Health Care Facilities Stuck Due to Inflexibility – Defend In Place Strategy (Flooding)

Because of building size, occupants with physical restraints, or occupants with impaired physical or mental abilities health care professionals in health care facilities have a defend in place strategy.  These occupants fall into three categories, hospitals, nursing homes, and residential-custodial care facilities. Some patients due to the nature of their injuries are considered outpatients and are housed in nursing homes, and residential-custodial care facilities.

Due to the nature of these facilities and the varying ambulatory status’ of the patients fire and emergency medical care professionals along with the health care staff must pre-plan and prepare for events that can bring harm to those clients.  In Hurricane Katrina and in the Japan flood as a result of the tsunami we saw patients trapped and loss of life because the health care facilities lacked adequate staff to evacuate the facility.  Planners at these facilities were so indoctrinated with the defend in place strategy that they could not envision a rapid evacuation even though one was clearly needed.

We read and heard stories of how patients were abandoned because the ambulatory staff got out before the flood waters came.  Governments send mixed signals and even ignore the need to make sure proper planning and plan evaluation takes place.  In most cases no local government agency or department even reviews health care facilities emergency plan.  Emergency plans are required of most occupancies but there is no oversight of the plans. (

Most Health Care facilities stick to the normal defend in place scenarios and never exercise their evacuation plans.  Sadly, the staff is left to figure out on the fly how to evacuate a facility as complex as a health care facility until it is too late.  Systems Emergency Preparedness Consultants can help bridge the gap between governments and health care facilities to produce plans that will stand the test of mother nature and time. Email us at for a free consultation. We will give a free assessment of your organization’s emergency plans.


About managingemergencies

I am a professional consultant with 30 years of experience in managing emergencies. My background and skills gave me the foundation to start Systems Emergency Preparedness Consultants. If you need preparedness training or would like to have a preparedness discussion for your employees contact me via email at I held various positions in the Prince George's County Fire/EMS Department until I retired in 2007. As a emergency planner and trainer in the Prince George's County Office of Homeland Security I planned exercises and training for government agencies and citizens groups. I was appointed Fire Chief of the Prince George's County Fire/EMS Department in 2009. I started Systems Emergency Preparedness Consultants in June of that year. I had the opportunity to become the Assistant Fire Chief - Operations of the District of Columbia Fire/EMS Department and served for a year as the Interim Fire Chief. I am a trained mediator, mediator team leader and trainer. I also served as the Fire/EMS Department Equal Employment Opportunity Officer.
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