Should Emergency Response Plans be integrated to Business Continuity Management System? What benefits it brings when building healthcare sector resilience?

With the healthcare sector’s emphasis on health and well-being, Emergency Response Plans (ERP) and Business Continuity Management Systems (BCMS) are major plans organisations must prepare to mitigate and overcome the ever-changing threats and crises. The unique risks possessed by the healthcare sector mentioned in June’s Article have highlighted the importance of having a suitable ERP. These include workforce shortage, material scarcity, machine reliance, infrastructure vulnerability and need for premises. Having the suitable ERP is especially critical in Healthcare as preventing loss of life is at the core of the business. In the broader picture, a subsequent Business Continuity plan can be activated to ensure the organization’s service levels are being maintained.

Key Considerations

While we cannot predict what future risks and threats might affect the organisation, a well-designed ERPs can help minimise the decision and response time of an incident in the healthcare industry. It should also be developed in advance to ensure that the plan’s various components are in place and can be implemented efficiently with the Business Continuity plan. Some key factors that must be considered include the availability of resources, the location of the emergency supplies, and the training of the staff personnel. From the Man (manpower), Material (Infrastructure) and Machine perspective, major concerns in healthcare industries’ resiliency and Business Continuity were highlighted during the Covid-19 pandemic and other recent events. While many organisations would have a Business Continuity Plan (BCP) in place, it is paramount for continual maintenance of BCP to keep up with new risks as they unfold and align with raising industry standards. Here are a few suggestions to improve the resiliency of healthcare establishments:

  • Manpower redundancy

Often we underestimate the importance of having a healthy margin of manpower, especially for frontline healthcare workers. Yet it was a key obstacle during the recent pandemic, highlighting the shortage of medical personnel worldwide. Redundancy needs to be designed for the roles handling key processes to improve resiliency. This can be achieved by cross-training staff to ensure that they can be deployed readily in the event of an emergency, especially when there is a mass casualty and a sudden surge in workload. For instance, all nurses can be cross-trained to take up different duties so that during a pandemic, if any department has a staff shortage, they can redeploy staff quickly to their respective wards or clinics.

Aside from having buffer staffing, developing a program to train medical personnel to be prepared for emergencies and continue Business Continuity is key to the program’s success. This can be done by creating a training program and establishing a resilient network of suppliers.

  • Safeguarding supply chains

A proactive assessment of the organisation’s upstream suppliers would help organisations have a clearer picture of the potential stressors which may result in critical breaks in their supply chain. One option would be to diversify supply sources using a hybrid model of performance contracting and appointment of secondary or tertiary alternative vendors. Proper relationship management is also vital in ensuring that vendors can deliver the goods and services as hired, as they would be more transparent about their baselines. Consistent performance monitoring should also be in place to ensure any gaps can be addressed early. Given the organisation’s resiliency, consumable stock levels and inventory must be proactively assessed based on global risk profiles and trends for a prompt response.

  • Preparing Backup Machinery

Biomedical equipment is usually proprietary, so it would be prudent for biomedical department technical professionals to work with the end-users and medical personnel to source alternative brands to reduce reliance on a particular brand. During a manufacturer product recall, equipment will need to be put out of action with immediate effect. However, suppliers may not have sufficient loan sets to supplement the existing deployment. Healthcare-related machines are usually expensive and have an extended lead time. Hence policies can manage this process in advance to ensure that products purchased can reach the users in time without being caught up in additional corporate red tape. In the same vein, medical personnel from various departments must know the alternative procedures to undertake and identify similar machinery they could borrow from other departments to maintain regular operations.

  • Machine reliance

Modern medicine hinges on specific equipment and machinery tools, which means supply disruption at production source will inevitably adversely affect the ability of the healthcare organizations to continue their business. From diagnosis to treatment to after-care, medical services cannot operate smoothly without high tech machinery like x-ray machines, CT scanners. Reliance on machines was highlighted during the global semiconductor shortage, which had a massive impact on the medical industry as machines required for procedures were unable to function due to the lack of parts. Machinery required for treatment using medical implants like pacemakers also could not be delivered in time due to shortage of microchips (Kendall-Windless, 2022).

