily retrievable. A systems disaster closet stocked with items such as documentation forms and alternate communi cation devices will be necessary to maintain a functioning department in the event of unplanned downtime. As with other disasters, a system outage requires that a local command center be implemented. Administrative, clinical, and operational senior leaders should staff the command center and be prepared to give precise direction to avoid confusion. Leadership responsibilities should be clearly articulated and detailed so there's an acute understanding regarding the tasks and actions to be completed. Redundant communication mechanisms should be in place to ensure that information is conveyed in a timely and accurate manner.


Our reliance on information systems will continue to grow. Leaders must cultivate the importance of preparation to minimize panic and erode the chance of disaster.


Richard Hader