Hospital Standard for Homeland Security Approved

ASTM International’s Committee E54 on Homeland Security has approved its first standard, E 2413, Guide for Hospital Preparedness and Response.

The purpose of the guide is to answer questions regarding the minimal levels of preparedness needed for hospitals to deal with a large-scale terrorist attack or other serious emergency. Guide E 2413 is under the jurisdiction of Subcommittee E54.02 on emergency preparedness, training and procedures.

James J. Augustine, MD, an emergency physician in Atlanta, GA, and chair of the task group that developed the new guide, says that vast amounts of knowledge are available to assist healthcare facilities in preparing for and responding to large-scale emergencies. “However, despite all this information, a medically and environmentally driven definition of ‘minimal levels’ of preparedness has been lacking. E 2413 addresses this need,” says Augustine.

The new guide deals with the following issues:

• The process for developing disaster preparedness and loss mitigation
• Organizing a hospital response plan
• Supplies that hospitals need to make available
• Existing regulations and guidelines
• Protecting patients, staff and facilities for normal operations while still providing an effective level of response.

The standard suggests minimum levels of preparedness for acute care hospitals, placing emphasis on the coordination of operations with community assets, including local emergency planning committees (LEPCs), and emphasizes the effective development and utilization of a hospital vulnerability analysis (HVA). It also encourages the use of a hospital incident command system for organizing human resources, then mandates communications and infrastructure systems to integrate the response.

The task force identified weaknesses in hospital preparations for contaminated patients, according to Augustine, so the standard includes provisions for these, including the number of patients to prepare for, what type of facilities to use, the level of protective equipment needed and necessary protocols involved with decontamination procedures.

“We believe that this standard will improve patient care in major and minor incidents by making the planning process more efficient,” says Augustine, who notes that the standard underscores the need for hospitals to participate in community drills and tabletop exercises as part of their ongoing training and continuing education. He also says that Committee E54 hopes that hospitals—defined as first responders last year by presidential directive and eligible as such for funds—will use the standard to focus their preparedness activities, and that funding and regulatory agencies will utilize the guide to assist hospitals in obtaining and maximizing physical resources for patient care and facility management. “Communities will benefit when hospital planning is integrated with community planning,” he says.

Kathleen Higgins, chair of Committee E54 and director of the Office of Law Enforcement Standards at the National Institute of Standards and Technology (NIST), feels that the Guide for Hospital Preparedness and Response is an important standard. “E 2413 is a milestone for both the homeland security and public safety communities,” she says. “It gives hospitals all across the country uniform guidelines for preparing their facilities and personnel to handle casualties from a large-scale terrorist attack and coordinating their preparations with other organizations in their communities. That’s a major step toward domestic preparedness.”

Committee E54 is one of 136 ASTM technical standards-writing committees. Established in 1898, ASTM (the American Society for Testing and Materials) International is one of the largest standards development and delivery systems in the world, with its standards accepted and used in research and development, product testing, quality control systems and commercial transactions around the globe.

For further technical information about E 2413, contact James J. Augustine, MD, at jaugust@emory.edu. More information about all ASTM standards is available at www.astm.org.

—KR