An Emergency Operations Plan (EOP) for any healthcare organization consists of procedures designated to effectively handle any natural, resource, system, or human-related incident or disaster. The procedures are in compliance with various national emergency response requirements. Each healthcare organization follows these requirements while establishing a plan that makes the most sense for their specific location, given their capacity and resources. For this particular assessment, Banner Thunderbird Medical Center's (BTMC) Emergency Operations Plan has been reviewed and M, C. (2013) that is experienced handling these procedures, has provided the following information. Banner Health (2013), has categorized six critical areas at risk of being effected by potential disasters and would require an emergency response: communications, resources and assets, safety and security, staff roles and responsibilities, utilities, and clinical activities. Examples of a disaster for this organization in the Phoenix metro area are: Infant/Child Abduction, Fire, Haz Mat Spill, Cardio/Pulmonary arrest in hospital, Over Capacity, Bomb Threat, Combative person, IT systems failure, Utility outage, and Internal/External Disaster (this could be an outbreak). In response to a disaster, the administrator is notified. The administrator will designate an Incident Commander, typically a House Supervisor. The Incident Commander will then make critical decisions for patient care and safety decisions. One of these decisions would be to assign Care Units under Team Leads to handle their appropriate department as it relates to the disaster. Each team will classify patients as Serious/Critical, Serious/Delayed, or Minor/Observation. The purpose of this classification is to determine which patients require continued critical care despite the effects of the disaster. Staff outside these units will report to the Incident Commander in preparing and handling the disaster situation as it concerns the community. Banner Thunderbird Medial Center utilizes Hospital Incident Command System (HICS) to manage any disasters. This tool outlines an organizational chart that defines the chain of command with job action forms. These job action forms have been established to instruct each staff, within their role, the responsibilities they have around the HICS. All clinical staff are continually trained and assessed for effectiveness under the roles established by this HICS. The results will provide Incident Commanders with pertinent information about the staff in order to appropriately assign the responsibilities to the best equipped personnel. (Banner Health, 2013) After improvements to the disaster improvement plan have been identified, the administrative staff will make educated decisions on what some of the position assignments are and what resources can be used under an emergency occurrence. For example, emergency radios were distributed immediately and considered to be the main source of communication under emergency situations. However, as time has gone on, cell phones have been integrated into healthcare organizations as vital means of communication in emergency situations. Because of this change, cell phones are now considered, under the Emergency Operations Plan, as an appropriate means of communication in emergency situations. As mentioned previously, Care Units are assigned under each department to assign patient classifications in response to emergency situations. This representation of the disaster preparedness plan is to determine which patients require continued critical care and which patients are not as severe and can be moved to appropriate areas for preparations of an anticipated increased residency. The Maricopa County Division of Emergency Management is notified of some disasters so that they may provide additional communication and support. This organization's purpose is to assist organizations when a disaster occurs. This division may reach out to other organizations for disaster relief support. Alternate Care Sites are off-campus sites identified by BTMC as locations for transport when evacuations are required. These locations include other Banner Health medical centers and the Glendale and Phoenix PD MMRS 100 bed cache. (Banner Health, 2013) Under the Hospital Incident Command System of the Emergency Operations Plan, BTMC has created positions with job action sheets. Within these sheets, definitions of the roles and responsibilities are listed. All team leads assigned under the HICS are trained quarterly on emergency procedures and the job action sheets. The remaining staff is required to review the Emergency Operations Plan and can be pulled into a care unit at any given time if the disaster requires additional support. These care units must have a basic understanding of the EOP. Like many healthcare organizations, Banner Thunderbird Medical Center adopts the Hospital Incident Command System that has been established by the National Incident Management System. As it states in the HICS, a Hospital Command Center (HCC) is setup in the 'Admin Conference Room'. This is the focal point for all communications related to emergency operations for the purpose of relaying all disaster-related information to the CEO or on-call administrator. The same ethical standards required within the hospital are required in emergency situations. However, in emergency situations, as resources become unsustainable, a new standard has to be adopted. That is, an ethical analysis of every situation. There are no standard set of policies that can possibly encompass all that may occur in a disaster scenario. So, the standard would be to regularly perform and document a full ethical analysis. (Roberts & Renzo, 2011) A sense of cooperation is essential to develop and maintain a disaster preparedness plan. Every quarter, when training occurs, the HICS staff is asked to ask questions and give feedback in regards to the Emergency Operations Plan protocols. Their feedback is not only taken into consideration, but valued as a medium for those healthcare professionals to voice their concerns and feel involved with how the community will manage and recover after a disaster. Banner Thunderbird Medical Center’s Emergency Operations Plan seems very organized and well maintained. It was a great learning experience and a relief to know that even in a place where disasters may not occur frequently, emergency healthcare organizations are regularly training, exercising, and improving their disaster preparedness plan. A plan that is regularly exercised and improved is vital to effectively handle any natural or man-made disaster in any community. Given the potential magnitude of a given disaster, it is important for an organization to be organized and involved with the community that could be affected. Having a well-trained, centrally communicating emergency staff that is prepared for anything can make all of the difference of many lives at risk due to disasters.

References
Banner Health (2013, June). Emergency Operations Plan. Retrieved June 26, 2013, from http://www.bannerhealth.com/NR/rdonlyres/8B4C692B-9265-49DC-8D15-6DAE9AA8E29E/59330/EmergencyOperationsPlan.pdf
M, C. (2013, June 26). Personal interview.
Roberts, M., & Renzo, E. G. (2011). Ethical Considerations in Community Disaster Planning. Retrieved June 29th, 2013, from Agency for Healthcare Research and Quality website: http://archive.ahrq.gov/research/mce/mce2.htm