Emergencies happen, weather-related disasters, cyberattacks, disease outbreaks, and pandemics are just a few examples. Is your healthcare organization prepared? Conducting a hazard vulnerability assessment (HVA) is an essential first step in developing a comprehensive emergency preparedness program in healthcare.
“The hazard vulnerability assessment is a systematic way to assess your top threats to your institution’s community,” explains MetaStar project specialist, Kelli Engen. These threats could be natural, technological, or human-made threats. Examples include tornados, cyberattacks, pandemics, and active shooter situations.
“Ideally, your hazard vulnerability assessment drives your emergency preparedness program,” emphasized Engen, “Whether you are a hospital, a clinic, a public health department, an Emergency Management department, even law enforcement and the emergency medical services (EMS), you really want to structure your preparedness program based on your top threats.”
The process begins by identifying potential hazards, using a tool such as the Kaiser Permanente Hazard Vulnerability Analysis tool. The tool provides a list of common risks, but organizations should also assess additional risks specific to their organization or operations. Different types of organizations manage the process differently. They can be done by a few individuals, as an organization, or in a collaborative group with other organizations in the same community or geographic region.
“We would review ours on an annual basis and typically it would be done amongst our QAPI team, organization leadership, and staff,” Aimee Rassmussen, Program Manager in Healthcare Transformation at MetaStar shares her experience as a previous nursing home administrator. “We attended a few annual HVA sessions, held by the county, which included representatives from area hospitals, other nursing homes, public health, clinics, etc.”
The second step in the process is assessing the risks identified to determine the probability and impact of each hazard. The tool includes scoring for probability and severity, assessing potential impacts on people, property, and operations—such as risk of injury or death, property damage, and service disruption. Scoring also measures preparedness, internal response time, resource availability, and the effectiveness of external support, such as mutual aid, community resources, and supplies.
Once those risks are identified and assessed, step three is when the organization needs to prioritize or rank the risks to focus resources on the most serious threats.
Gathering a larger group often helps organizations identify the top five to 10 risks, allowing them to prioritize training staff and creating a robust emergency preparedness program. Each organization brings a different perspective to the process and often has the same hazards.
“When looking at the community, you may find something that’s not listed on the assessment. For example, you might be in a hospital or nursing home that lives near a railroad track. And so, you want to put something on the HVA about the possibility of a derailment of a train or you live near a chemical factory, so there might be a risk of a chemical explosion or spill.” explains Rasmussen.
Step four is mitigation and planning, which is where an organization wants to be sure to coordinate with other organizations in the community, often emergency situations involve people and resources outside of the healthcare organization conducting the HVA. Organizations review or create plans to address high-priority risks. They might choose to conduct a tabletop or a functional exercise to train and test your staff, so they really know how to handle an emergency.
The HVA process and development of an emergency preparedness program is not a one-time process you must complete.
Organizations should conduct HVAs annually. An incident or training exercise does not usually trigger a new HVA. However, Engen explains, “After every situation, exercise or real-life event, the organization should conduct an after-action report (AAR). The AAR asks what went well? What did not go well? How do we improve?”
Rasmussen explains, “The AAR might trigger the organization to adjust the HVA to show that we didn’t identify this as a threat before. Then the organization needs to make sure that they have policies in place or adjust the emergency preparedness plan.”
“Emergency preparedness is a continuous improvement cycle; you want to evaluate, train, test, and then repeat the cycle to strengthen your preparedness program,” explains Engen.
The HVA process is the foundation for building a strong and effective emergency preparedness program. By systematically identifying, assessing, and prioritizing risks—such as natural disasters, cyberattacks, and pandemics—healthcare organizations can focus resources on the most pressing threats and strengthen coordination with community partners. HVAs should not be a one-time task; it is a dynamic process that informs emergency preparedness planning.
Emergency preparedness planning must be a priority for healthcare leaders. MetaStar offers expert support and resources to help organizations develop and maintain effective emergency preparedness strategies.