Emergency Preparedness 101: Going Beyond “Process and Roll”

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Original story posted on: September 19, 2018

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    Learn about the ICD-10 Z 'Stress' codes and their utilization and application with Ellen Fink-Samnick

Accounting for socioeconomic factors is critical to the sustainability of healthcare.

Editor’s Note: This article was written as Hurricane Florence was heading directly for the United States’ East Coast. Stores from the Georgia to Delaware have barren shelves where staples, as water and toilet paper are usually stocked.

Nature and technology do not always agree, as has been clear with Hurricane Florence having a somewhat unpredictable trajectory despite advanced technology tracking systems. Yet, by the time you read this article, the wrath of the latest storm and its aftereffects will have been experienced by millions.

The health and behavioral workforce stands at the ready, especially amid hurricane season, or in the wake of any natural disaster. We move into action, reconciling our multiple roles across personal and professional domains. That means a few things:

  1. We actively consider not only “what do I need to pack again?” but also, “where's that emergency protocol for my employer?”

  2. We follow the industry mantra of “process and roll,” a.k.a. we deal with what we need to in the moment, then toss that valuable information away, or at least tuck it in a safe place that not even the most organized brain can recall.

  3. We wonder who else out in the universe needs our help and attention, and consider volunteering our time and expertise.

As a former emergency department and intensive care unit case manager I know a lot about the ‘process and roll’ mentality. While it rocks in the short term, it leaves a bit to be desired for the long haul. To foster a more strategic and proactive approach to emergency preparedness for health care professionals, I wanted to share this comprehensive resource list to address each of the aforementioned areas and empower your efforts:

Personal Resources

The American Red Cross provides an organized listing of “must-have” supplies for each person, from non-perishable items to key supplies for individuals and family members (e.g. batteries, secured copies of personal documents, a seven-day supply of medications, sealable storage bags to securely store electronics and chargers, money, maps, and items for unique needs dictated by a community and/or the type of event, e.g. whistles, surgical masks, rain gear, towels, etc.).

For those with pets, the Humane Society has an equally robust list for animal family members, including but not limited to food and water, medications, medical records, sturdy leashes and carriers, current photos, plus special information like microchip tracking numbers, as well as the name and phone number of your veterinarian.

The American Public Health Association website lists 10 must-have items:

  1. A three-day supply of water, with one gallon of water per person per day
  2. Three-day supply of nonperishable food
  3. Manual can opener
  4. First-aid kit
  5. Radio
  6. Flashlights and lanterns
  7. Batteries
  8. Whistle to signal for help
  9. Prescription medications
  10. Battery-operated or solar cellphone charger

Ready.gov provides information needed to build preparedness kits, with printable lists for the following:

  • Food preparedness
  • Car safety
  • Water

Professional Resources

For those who missed Monitor Mondays’ Sept. 3, 2018 broadcast, all should be mindful of the HIPAA implications of National and Public Health Emergencies for covered facilities and organizations.

Occupational Safety and Health Administration: Hurricane Preparedness and Response provides strategic direction for workforce evacuation and emergency plans.

Many readers know I’m a stickler for using the ICD-10 Z Stress codes to address Social Determinants of Health (SDoH) for social and environmental circumstances that accompany patients into facilities, whether inpatient or outpatient.

For those who have come to rely on me for relevant codes, here are a few considerations:

Z 56: Problems related to employment and unemployment

  • 8Other problems related to employment
  • 82Military deployment status

Z59: Problems related to housing and economic circumstances

  •  Z59.0 Homelessness
  •  Z59.1 Inadequate housing
  •  Z59.4 Lack of adequate food and safe drinking water
  •  Z59.8 Other problems related to housing and economic circumstances
  •  Z59.9 Problem related to housing and economic circumstances, unspecified

Z63: Other problems related to primary support group, including family circumstances

  • 31Absence of family member due to military deployment
  • 32Other absence of family member
  • 4Disappearance and death of family member
  • 6Dependent relative needing care at home
  • 7Other stressful life events affecting family members

Z65: Problems related to other psychosocial circumstances

  •  Z65.4 Victim of crime and terrorism
  •  Z65.5 Exposure to disaster, war, and other hostilities
  •  Z65.8 Other specified problems related to psychosocial circumstances
  •  Z65.9 Problem related to unspecified psychosocial circumstances

Of course, do not forget to include the both clinical and essential non-clinical documentation to validate each ICD-10 code.

Follow the guidance provided by the American Hospital Association, as well as my prior articles and broadcasts on RACmonitor and ICD10monitor, as well as Monitor Mondays and Talk Ten Tuesdays.

For those interested in volunteering, a wide array of organizations and opportunities exist. An expansive and current listing can be accessed through the website for National Voluntary Organizations Active in Disaster.

Last, but certainly not least, it is an occupational hazard of the health and behavioral health workforce to care for others before and instead of ourselves.

Unfortunately, we all have limits to our energies and must equally engage in self-care. SAMHSA’s Efforts for Disaster Preparedness, Response, and Recovery site provides behavioral health resources to help responders, professionals, and their communities prepare, respond, and recover from disasters.

Stay proactive and prepared!

Ellen Fink-Samnick MSW, ACSW, LCSW, CCM, CRP

Ellen Fink-Samnick is an award-winning industry expert who empowers healthcare’s transdisciplinary workforce through professional speaking, writing, mentoring, and consultation. Known as “The Ethical Compass of Professional Case Management,” Ellen is an esteemed author with more than 100 publications to her credit. She has developed content for many of the industry’s knowledge projects for case managers, including books, chapters, articles, and continuing education on the Ethical Use of Technology, Competency-based Case Management, Collaborative Care, the Social Determinants of Health, and dimensions of Workplace Bullying. Her contributions to professional case management, ethics, and clinical social work transverse professional associations and credentialing organizations.

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