Category Archives: Disaster Preparedness

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Business Continuity Awareness Week Takes On Emergency Preparedness

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Resilience is constantly on the minds of risk professionals. If last year taught us anything—between ransomware attacks, natural disasters, and pandemics, just to name a few examples—it is that businesses have unlimited reasons to plan for major disruptions.

To help professionals address emergency preparedness, the Business Continuity Institute (BCI) has initiated the annual Business Continuity Awareness Week (BCAW), May 14 through May 18. The online event will feature 29 webinars tackling a variety of issues under the resiliency umbrella, including crisis leadership, workplace recovery and data breaches that will be hosted by BCI members and organizations such as Amazon and Google. Additionally, BCI will host three onsite launches for its organizational resilience manifesto in London, Toronto and Sydney.

BCI uses the global event as a vehicle to raise awareness of the profession and demonstrate the value effective business continuity management can have to organizations of all sizes. The organization is also hosting a blog writing competition and a photo face cut-out contest with Amazon vouchers for prizes.

Other resources include BC24, an interactive roleplay game where you and up to five colleagues can test your responses in an emergency and tackle the challenge of recovering after an incident. The game is designed to encourage critical thinking about the importance of decisions made in a crisis and demonstrates how these decisions can impact the wider organization. There is free access to the game for the month of May only.

In an effort to bring BCAW awareness into the workplace, BCI advises risk managers to initiate campaigns in their companies, with suggestions including:

  • Run an exercise. You can use BC24 or devise your own exercise to ensure that employees and colleagues are informed on what to do during an incident.
  • Host Q&A sessions. These can be in-person or on social media channels. Asking your staff important questions relating to your incident response strategies can help in identifying your training needs.
  • Circulate your documentation. Does your staff know where to find your business continuity plans? Why not circulate them to everyone, asking for feedback or questions.
  • Hold competitions. You put some fun into learning by holding your own contests. Devise a quiz relating to your business continuity plan, or even send staff members on a scavenger hunt for clues relating to an incident.
  • Host a webinar. BCI will host webinars throughout BCAW, however, there may be a topic relevant to your organization or discipline that it does not cover. You can contact the BCI with questions on how to host a webinar and the best ways to engage your staff.
  • Publish white papers. Every organization approaches disaster recovery in a slightly different way. You can share your analysis with staff members by publishing white papers from various disciplines. This raises awareness about resilience and helps employees understand your organization in more depth. You can email yours to BCI here, and it may publish via its news channel through BCAW.
  • Social media. Social media campaigns will be running throughout the week, asking questions about business continuity and organizational resilience. Tweet BCI at @thebceye with your BCAW activities to inspire other organizations.

LIRR Misses Critical Juncture for Positive Train Control

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Last week, the Long Island Rail Road (LIRR) confirmed interruptions in its ability to fully install positive train control (PTC) across its system by the end of the year. Newsday reported that the LIRR system, which is a unit of the Metropolitan Transportation Authority’s (MTA) network, failed 16 out of 52 factory tests performed in early March using a computerized simulation of the new technology.

Although its PTC contractor continues to investigate the cause of the failures, MTA officials said they believe it stems from the complexity and density of the LIRR, which is the busiest commuter railroad in the country averaging more than 311,000 daily riders.

PTC is designed to eliminate human error by using four components: GPS satellite data, onboard locomotive equipment, the dispatching office and wayside interface units. The system communicates with the train’s onboard computer, allowing it to audibly warn the engineer and display its safe braking distance based on its speed, length, width and weight, as well as the grade and curvature of the track, according to railroad operator Metrolink.

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If the engineer does not respond to the warning, the onboard computer will activate the brakes and safely stop the train.

An approved PTC System must protect against:

  • Passing a stop signal.
  • Train-to-train collision.
  • Overspeed on curves and other civil restrictions.
  • Unauthorized incursions by a train into a work zone.

