Ambulatory Leaders: 5 Steps for Successful Mock Disaster Drills


Emergency preparedness can be a struggle for ASCs and small facilities. For starters, regulations can be difficult to navigate and understand, according to Lori Tamburo Martini, CASC, administrator at Specialty Orthopedic Group Surgery Center in Tupelo, MS. “Compliance with the emergency plan, particularly drills, tend to be challenging for most facilities and often lead to citations during a survey,” Martini said.

Freestanding ASCs also have fewer resources immediately available compared to centers who have a hospital partner on the same campus that provides emergency support.

That’s why Martini stressed the value of “drilling your skills” in her education session on ASC emergency preparedness at AORN Expo 2023.

With tight staffing and busy schedules, we asked her where ASCs should start to get teams ready for any emergency. She shared these top five steps to dial-in safety drills for maximum preparedness:

  1. Know the Regulatory Requirements for ASC Emergency Preparedness

Accreditation agencies and the Centers for Medicare and Medicaid Services (for Conditions for Coverage) provide guidelines for emergency and disaster drills. An ASC’s Emergency Preparedness plan must also meet federal, state, and local requirements and reflect continuity of care. 

Martini says: Schedule time to review your plan annually to make sure current emergency preparedness requirements are reflected in your policies/procedures and your planned drills for the coming year.

  1. Train Staff on Assigned Emergency Roles Before You Drill

“Train first,” Martini says. Don’t try to drill if staff members aren’t fully comfortable with what to do during an emergency. Remember that drills can cover a wide range of emergencies, from Code Blue and malignant hyperthermia to incapacitated MD or active shooter, so you must reinforce the responsibilities within a role that might be needed in any emergency.

Training strategy: Roles should be assigned by position or scenario rather than a specific person.

  1. Get Creative with Drills to Engage Staff and Ensure Accountability

Identify creative ways to engage staff in drills, such as using outside resources like the local fire department or police department to be a part of emergency training, Martini suggested. To ensure active participation in drills, Martini includes it as a positive performance measure in annual staff evaluations.

Don’t forget: Drills must be performed at different times to ensure all staff can participate.

  1. Find Easy-to-Use Drill Documentation Tools

Put tools in place to ensure proper documentation and evaluation of drills, but “don’t reinvent the wheel.” Instead, look for drill evaluation tools from professional practice organizations and accreditation agencies.

Learn more: Use a fire drill evaluation from AORN’s Fire Safety Tool Kit.

  1. Have a Plan for Drills That Fail

Drill failure is part of the process, Martini acknowledged. But don’t let failure slide, she said, because you can use areas for improvement as opportunities for re-education. Emphasize the “why?” behind drill compliance, not only to prevent a survey citation, but ultimately to protect patient and staff lives.

Martini’s suggestion: Rotate staff to be evaluators of drills. Why? This gives leaders and frontline staff members a chance to look more critically at the drill and encourages staff to be more actively involved with planning and evaluation.

Implementation Tip:

Here’s one more emergency readiness tip Martini has found effective:

Create quick-reference tools that staff can use to know what to do in an emergency without struggling to find a policy.

For example: Place a simple flip chart that summarizes key information for each type of emergency at key locations throughout the facility. You can also create a badge insert to simplify important tips for all into visuals, such as four key steps for fire response.

AORN's ASC Academy: A Guide to Emergency Drills provides step-by-step guides, along with templated tools to make emergency drills turnkey at your surgery center. With this new resource, you can plan and conduct effective drills easily: fire, active shooter, malignant hyperthermia, and more.

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