Executive Summary
Infrastructure identification is an important part of securing assets and ensuring they are managed properly within the organization. Assets that are identified and rated as critical are more likely to be given more resources in terms of time, personnel, and risk cover among others. On the other hand, assets that are less critical are given less financial and technical attention. According to Regehr & Bober (2005), the purpose of identification and assessment is to save funds that could have been used in securing assets that are insignificantly consequential to the company. This paper is an assessment of Baptist Health Richmond Hospital in Richmond Kentucky as a critical asset. This paper assesses the criticality of the Hospital and how it services the people. It also looks into the value of the decontamination room and why I think it should be protected.
Because of its value and importance, the hospital is subjected to a number of threats and risks both natural and manmade which are also discussed herein. Its vulnerabilities are also included as well as the consequences that are associated with failure to properly protect this asset. The paper also includes the connection between the hospital and other sectors both in Kentucky and outside. Current legislative programs and measures that are in place to offer protection to this asset. This paper also includes the sectors profile, interrelationships and protection of sub-sectors and lastly conclusion.
Baptist Health Richmond Hospital
Introduction and Asset Criticality of the Hospital
Madison County is well equipped in terms medical and emergency care. There Emergency Department serves a vital role in serving patients that are in critical condition. The 105-bed hospital serves the Madison community and its surrounding. The primary intention of exploring Madison County Richmond Hospitalsis to determine whether the asset is indeed critical. It is, therefore, paramount to understand the services being offered by the asset, before understanding whether it is critical or not. Furthermore, it is important to explore and comprehend the peripherals associated with the asset in question.
The composition, functionality, and services related to the Richmond Hospital (Baptist Health) form an important topic for discussion.In Richmond Hospital, there are also Decontamination Rooms with one inbuilt and also there is an outside facility. The Room is equipped with board-certified staff for serving a large number of patients that need Deacon attention. This means that any incident happening at the other place within the Emergency sector is likely to affect the operation of the Deacon Room, as it is interconnected with other assets in the Emergency Sector.
Core Functions of the Hospital
The hospital provides variety of services which include; Allergy & Asthma, Bariatric Care, Cancer Care, Diabetes, Emergency Care, Express & Urgent Care, Heart Care, Imaging & Diagnostics, Infection Control, Mother & Baby Care, Neuro & Stroke Care, Orthopedic Care, Physical Rehab & Therapy, Retail Pharmacy, Sleep Center, Women’s Services, and Wound Care.
The hospital also has a decontamination room. Decontamination is defined as a process of neutralizing a hazard from the environment, property or life form. The purpose of decontamination is to prevent further harm and create a chance for full recovery or restoration of an object exposed to the contaminant (NCTC work group 2004). In this room, patients are received and attended to before proceeding to the next level for treatment. There are decontamination facilities in the Decontamination Room at Richmond Hospital, and in 2009 it was expanded to meet a large number of patients (Jabs). There is Personal Protective Equipment (PPE) that protects staff from contamination as they deal with patients. The staff is also trained to handle various levels of contamination. The decontamination contingency plans see to it that the patients being attended to are served immediately, before proceeding to the next room, in case there is the need to.
Asset Value of the Hospital
The hospital has covered more than 30,000 annual medical emergency cases. The asset is efficient having been upgraded in 2009 to meet 32,000 average cases over the past few years. Furthermore, rendering the asset ineffective will mean the staff dealing with various services are rendered jobless. The hospital has different departments like the lab, decon room, theatre and pharmacy. Sometimes, the hospital’s medical team reaches the victim’s door and back to the facility in less than 17 minutes. Deacon services are therefore geographically mobile, where patients can be served away from the Deacon Room or in the Room. The hospital has a well-trained workforce. The board and the general workforce is comprised of physicians, nurses and other medical practitioners who are certified. Their main areas of expertise are in dealing with emergency cases in contamination.
The hospital is very likely to continue with its numerousservices in the event of a breakdown because of the plans that are in place with the management to collaborate with local authorities efficiently to ensure prompt medical attention in case of poisoning or gas contamination. There is also better communication suppose one is in distress, and the hospital’s email and other communication are not working, calling the number 911 should be enough. Allen and Derr (2015) indicated that the county management has a smooth working relationship with the hospitals which helps to build a close and secure connection between the two and the community. Furthermore, there is another alternative for patients in need of urgent care. A medical facility is at 648 University Shopping Center where a designated doctor and his team of health are in waiting to attend extreme and emergency medical cases.
In the event of a breakdown in Madison Hospital’s Deacon Room, the county offices are the ultimate destinations. The county has its emergency management system with its Deacon Room. Through the system, the county sends out alerts and notifications to different institutions. Madison Hospital is one of the institutions that benefits from these services. In the case of a break down in the asset, the jurisdiction, in this instance, the county emergency management is likely to be pressured. Suppose there is some biological outbreak, and the hospital’s Deacon unit is unresponsive or obsolete, the many alerts sent by and to the county emergency unit will be unattended. Legal actions might probably follow.