The installation began in January as part of a $1 billion safety upgrade, although it had been on the LIRR’s strategic plans for years. So far, substandard testing results are not instilling much confidence that PTC will be complete by the federal deadline of Dec. 31, 2018. If that deadline is missed agencies without properly-installed PTC may face fines of up to $25,000 per day, as enforced by the U.S. Rail Safety Improvement Act of 2008.

MTA Board member Neal Zuckerman told Newsday he is less concerned about meeting a federal deadline than he is about “having a system that works for riders.”

“It is better to have this right than fast,” Zuckerman said. “A nonfunctioning system is not worthwhile. It’s a waste of money and time and ultimately will not serve the needs of the riders.”

The LIRR is not the only major transit system to be missing the mark. Risk Management Monitor reported on Amtrak’s struggle to meet the deadline in February and that by the end of 2017, only 8% of NJ Transit’s locomotives and none of its tracks were updated with PTC.

Efforts to upgrade train technology has been a nationwide priority. There have been a number of accidents in recent years. The most recent was a major derailment occurring on Dec. 18, 2017 when an Amtrak train derailed near Tacoma, Washington, killing three passengers and injuring about 100. That crash was the result of excessive speed in a steep curve, which experts suggested could have been prevented with PTC’s automatic braking technology. Amtrak Train No. 501, on its inaugural run, was traveling 80 miles per hour in an area limited to 30 miles per hour when it derailed on an overpass, sending the train’s 12 coaches and one of its two engines careening onto the highway below.

As previously reported in Risk Management, a similar derailment in Philadelphia in May 2015 that killed eight, was also blamed on excessive speed and could have been avoided if PTC had been in place.

After Congress passed the PTC Enforcement and Implementation Act of 2015 it also authorized the FAST Act, which allocated $199 million in PTC grant funding and specifically prioritized PTC installation projects for Railroad Rehabilitation and Improvement Financing funding. The Association of American Railroads estimates that freight railroads will spend $10.6 billion implementing PTC, with additional hundreds of millions each year to maintain.

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 The American Public Transportation Association has estimated that the commuter and passenger railroads will need to spend nearly $3.6 billion on PTC.

Risk Manager of the Year: Q&A with Rebecca Cady

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Rebecca Cady, vice president and chief risk officer of Children’s National Medical Center (CNMC) in Washington, D.C. was named the RIMS 2018 Risk Manager of the Year today. CNMC is the largest freestanding pediatric academic medical center and health system in the greater D.C. area., with annual revenues of nearly $1.2 billion.

She was praised by her peers for her success in elevating CNMC’s culture of safety, addressing risk on an enterprise basis and lowering the system’s total cost of risk. Under her leadership, programs continually seek to benefit the system’s 6,000-plus employees, and ultimately, the services they provide to children and their families. Cady spoke with Risk Management Monitor about her journey to the profession and the combination of challenges she faces as a health care risk manager.

Risk Management Monitor: Your professional career began as a labor and delivery nurse. How did you make your way into risk management?

Rebecca Cady: I was a staff nurse at a small, rural hospital in Kingsville, Texas. During a shift, several co-workers were gathered at the nurse’s station, discussing a lawsuit that many senior nurses were anxious about having to take part in.

They didn’t understand what was going on. I remember thinking: ‘What if lawyers knew what it was like to be a health care provider or practice medicine and nursing?’ It would help them do a better job of guiding the nurses and doctors through the legal process. I thought, ‘I could go to law school.’ And I did. It turned out to be a great idea because it has made for a fulfilling and interesting career.

RMM: After becoming a lawyer—and eventually partner—at a law firm, what drew you to CNMC?

RC: I saw this as an opportunity to get in the practice of avoiding litigation in the first place. I was attracted to the idea of working more closely with providers and in a hospital environment where I felt I could have a greater impact on the organization and manage its risk.

RMM: What is one of CNMC’s top challenges?

RC: Recruitment is up there. Pediatric neurosurgeons are not working at Starbucks while they’re looking for a job.

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In some of the specialties, there are very few qualified people. Being able to recruit and hire the best and the brightest, which we think our kids deserve, is hard because we’re competing with pediatric hospitals that are part of other systems.

