How prepared are Health Information

Services for system failures due to

internal disasters?

Cheens Lee, Kerin Robinson,

Kate Wendt and Dianne Williamson

26th

September 2008

What if?

What is a disaster?

‘An occurrence that causes serious disruption or disables necessary business

functions’ (Corrigan 1995)

• External Disasters

Internal disaster definition

• is any disaster or event that originates in the wider organisation (i.e. the hospital or network) or within the Health Information Service, and affects the infrastructure, staff, equipment, systems, services, normal functioning or business continuity of the Health Information Services.

Examples of internal disasters

– Hardware or software malfunction

– Power failure– Water pipe breaks– Construction accidents– Fire– Sabotage– Employee/ex-

employee violence

– Sewer blockages– Equipment failure– Hazardous material

leak– Security breach

Context of study

• Risk Management

• Contingency Plans

• Business Continuity Plans

Documented disasters in Victorian Health Information Services

• Warringal Private Hospital

• The Royal Children’s Hospital

Aim of the study

To investigate the level of preparedness of Victorian public and private sector hospitals’ Health Information Services in the event of system failures due to internal disasters or events that severely impede normal functioning.

Methodology

• Combined quantitative-qualitative methodology.

• Hospitals surveyed(i) a Health Information Service department

(ii) a bed capacity of 80-plus admitted beds; and

(iii) a manager of the Health Information Service department

Who responded?

• 38 hospitals– 30 metropolitan; equal public and private– 8 non-metropolitan; 7 public

Metropolitan and rural hospitals overall questionnaire response rate, according to hospital size

Metropolitan

Rural  

Hospital size Public Private Public Private Total

Small 2 11 2 1 16

Medium 4 3 4 0 11

Large 9 1 1 0 11

Total 15 15 7 1 38

Internal disasters experienced by the organisation within the last 10 years, according to hospital size

Hospital size Yes No Total

Small9

(56%) 7 16

Medium4

(36%) 7 11

Large6

(55%) 5 11

Total19

(50%) 19 38

Types of internal disasters experienced by the respondents’ organisations within the last 10 years

0

2

4

6

8

10

12

Computersystemfailure

Powerfailure

Fire Flood Storm Staffindustrial

action

Types of internal disasters

No.

of i

nter

nal d

isas

ters

Respondents

Types of disaster contingency plans within Health Information Services, according to hospital size.

Hospital size

Internal only %

External only %

Internal & External %

Did not answer Total

Small 3 19 0 0 8 50 5 16

Medium 1 9 2 18 7 64 1 11

Large 2 18 0 0 9 82 0 11

Total 6 16 2 6 24 63 6 38

Types of scenarios provided for in the internal disaster plan(s)

0

5

10

15

20

25

30

35

Computersystemfailure

>30mins

Powerfailure

>30mins

Fire Sabotage Flood Staffindustrial

action

Scenarios

No.

of r

espo

nden

ts

Respondents

Resource allocation to disaster planning

• Equipment back-up

• Staff

• Procedures/equipment

• Budget

• Back-up Patient Master Index

• Fire training

Health Information Services that have a back-up system in the event of an internal disaster

Hospital Size Yes (%) NoDid not answer Total

Small10

(62.5%) 5 1 16

Medium8

(72.7%) 3 0 11

Large9

(81.8%) 1 1 11

Total27

(71%) 9 2 38

Types of back-up systems in place in the event of an internal disaster

0

2

4

6

8

10

12

14

Medical recordtracking

Patient MasterIndex

Computersystems

UR number issue

Back-up system

No. o

f res

pond

ents

Respondents

Recovery plan ready to take effect following an internal disaster

Hospital Size Yes (%)

Small6

(37.5%)

Medium6

(54.5%)

Large8

(72.7%)

Total20

(52.6%)

What was interesting?

• Within the last 10 years 50% of hospitals have experienced at least 1 internal disaster

• Larger hospitals are better prepared to avoid and recover from internal disasters

• Respondent hospitals generally rate themselves at a ‘medium’ level of preparedness

Thank You