"This plan should have different levels for influx of patient surge or visitor population onto the campus," she said. "Whether you are dealing with a school bus accident of 20 people or in the case of the tsunami, you are bringing in tens of thousands of people, without that practice and prior preparation the hospital is really going to be at a loss as to how to handle that."
In addition to a patient or visitor surge, Meserve says that hospitals also have to take other considerations into account.
"Not only do they have to take into consideration the additional people coming in, but they have to take into consideration what effect is the situation going to have on the hospital? If we lose power, what are we going to do? If we lose water, what are we going to do? Those are all part of the backup plans that the hospital really has to think through ahead of time and have good situational plans in place," she said.
In the aftermath of Hurricane Katrina, Hebert said the industry learned about the importance of having risk mitigation plans in place and how crucial it is to practice those plans regularly.
"Complacency is our enemy," she said. "When we don't have an event for a long period of time, planning seems to kind of wane. What we learned is that whether we have a hurricane this season or not, we continue to do that planning."
As part of preplanning for a large-scale incident, Warren said that hospitals need to designate areas for everyone that will be descending upon the facility in a disaster aftermath scenario.
"You need to have designated areas of your facilities already setup for the media and you need to have designated areas prepared for those that are looking for lost family members and make sure someone is there that can communicate with them," he said. "One of the worst things that happens, and we see this on a small scale everyday in emergency rooms across every country really, is when people come to the emergency room to be treated or to visit someone, one of the worst things is not getting any information at all because the mind tends to go to the worst case scenario and the imagination turns into a 'well this has to be bad or they would be telling me something.' We need somebody to give information even if it is simply 'we don't have the details now, but we are working on it for you.'"
Warren added that it is also imperative that hospitals develop relationships and have memorandums of understandings with local authorities so that they will know what the facility's control plans are for a disaster situation. Despite these additional challenges created by natural and unnatural disasters, hospital security managers must still focus on normal day-to-day security tasks to ensure that the facility's employees and patients are safe.
"Unfortunately, there is always opportunity in chaos," Warren said. "There is potential for looting and there is potential for other criminal activity because police are otherwise involved in life saving or more important things at the time rather than crime prevention efforts. I think you have to be ready, not only for the surge event and the emergency management aspect, but you also have to be very vigilant about people taking opportunity to take things, to sabotage things at your facility that might impact your ability to provide medical service. I think it's tough because you have to switch your focus to the emergency management aspect, but you can never let the security of the facility go astray."
When it comes to biological, chemical or radiological incidents, Meserve says that most hospitals have programs in place to handle them and many have used grants to fund the purchase of protective gear. She says, however, that a facility's ability to effectively handle these situations goes back to their teamwork initiatives with local first responders.
"The key in one of (those incidents) is early communication," Meserve said. "If it is identified early, you can setup and prepare for it, but the unfortunate truth is that a lot of times someone is going to be in the emergency room before you realize what you have got and then you have to implement steps after the fact to try and shut down and prevent that incident from spreading to different locations in the hospital."
Hebert said that isolating patients presents a huge challenge for many hospitals.