  • Redundancy for infrastructure

With the high risks healthcare centres are subjected to and the dire consequences that follow crises, it is crucial to prevent such events by tackling flaws in the system early on.  While it may be more costly in monetary terms, such costs cannot be scrimped on as the severe consequences are too much to bear. Akin to purchasing an insurance policy to prepare for the worst-case scenario, healthcare organisations should lay the groundwork in their BCM by providing for redundancy in infrastructure. For hospitals, it is ideal to have a dual electricity supply from 2 electrical substations on top of an Uninterrupted Power Supply (UPS) battery backup power for essential equipment. Additionally, having multiple separate tanks for clear water and oxygen would diversify the risk of contamination and leaks. The key infrastructure supporting the clinic, such as fire pumps, air conditioning units, and generators, will need to be periodically tested and maintained on time to ensure that these redundancy systems will be ready when needed. With these measures in place, there is a lower risk of having complete loss of utilities and higher resiliency of infrastructure to cushion the fall should an emergency occur.

  • Alternative Premises

For treatments and operations to proceed as usual, BCM should provide alternative premises and backup facilities to allow the continual provision of medical services despite the disruptions. One example would be to have a plan on hand to convert a nearby exhibition hall into a patient ward readily, or an A&E room within the RTO stated in BCP. While they may contribute to overall costs and resources, keep in mind the dire consequences of losing premises and the inability to continue operations should a complete loss of property occur.

Key to success

While many plans are made on paper, not all may be successfully implemented in reality. Developing a comprehensive ERP and Business Continuity goes beyond plans on paper. It is also required to ensure that all staff members are trained and equipped to respond to an incident. It is thus crucial to consider some key factors to ensure the successful implementation of such emergency plans.

  • Leadership commitment

One of the most important factors that apply to healthcare organisations and across industries is establishing a management support team when implementing a new strategy or procedure. This can help ensure that the various processes are being properly monitored and that the financial resources are used to address the identified gaps. It is also vital that the management team can initiate a paradigm shift to improve the flow of information and the organisation’s efficiency. With consistent visible and evident leadership, such implementation can overcome initial pushbacks and barrier to roll-outs by employees.

  • Alignment of expected outcomes

It is imperative that the ERPs and Business Continuity in healthcare sectors are set out with the same intent in mind to increase the organisation resilience. To start off, some of the key goals of expected outcomes in healthcare organizations include:

(i)          Prevention of fatalities and injuries

(ii)         Reducing damage to the buildings, stock, and equipment

(iii)        Protect the environment and the community

(iv)        Accelerate the resumption of normal operations.

  • Commitment to Infrastructure Betterment

Given the various demand for high-quality infrastructure, organisations should integrate their backup plans early on from the design of their facilities. For instance, it would be much easier to incorporate a UPS within the hospital premises, perhaps integrating it with other power supplies in the backrooms to provide redundancy early on. In a similar vein, the Disaster Recovery Plan for Information Technologies (IT) should also have clear objectives and responsibilities allocated, which are equally essential to ensure sufficient redundancy in infrastructure is in place in case of crisis.

  • Iterative Testing and Improvement

Although the plans are not always set in stone, it is still important to regularly review and modify them to ensure they are working correctly. Implementing exercises and drills to practice critical portions of the plan will allow the organisation to identify areas of concern and improve the plan’s effectiveness. Aside from regular drills and exercises, it is also crucial that the knowledge of individuals’ responsibilities of the plan are evaluated from tabletop, paper tests, control exercises, interviews reviews and eventually simulations as well as functional exercises.


In closing, ERPs are complex, and healthcare organisations must take time to craft such plans as they bear high risks. By improving buffers for manpower and infrastructure and diversifying suppliers, healthcare organisations would be better build up their resiliency of healthcare organisations.  At the same time, ERPs must be integrated to the BCM to be congruent with the bigger picture to achieve both the goal of saving lives and continuing regular operations. On the other hand, seamless integration with ERP could aid in determining the risk profile for the organisation’s BCM. It is paramount for leaders to have a strong commitment to the cause and for continual improvement of plans to ensure the success of plans in the long run.

Written by: BCP Asia Consulting Team


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