Learning From Our Mistakes

No one wants to experience a crisis, yet if you must go through a disaster, it is critical to learn from it. One of the most underrated functions of a crisis is having the chance to look back at mistakes and/or unforeseen outcomes. Here are some common lessons:

1. Simple things matter. For example, a minor fire (even one under control) in a breakroom can turn into a major disaster if it sets off the building’s sprinkler system. This disaster can become significantly worse if a sprinkler head is in the computer room. Most experts disable sprinkler heads in their computer rooms and replace them with an oxygen suppressor to avoid water damage to expensive equipment. It is also crucial to confirm that the sprinkler system is in zones, so the devices only activate in the area where there is a fire. Older sprinkler systems could flood an entire building in response to a burning bag of popcorn.

2. Do not wait for a disaster to discover that all your important documents are still in the office. Store essential documents offsite in a fireproof filing cabinet. Make a second and third set of these documents and keep them in different places for added security. Scan and upload documents and back them up to an offsite server as a backup to the backup. Access to critical documents will be essential during and after the crisis.

3. Review your insurance coverage frequently. Policies can change, and so can their terms. Never wait until after a disaster to decide what to cover. For example, most cybersecurity policies do NOT cover a loss if the practice violated a HIPAA rule. (See Chapter 12 for more information about insurance considerations.)

4. There is no excuse for not having a plan. The worse outcomes happen when there is no plan. Not having a plan creates chaos and confusion and leads to costly mistakes.

5. Practice, practice, practice. A crisis does not come with advance notice, so be prepared. Run fire drills, hold mock active shooter drills, practice evacuating the building, and conduct other exercises. Again, your insurance policy may require you to demonstrate that you have a functioning readiness posture when they consider claims.

6. Have cash on hand. Depending on the type of disaster, banks and ATMs could be disabled. Even credit card machines can go down. We recommend one of the physician-owners keep up to $10,000 in a locked safe at their home to cover emergency expenses.

7. Have a hard copy list of the following information:

• Staff phone numbers and next of kin

• Key emergency contact information

• Vendor and suppliers contact information

One lesson from EVERY disaster is the difficulty with communication. Searching for information in a crisis can be stressful.

8. Document critical infrastructure about your office space. Know where and how to shut off power and water. Know the storm drains’ location(s) and have the tools necessary to unclog them if this is a known issue. Have your fire escape plan documented and posted. Identify a safe place to meet so you can easily account for staff. Ensure that all doors and windows operate correctly and can be opened easily in the event of an emergency.

9. Have proper tools on hand. For example, some water shutoff valves require a specific tool to turn off. Now would be an excellent time to verify if you have this tool. (See checklist below for a complete list of tools.)

10. The key to being prepared is education and awareness during regular times.

Avoid previous errors in planning, preparation, and implementation. This principle goes hand and hand with learning from mistakes, but one additional action is to redesign any flaws in the previous plan that lead to an unfavorable outcome. Catastrophes never show up with a pre-defined playbook. Some events take a life of their own and can evolve for the better or worse in real-time. Therefore, build a plan capable of adapting to changing circumstances. For example, the response to a hurricane warning will differ significantly from a mandatory evacuation. When the evacuation notice sounds, someone must oversee removing the vaccines from the refrigerator and placing them into an ice chest, so they do not ruin when the power goes out. This pivot is an example of a significant shift from readiness to evacuation.

Excerpted from Effective Crisis Leadership in Healthcare: Lessons Learned from a Pandemic by Aimee Greeter, MPH, FACHE, and Max Reiboldt, CPA, Coker Group.