By Terri Mock - February 10, 2021
Hospitals rely on many different types of mass notification and crisis communications systems to account for the many different types of emergencies that can occur in a healthcare facility. In most circumstances the systems integrate with one another to increase the effectiveness of mass notification and crisis communications for hospitals, but they don´t necessarily maximize their effectiveness – potentially exposing staff, patients, and visitors to danger.
There is a long list of events that could prompt the activation of mass notification and crisis communications systems; and while most events can be categorized into medical emergencies, environmental emergencies, and emergencies involving violence, within each category there can be dozens of sub-categories. Furthermore, each event within a sub-category may require a different response depending on the nature of the event and whether it is localized or widespread.
Because of the broad range of events, healthcare organizations invest significant resources into mass notification and crisis communications for hospitals – not only in terms of hardware, but also in respect of planning, training, and drills. Due to the volume of resources being invested in hospital emergency preparedness, staff are usually well prepared to physically respond to most types of foreseeable emergency – but physical preparation alone does not guarantee an effective response.
One characteristic most emergency events share is that they can cause people to act unpredictably. When life-threatening events occur, the brain´s “fight or flight” response is to pump adrenalin and hormones into the bloodstream – which drains the brain of the serotonin and dopamine it needs for optimal cognitive function. Therefore, no matter how well staff are prepared physically to respond to an emergency, if they are unable to think clearly, their responses could be compromised.
In team response scenarios, the inability to think clearly under stress can result in members of staff blindly following a team leader´s unpredictable behavior, which further impacts the effectiveness of response training. In scenarios in which patients and visitors are involved – who may also be unable to think clearly – the exposure to danger could be exacerbated with potentially devastating consequences. Commonly reported mental responses in these scenarios include:
Integrated systems of mass notifications and crisis communications for hospitals are often based on NFPA 72 – a four-layered notification structure that covers communication requirements in most emergency scenarios:
Layer 1 Immediate and Intrusive Alerting
• One-way voice communication system
• Two-way voice communication system
• Visible notification appliance(s)
• Textual/digital signage and displays.
Layer 2 Wide Area
• Wide area outdoor notification system
Layer 3 Distributed Recipient Notification System
• SMS Text / Email
• Desktop alerts
• Smartphone apps
• Reverse 911
Layer 4 Public Alerting
• Radio & TV broadcasts
• Social media
Because hospitals can pick one or more solutions from each layer, mass notification systems can be configured to comply with federal legislation (i.e., the Americans with Disabilities Act Title III) and with state or local ordinances when required (i.e., see California §8593.7). However, with the exception of email, these channels of communication are limited in the amount of information they can provide, and this can cause issues with providing the right information at the right time.
If staff do experience a lapse in cognitive function and require more information than provided by (say) a PA announcement, the options are limited for where they can get it from. Many staff will not have access to PCs when an emergency starts, and therefore will not have access to repositories of information relating to their roles in specific types of emergency. Likewise, patients and visitors will not have access to further information and will be relying on staff for direction.
Because of the inaccessibility to PCs, staff will have to rely on communicating via a personal mobile device. However, while email does not have the same information limitations as other communication channels, most healthcare organizations do not allow staff to access corporate emails from personal devices due to HIPAA requirements. Furthermore, patients and visitors will not have access to email information they might need to make informed decisions in a stressful situation.
The solution to maximize the effectiveness of mass notification and crisis communications for hospitals is to prepare web pages in advance with the procedures for each type of emergency and include a link to the relevant web page at the end of each SMS text alert. Then, when a staff member, patient, or visitor receives a short SMS alert, they click on the link at the end of the alert to access a web page with full instructions on how they should respond.
Having mobile access to a web page will mitigate the risk of staff forgetting what they are supposed to do or making an impaired decision. It will also enable patients and visitors to make informed decisions about what they should do in an emergency to reduce the burden on hospital staff. However, it can often be the case that different staff have different roles since (for example) some may be responsible for evacuating immobile patients, while others may be on first aid duty.
It would be impractical to create one web page containing every procedure and every individual´s role for one type of emergency because it may take too long for an individual to identify which procedure is relevant to them. Therefore, healthcare facilities will need to prepare web pages for different recipients and ensure the link to the right web page is sent to the right person at the right time. This may sound complicated, but it is simple to organize using the attribute feature and SMS opt-in capabilities of the Rave Alert platform.
Rave Alert is a multi-modal platform capable of sending mass notifications and crisis communications for hospitals via SMS text, voice broadcast, email, social media, and desktop alerts. The platform also integrates with CAP and Alertus-compatible warning systems to support the NFPA four-layered notification structure. There are various ways in which the platform´s database is populated – with the two most efficient methods being synchronization with a personnel database and SMS opt-in.
When Rave Alert is synchronized with an existing database, personnel on the Rave Alert database inherit roles from the existing database. This means nursing staff are grouped together, security staff are grouped together, environmental staff are grouped together, etc. Staff within each inherited group will likely have different roles in an emergency: so, to ensure the link to the right web page is sent to the right person at the right time, staff are assigned an attribute which reflects their role in an emergency.
Then, when an emergency occurs, administrators send one alert to staff with (for example) responsibility for evacuating immobile patients and a second alert to staff who are on first aid duty. The content of both alerts is the same – and both alerts can be sent with three clicks of a mouse because of provided alert templates that have been prepared in advance - but the link at the end of each alert will lead the recipient to a different web page providing information relevant to the individual´s role.
The SMS opt-in capability is even easier to manage. Patients and visitors opt in to receive notifications sent via the Rave Alert platform by texting a keyword to a short code number (i.e., text “visitor” to 654321). The option exists to use multiple keywords for different hospital buildings or length of stay. Then, when an emergency occurs, administrators send alerts to opted-in patients and visitors with a link to the procedures they should follow depending on their level of mobility.
The way the mind responds in emergencies is not the only issue that can impact the effectiveness of mass notification and crisis communications in hospitals. In many jurisdictions, English is not the first language for large numbers of patients and visitors, and they may have trouble understanding emergency alerts broadcast in English. This not only impacts the safety of these patients but might also impact the safety of personnel trying to help them if communication barriers exist.
A solution to this issue is to conduct a risk assessment to identify what other languages an emergency alert may have to be broadcast in, and then prepare web pages to support these communities. To let non-English speakers know the web pages exist, multi-lingual signs can be erected around the hospital campus inviting patients and visitors to opt in to the mass notification system and texts included with links indicating the content exists in other languages. For example:
HOSPITAL ALERT: A SUSPECT WITH AN ARMED WEAPON IS IN THE BUILDING – INFO | ES | IT | عربى (Arabic) | 中文 (Chinese) | עִברִית (Hebrew)
While the above may sound complicated, it is a lot simpler than it appears. However, if you are unsure about how the processes explained above might complement existing mass notification solutions used by your organization, or you would like to know more about maximizing the effectiveness of mass notification and crisis communications for hospitals, do not hesitate to get in touch.
Our team of safety experts will be happy to elaborate on how you can maximize the effectiveness of mass notification and crisis communications for hospitals with the Rave Alert platform – not only by getting the right message to the right person at the right time, but by making sure the message contains the information they need in a language they understand.
Terri Mock is Rave's Chief Strategy & Marketing Officer, overseeing strategy, product, and marketing. She is an executive leader with achievements in delivering revenue growth, driving go-to-market, innovating products, and scaling operations from high-tech startups to global companies.