The hospital has no alternative assets that can offer the Deacon services needed in case the current one breaks down. This is what forced the hospital to expand the room in the year 2009 at the cost of $4.9 million. The peripheral services in the palliative care and the Intensive care units are not well equipped for the cases of contamination, and hence there may be spread of the contaminants to other patients. The hospital website has well scripted curative instructions that might help mitigate crisis effects. For example, there are self-care instructions under the emergency sector, and instructions to follow in case of an emergency. These instructions are instrumental in ensuring that relatives caring for their loved ones go about their activities without being self-destructive.
Criticality of the Hospital
The hospital’s emergency response unit is tremendously important. There is no doubt that a breakdown in the hospital can be catastrophic and have detrimental effects. Since there is the likelihood of an enormous consequence of failure, the assets should have a score of 4 out of 5. This means that the asset is significant to the patients, authorities, the hospital, the county residents and surrounding county residents (Broder & Tucker, 2011). The score could have been 5 out of 5 were it not for the peripheral institutions such as the Urgent Care clinics and the Deacon rooms available at the County. On vulnerability, a score of 2 would suffice. The program is very unlikely to fail. This is due to the input resources pumped into the system by the ministry of health, ensuring that more than 32,000 patients are attended to per year. The existence of reliable resources with certified staff underlines this unlikelihood.
- b) Risk Management Overview
The Hospital is very important not only to the people of Madison but also those from Jackson, Rockcastle, Garrard, Lee and Estill. It could face a number of threats and vulnerabilities of different kinds including natural, technological and man-made which can result in serious consequences. The hospital has a decontamination room is meant to contain outbreak or further spread of contagious infections. Sometimes patients can leave the room if not properly manned and spread the disease beating the sole purpose of the room. The medical experts who work in the room or the hospital face the risk of contamination. If an accident occurs in the process of taking care of a patient, then they may face the risk of exposure. Cold weather is also a vulnerability of the asset. Since it has another facility out of the building, cold weather could prove problematic when performing decantation. Transportation is also critical to this asset. The technology used to make the ambulance and the number of vehicles also matters. When an emergency response is required, patients should be transported to the decontamination room in time and in a way, that contains the spread of any hazardous chemical or contagious infection
The hospital holds a good number of patients and this can make it face the risk of a terrorist’s attack. The hospital is close to a university which has other activities involving a large number of people. Terrorists have always targeted structures that are not well protected and with dense populations. This is also a possible threat to the hospital as a whole. The hospital is also at risk of natural occurrences such as earthquakes and tremor. Kentucky has also witnessed several cases of floods which could also pose a threat to the facility. The floods also interfere with the movement of patients and medical personnel which limits the effectiveness of emergency response. Technologically, the hospital faces vulnerabilities that come with the advancement of technical know-how. There are nuclear attacks and explosions that can be used by terrorist to destroy the asset. Power outages is also a vulnerability that is likely to be faced by the hospital. This can slow the activities of the medical personnel attending to patients.
The fire has also been a major problem to buildings. Fire can break and bring the facility down. Unqualified personnel can also cause complications if they are employed. When an unqualified staff handles patients, they can cause further harm to the patients or to themselves if the patient has a contagious disease. The decontamination room is for patients who require such services which are emergencies. When patients are exposed to hazardous materials such as chemicals, biological and radiological weapons, the response should be a very fast failure of which might result in loss of life. Terrorist attacks on the asset can also lead to great loss of life. If the Deacon room is compromised or in the case of a breakthrough, there can be unmeasurable damage. If a single person fails to be decontaminated, then they can contaminate others around that area. The facility is close to the Eastern Kentucky University which is also has a dense population. It is, therefore, important to keep the facility safe at all times.
- c) Regional and National Interdependencies
The asset is interconnected in a way that there is a symbiotic relationship with other sectors both at regional and national levels. The asset joined to form a purchasing partnership in order to purchase and distribute medical and surgical items. This has helped them reduce the costs of purchasing such products. They also considered this as a means to reduce medical costs for the communities that they serve. The hospital works with the police in ensuring public safety (Lewis 2014). When there is a contagious disease, dangerous chemical, or a biological weapon discovered then they take the responsibility of informing the police who will then investigate the origin.
The asset works with the local authorities to ensure that the services of decontamination continue even in the case of a breakdown. There are communication channels that have been laid down so that when the normal Deacon rooms are not able to offer services then other programs are used as alternatives.
- d) Protective Measures
A number of protective measures could be put in place to curb the risks, threats and vulnerabilities to ensure that the Baptist Health Richmond Hospital provides services to the community in the best way they can. First and foremost, the bond between the asset and the local authorities need to be stronger. Partnerships are vital in this case to ensure the protection of the of the hospital. Partnerships would mean that each sector has a part to play when it comes to security matters. The medical experts at the Baptist Health Deacon room should engage the relevant authorities for example when there is a suspicion of a biological weapon. Partnerships would also mean that there would be sharing of information. Sharing of information would ensure that the different sectors receive relevant information to stop terrorism before it happens.
