Although it may appear that hospital incident management systems with mass notification capabilities and healthcare mass notification systems with incident management capabilities are the same thing, there are differences between them that can significantly impact healthcare operations in the event of an emergency.
The worst mass shooting in U.S. history took place on the night of Sunday 1st October, 2017, when Stephen Paddock opened fire on 22,000 Las Vegas concertgoers from the 32nd floor of the Mandalay Bay Hotel. 58 people were killed in the attack, and a further 869 were injured - many of whom suffered injuries as they tried to escape the incident.
Despite having drilled emergency preparedness plans, hospitals in the area were overrun due to the scale and time of the attack. To further complicate operations, many of the victims were guided to the nearest hospital by cell phone GPS systems, which meant hundreds of injured concertgoers arrived at hospitals ill-equipped to treat their injuries.
The Hospital Incident Management System Didn't Work as Well as It Could Have
Subsequent studies into how Nevada's hospitals coped with the tragedy generally commended the healthcare system and emergency personnel. However, both the Nevada Hospital Association's “A Day Like No Other” report and the Association of State and Territorial Health Officials “Peer Assessment Report” both identified communication issues:
- Hospitals were not made aware of the incident until after the first victims arrived. Subsequent rumors of a second gunman put many hospitals into lockdown.
- Healthcare personnel arrived at the hospitals without being called in, raising concerns about staffing levels in subsequent shifts.
- Where there were gaps in medical specialties, staffing managers had to make calls to individual healthcare personnel.
- Hospital environmental services were understaffed due to databases being populated exclusively with healthcare personnel.
- Staff who were unaware of the hospital incident management system refused to give incident managers details of patient information due to concerns about HIPAA violations.
- The same lack of awareness resulted in details about bed availability, equipment availability, and non-medical supplies being withheld.
- Law enforcement used a secure text messaging system that did not integrate with other communication systems nor allow emergency contacts to be added to the system.
The conclusion of both reports was that, although the hospital incident management system worked for the operations management of the incident, it didn't work as well as it could have because of the communication issues. Specifically, the Nevada Hospital Association notes the communication issues resulted in “administration functions were slow to be implemented and made various elements of staffing and information flow less efficient”.
How a Healthcare Mass Notification System Would have Coped with the Issues
The two reports referenced above don't elaborate on whether the hospital incident management system being used had mass notification capabilities. Even if they had, it is often the case that when incident management is the primary function, communication tools lack the full range of capabilities that can be found in healthcare mass notification systems with incident management capabilities.
- As soon as the incident started, a notification could have been sent to hospitals alerting them to potential casualties. The system could also have quashed rumors of a second gunman.
- A notification could have been quickly sent to all staff informing them their services may be required, but to refrain from arriving at the hospital until such time as they are called in.
- The database segmentation capability would then have come into use to contact personnel with the medical specialties required, and to contact personnel in hospital environmental services.
- Because notifications can only be sent by authorized users, this would have eliminated concerns over the authenticity of requests for information relating to sensitive data.
- Healthcare mass notification systems have an opt-in/opt-out capability that allows unconnected agencies to access mass notifications in order to enhance situational awareness.
Although healthcare mass notification systems have more advanced communication tools, it is not the case their incident management capabilities are compromised. Healthcare mass notification systems have the same NIMS-compliant incident management capabilities as hospital incident management systems, only - due to their advanced communication tools - they enable the incident management capabilities to work more effectively.
Further Considerations When Comparing Hospital Incident Management Systems and Healthcare Mass Notification Systems
Whereas healthcare mass notification systems are provided as Software-as-a-Service (SaaS) solutions, it can be the case hospital incident management systems with mass notification capabilities are supplied as a mixture of cloud and on-premises solutions. This not only incurs more costs for the healthcare facility (i.e. onboarding, software licenses, maintenance, etc.), it can also make the solutions ineffective if the healthcare facility experiences a ransomware attack or other system failure.
Another consideration is the solutions' relative ease-of-use. The complexity of some hospital incident management systems can deter users from taking full advantage of their capabilities. In an emergency situation, when every second counts, there can be a significant impact on healthcare operations - and the wellbeing of incident victims - if stressed or concerned administrators find the solution difficult to use. This may have been the cause of unnecessary delays in the Las Vegas shooting.
A further consideration healthcare facilities may wish to take into account when comparing hospital incident management systems and healthcare mass notification systems is the capability to send short form and long form notifications simultaneously. In many circumstances, it can be helpful for healthcare personnel to have a short form (i.e. SMS) message notifying them of an emergency and a long form (i.e. email) message reminding them of the appropriate actions to take.