RMM: In 2014, you updated the reporting systems to include reporting from mobile phones. What inspired that change?

RC: Being able to report an incident and have it instantly make its way up the chains of command was more of a way to cut past the tediousness of logging a report on paper, or even on a computer. I’m not a techie but I recognize that technology has the ability to make us more efficient and effective. We really do believe that more reports are better, because knowing about the low-level events that don’t reach patients or cause immediate problems can still be useful. You can then identify latent issues that need correcting and prevent something serious. Plus, it was embraced by our employees.

RMM: You are widely regarded by peers and co-workers as a relationship-builder and a strong communicator. What is your management style?

RC: My office is in the hospital and I make it a point to be visible. I go to meetings wherever possible and am present wherever possible, I administer our calls and speak at staff meetings as well and to the new residents and nurses as they come on board. The whole risk team is also out and about among the organization constantly, because having relationships builds trust and makes your job easier.

We’re not the department of ‘No.’ We’re the department of ‘Yes, If…’ Helping folks solve their problems – even if they seem small to you – is huge for them. And once they stop seeing you as the policeman, they see you as a business partner.

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Then they’ll start to call you earlier in the game when they are strategizing. That applies no matter what industry you’re in.

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200 New ‘Nightmarish’ Reasons to Wash Your Hands

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New nationwide testing in 2017 uncovered 221 instances of unusual resistance genes in what is known as “nightmare bacteria,” according to the Center for Disease Control and Prevention’s (CDC) monthly Vital Signs report, released last week. Germs with unusual antibiotic resistance (AR) include those that cannot be killed by all or most antibiotics, are uncommon in a geographic area or the U.

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S., or have specific genes that allow them to spread their resistance to other germs.

Examples of AR germs include: Vancomycin-resistant Staphylococcus aureus (VRSA), Candida auris, and certain types of nightmare bacteria such as carbapenem-resistant Enterobacteriaceae (CRE).

“CDC’s study found several dangerous pathogens, hiding in plain sight, that can cause infections that are difficult or impossible to treat,” said CDC Principal Deputy Director Anne Schuchat, M.D.

With spring break in full effect and peak travel season on the horizon, the timing of this new information should be noted by businesses and the public, since AR has been found in every state and can spread between facilities and even people without symptoms of infection.

The CDC warned that germs “will continuously find ways to resist new and existing antibiotics” and that it is currently impossible to stop new resistances from developing. Recent nationwide infrastructure investments in laboratories, infection control, and response are enabling aggressive investigations to keep resistance from spreading in health care settings.

According to the CDC, a hard-to-treat germ that spreads easily was found in 11% of screening tests among subjects who displayed no symptoms. The nightmare germs sicken 2 million Americans and kill 23,000 every year. Additional study findings showed that:

  • One-in-four germ samples sent to the AR Lab Network for testing had special genes that allow them to spread their resistance to other germs.
  • Further investigation in facilities with unusual resistance revealed that about one in 10 screening tests, from patients without symptoms, identified a hard-to-treat germ that spreads easily.
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    This means the germ could have spread undetected in that health care facility.

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  • For CRE alone, estimates show that the containment strategy would prevent as many as 1,600 new infections in three years in a single state—a 76% reduction.

The CDC’s rapid response Containment Strategy is launched at the first sign of unusual resistance. Recent cases were found and isolated in Tennessee, after a patient received health care outside the U.S.; and in Iowa, when a nursing home patient was diagnosed with an AR germ that spread to five other people. Follow-up assessments revealed the outbreak had been contained.

To mitigate the risk of contracting these germs, employees should:

  • Inform your healthcare provider if you recently received health care in another country or facility.
  • Talk to your healthcare provider about preventing infections, taking good care of chronic conditions and getting recommended vaccines.

CDC recommends practicing good hygiene, such as keeping hands clean with hand washing or alcohol-based hand rubs, and keeping cuts clean until healed.