Day-to-day life in a veterinary practice is full of challenges. Tricky clients, animals that don't want to be touched, medical cases that aren't obvious and require odd diagnoses through unusual testing; there are many unique problems that need to be solved on a daily basis.
Few vets give thought, then, to other challenges that can arise. What happens if the water main in front of your building bursts? What happens if a space heater overloads a circuit and starts an electrical fire? What if someone opens an email attachment and your computer system is hit with ransomware? What if you're located in the middle of a city in the path of a major hurricane?
Being able to adapt, respond to, and return to operations after a disaster is something few of us think about as much as we should. That's why a formalized process to put together a disaster response plan is essential for a veterinary practice or, really, any business.
A disaster response plan can mean one of two things:
A disaster that happens to your practice and how you respond to it.
A disaster that happens to your area and how you respond to it.
We'll discuss both here, but know that there's a lot of cross-over between them. A widespread disaster happening to your city (like a hurricane, massive wildfires, landslides, flooding, or a major earthquake) impacts your practice just as much as anywhere else. The disasters that happen to your practice specifically, like an office fire, ransomware attack, or serious break-in, all require their own preparation, but that preparation is similar to how you would start responding to a more widespread disaster.
Self-Contained Disaster and Response Planning
First, let's start with localized disasters. These can be things like a fire that devastates or destroys your building, a digital attack that compromises your computer systems and damages or destroys electronic records, or even malicious attacks on you specifically.
A disaster response plan is a set of backup options, response options, and plans that allow you to recover from a disaster as soon as possible.
Some of the basics include:
Maintaining off-site electronic backups with airgaps to prevent cross-over infections in the case of malware intrusion.
Maintaining insurance on your practice and building to help financially pay for and repair or replace your location in the event of a disaster.
Installing (and testing) fire response systems.
All of this, though, is putting the cart before the horse. First, you need to perform a risk assessment.
What is a risk assessment? It's as thorough and comprehensive an analysis of your business as possible to identify potential risks and hazards. Some of these are common to any business or household, like electrical fires or water main breaks. Some of them are more geographical, like flooding, severe weather, or freezing issues.
Consider risks at different levels, as well. A brief power outage is a disaster that can cut off your ability to provide care, but it's on a very different level from a tornado wiping out a local power substation and cutting off power to your city. They both have a similar result – no power to your practice – but with very different repercussions.
Risks can be categorized by threat level, potential impact on your practice, and even categories like whether they're manmade risks or natural risks. An earthquake, a disease outbreak in humans or animals, or a water main break are all potential risks, some more likely than others.
Don't forget the risks to the people involved in your practice. As the lead veterinarian, a significant risk is if anything happens to you. If you're in a car accident and need to spend a week in the hospital, how does your practice fare?
The second step is to quantify the impact of these risks on your practice. A standard practice is to perform a Business Impact Analysis for different risks. Focus on predicting the consequences of a disaster, how long it would take to set up a backup or to operate around the disaster if necessary, and what kinds of repercussions the disaster would have. Are there operational impacts? Are there financial impacts? It's your job to know.
The third step is to take any actions you can to minimize potential risks and hazards or to take actions that can reduce the impact of a given disaster. For example:
Move critical supplies to a more secure area where they are less vulnerable to flooding or other disasters.
Sign up for emergency alerts so you can proactively plan when larger disasters could happen.
Upgrade and test various security systems, including digital security systems for your EMR.
Install a backup power generation system or have generators on standby and ready to go.
Cross-train team members to handle duties in an emergency that are normally outside their usual scope.
Sometimes, these steps can be as simple as moving items from one location to another. Other times, they can be a significant monetary and even time investment.
Step four is to assess any given resources that are available to you to help you, both in terms of preparation for disasters and in responding to them. Consider:
Local, city, or county resources, funds, and teams that can help with any stage of disaster preparedness.
State-level associations and funds that can provide anything from tax breaks to grants for improving disaster preparedness. For example, a state-level grant to install solar can help mitigate the risks of a power outage.
Federal and national-level organizations, including veterinary associations, that can help.
You can consider resources like disaster response grants, assistance teams, travel vets that can help with temporary manpower issues, and more. While you don't need to call on or build relationships with these organizations now, having a list of them and what you can potentially get out of them in the event of a disaster can be a great resource.
At some point, you will need to put together an official business continuity plan. This plan includes safeguards and responses that allow you to respond to disasters and keep treating patients, paying your staff, keeping up client communications, and more. Moreover, it should have options in place if you are unable to continue those things and what backups you need in place, such as local or regional vets you can work with to send patients in need of care temporarily. There are a variety of resources available for this, including ready.gov, OSHA's emergency response documentation, and more.