The asset should also have helicopters that will come handy during floods and when traffic is congested but a medical emergency is required. The partnership is also important in this sector. Other sectors providing medical emergency services can also partner up to share the cost and improve their transport services. The asset should be equipped with sufficient fire extinguishers that can be used to put out flames in case of a fire outbreak. Firefighting department should also be a close partner with a well-established communication system between the two sectors to ensure that the risk of fire is sorted. There should be a distinct security guard that watches the entrance and exit of the hospital at all times so that terrorism is kept at bay. Nuclear explosions can be horrifying. Airplanes have been used to execute terrorist activities. They are used for air strikes as was witnessed during the 9/11 and their main target is critical assets. The local government should, therefore, monitor the air space above the asset to ensure that there are no unauthorized planes and jets roaring above it.
Disaster preparedness strategies should be put in place so that when natural disasters such as floods hit, the asset has all their options worked up from a to z. For example, when such catastrophic events take place and the roads become inaccessible, they can use air transportation to bring in patients who need decontamination. Disaster preparedness is the best way of handling disasters which occur naturally (Vatsa 2004). Because of the services they offer, it is important that patients get medical attention in time.
- e) Existing Legislation, Programs, and Initiatives
There are programs, legislations, and initiatives that are in place to ensure that hospitals offer the best services and reduce some of the risks, threats and vulnerabilities. The Hospital Preparedness Program (HPP) helps hospitals to prepare better for emergencies by providing leadership and funding. Such grants have helped assets such as the decontamination room respond to emergencies in time by sufficient preparation. It improves infrastructure, integration and enhances planning. The September 2001 the anthrax bioterrorism attacks made the U.S.Centers for Disease Control and Prevention (CDC) start focusing on emergency operations systems for public health facilities. The small number of the victims could easily fool you, 22 people, but not the widespread public health effects, with large numbers of people receiving antibiotic prophylaxis and some considerable Psychological effects (Hupert & Wattson et.,al 2009).
A popular initiative is the U.S. led Global Threat Reduction Initiative (GTRI), which has secured more than 1,700 radiological sites around the globe containing millions of curies which are enough for tens of thousands of large dirty bombs. Other efforts include United Nations Security Council Resolution 1540 and the Nuclear Terrorism Convention. Also, the IAEA has come up with a Code of Conduct on the Safety and Security of Radioactive Sources.
- f) Sector Profile
The headquarter is in Louisville and the Baptist Health family of hospitals, care centers, physician offices and health facilities has grown tremendously in recent years. Baptist Health Floyd in New Albany, Ind. Was initially known as Floyd Memorial Hospital and Health Services, joined the family latest on 1st October 2016. They were joined by Baptist Health Richmond previously known as Pattie A. Clay Regional Medical Center in 2012 and Baptist Health Madisonville was before known as Trover Health System joined much earlier. Other hospitals belonging to this family includeBaptist Health Louisville, Baptist Health Paducah,Baptist Health Lexington, Baptist Health Corbin and Baptist Health La Grange.They also manage Hardin Memorial Health in Elizabethtown. They have around 2,700 licensed beds across the 9 hospitals.
Conclusion
All critical assets should be protected from vulnerabilities, threats, and risks as it has been discussed in this paper. This paper has assessed why the Baptist Health Richmond Hospital should be safeguarded in a special way. The value, asset criticality, core functions which make it worth protecting are discussed herein. Also discussed in this paper are risk management overview, interdependencies with other sectors, suggested protective measures which can be used to protect the hospital the facility and its sector profile. The hospital provides critical services that are very much needed by the surrounding community.
References
Allen, G., & Derr, R. (2015). Threat assessment and risk analysis: An applied approach.
Broder, J. F., & Tucker, G. (2011). Risk Analysis and the Security Survey. Burlington: Elsevier Science.
Hupert, N., Wattson, D., Cuomo, J., Hollingsworth, E., Neukermans, K., & Xiong, W. (2009). Predicting hospital surge after a large-scale anthrax attack: a model-based analysis of CDC’s cities readiness initiative prophylaxis recommendations. Medical Decision Making.
Jabs, R. (15 Apr. 2011). Newly Expanded ER opens at Richmond. BC Gov News. Retrieved from orked nation. John Wiley & Sons.
NCTC work group. (2004). Decontamination Emergency Guidance for Hospitals.
Regehr, C.& Bober, T. (2005). In the line of Fire: Trauma in the Emergency services. Oxford: Oxford University Press.
Vatsa, K. S. (2004). Risk, vulnerability, and asset-based approach to disaster risk management. International Journal of Sociology and Social Policy, 24(10/11), 1-48.