Widespread Disaster and Response Planning
Pretty much all of the above applies both to small, localized disasters like a building fire or flood and to widespread disasters. Responding to something like the California Wildfires, hurricanes like Katrina, or other weather-related disasters is similar, but there's a greater likelihood that you'll have additional issues to contend with.
For example:
Are city-wide communications and power cut off?
Are response teams and funds being tapped by many other businesses, leaving little for yours?
Are your staff members dealing with their own personal responses to these disasters, leaving no time to work for you?
These kinds of more widespread repercussions are also worth considering. While some kinds of disasters are unlikely or even impossible in your area, others may be more common, and it's worth analyzing what has the potential to happen and how you can respond to it.
Tangible Steps for Disaster Preparedness
Let's go through a list of many of the things you can do to tangibly prepare or insulate yourself against risk. As a veterinary practice, your goal is to maintain operations as much as possible to prevent disruption of care and, in the case of an unavoidable disruption, to return to operations as quickly as possible.
Know what is critical and what isn't. Operations in an emergency should be reduced to just what is necessary. While this, unfortunately, means that many animals with the sniffles and many standard checkups are postponed or canceled, when you're limited on availability, staff, or resources, you need to spend those in the way they do the most good. That means treating animals injured by a disaster and providing critical care as possible.
Establish resilience against threats. There are a lot of different safety and security measures you can implement to protect yourself from potential disasters.
Security systems to warn you of, warn police of, and even prevent break-ins or vandalism that could damage operations.
Installed and tested fire suppression systems that can address all but the most aggressive fires and protect as much as possible from fire, smoke, and water damage.
Digital security, including reliable backups and employee training, to prevent malicious software from being able to compromise your systems.
Knowledge of and contacts with secondary suppliers for things like supplies and medications in the case of restrictions, limitations, or loss of primary suppliers.
Maintaining a stock of parts, supplies, and replacements for critical equipment in case of damage.
Reduction or substitution of hazardous components and proper storage of what can't be reduced to minimize hazards created in a disaster.
Reinforcement of a building to stand up to common disasters, like earthquakes or high winds.
Proactive landscaping, such as tree trimming to protect your building from storm-related damage.
Minimize "just in time" inventory practices that make you more susceptible to supply line disruptions.
The list can go on; this is just to give you an idea of the breadth and depth of possible concerns you might have. The disaster preparedness and planning process outlined above is a framework you can use to determine and outline which of these and which others will apply to your practice.
Helping Others
There may be a case where a disaster strikes, but it doesn't strike you. A city-wide disaster that leaves your neighborhood unscathed or a localized disaster hitting another veterinary practice is not necessarily something that doesn't affect you.
As a veterinarian in your area, you are likely interested in – if not obliged to – providing assistance. This can take many forms, including boarding animals temporarily, providing backup critical care, or lightening the load of secondary patients while the most critical cases are still handled by other vets.
Providing these services can put an additional burden on your practice, but it can be beneficial as well. Some clients may choose to switch to you. Some temporary partnerships with other vets may become more long-term relationships.
There are also assistance programs available for vets that provide disaster response and emergency care in the event of a disaster. For example, the American Veterinary Medical Foundation has a Disaster Reimbursement Grant program, which provides up to $5,000 per grantee for expenses incurred during an emergency to help provide care. You do have to be a member of the AMVA to qualify, and there are many expenses that don't qualify because they should be covered in other ways, such as through the PETS Act. However, it's still better than nothing and encourages helping out your community above and beyond the simple obligation.
Don't Do it Alone
If you're looking at the daunting task of setting up an entire disaster response plan on your own, realize that you generally don't have to. Often, one of the first things you should do is build a team that can work on it with you. Your planning committee should consist of key employees, managers, and anyone with a higher level of authority and awareness of systems and a potentially unique insight into what should be considered a concern. In a small practice, you might simply include everyone on your staff.
At Hope Vet, we can also help with some elements of your disaster preparedness. We aren't exactly in a position to help you plan or adapt your practice; however, what we can do is help lighten the load on your veterinarians and vet nurses. For example, if you have to triage which cases are in need of rapid attention and which can wait a few days/weeks/months, our second opinions can help clarify your thoughts and guide you in the right direction.
Navigating all of this is tricky. That's why preparing for a disaster ahead of time is such an important task. When you can spend a year or more developing, testing, and implementing various aspects of disaster preparedness, you're in a much better position than you would be if disaster struck and you had nothing in place to handle it.