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Voices & Views

Aug 15
Many thanks!!!

​I want to thank the people at the University of Kansas Center for Research's LSI Center for Community Health and Development for their patience and assistance as we revive this HELPERS online effort! They built and maintain the background workstation 'architecture' that allows us to communicate and share content. They have been absolutely GREAT to work with!! Many thanks!

Aug 15
We're Back!

​While this HELPERS site has been inactive for a couple of years--the members have not! In the coming days, I plan to post a lot of stuff to 'catch up'---a lot of learning, some pockets of new information and and some new resources!

This content is not provided as official edict from any one healthcare facility or member organization. It is provided as an outlet to share discoveries, regulations, connect those interested and support healthcare resilience. 

The target audience is those working with healthcare emergency management. 

Aug 12
CMS Clarifies Emergency Preparedness Rule from February 2019

HELPERS in Central iowa and colleagues--CMS providers and suppliers are reminded of this update (Appendix Z). Clarifications in it include inclusion of Emerging Infectious Diseases language in core planning and HVA considerations, generator-related specifics, and additional clarifications from the original Final Rule.

The Center for Medicaid and Medicare Services (CMS) released revisions  to Appendix Z for the Emergency Preparedness Rule. The revision does not change any requirements to the rule, but adds clarification.

CMS sent a memo to state survey agency directors regarding an update to Appendix Z of the State Operations Manual (SOM) to add emerging infectious diseases to the definition of all-hazards approach. In the memo, CMS also responds to questions about alternate source power and emergency standby systems under the Emergency Preparedness Final Rule.

Additionally, since the release of the Interpretive Guidelines for Emergency Preparedness in 2017, stakeholders and providers have asked for additional clarifications related to portable/mobile generators. CMS has added guidance under Tag E0015- Alternate Source Power as well as clarifications under Tag E0042- Emergency Standby Power Systems. Facilities should use the most appropriate energy source or electrical system based on their review of their individual facility’s all-hazards risks assessment and as required by existing regulations or state requirements. Regardless of the alternate sources of energy a facility chooses to utilize, it must be in accordance with local and state laws, manufacturer requirements, as well as applicable Life Safety Code (LSC) requirements.

If a facility risk assessment determines the best way to maintain temperatures, emergency lighting, fire detection and extinguishing systems and sewage and waste disposal would be through the use of a portable and mobile generator, rather than a permanent generator, then the LSC provisions such as generator testing, maintenance, etc. outlined under the National Fire Protection Association (NFPA) guidelines requirements would not be applicable, except for NFPA 70 – National Electrical Code. However, the revisions, as the provisions under emergency preparedness themselves, do not take away existing requirements under LSC, physical environment or any other Conditions of Participation that a provider type is subject to (for example to maintain safe and comfortable temperatures).

With the brutal winter this year in Wisconsin, is your facility ready for an emergency? Please click HERE to view the registration for our “Emergency Preparedness: Plan It, Test It, Be READY” webinar series to help you and your facility prepare for emergencies.

Aug 12
Pandemic and All-Hazards Preparedness and Advancing Innovation Act 2019: What Does It Mean for Me and My Organization?

Author: By Dr. Robert Kadlec, Assistant Secretary for Preparedness and Response
This was first posted on the webiste (Published Date: 6/25/2019)

At ASPR, we’re excited about the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 (PAHPAIA), which the president signed last night (6-24-2019). The new law strengthens public health and healthcare readiness, bolsters response and recovery programs, and increases transparency. What do the changes mean for our non-federal partners? We see some key provisions that can significantly improve preparedness and response for our partners.

Improving preparedness

PAHPAIA authorized a funding increase for the Hospital Preparedness Program from $374.4 million to $385 million which would continue to pass through state and territory health departments to healthcare coalitions. Congress must appropriate specific funding levels as part of the annual appropriations process, including any increase.

ASPR, the Director of National Intelligence, and the Department of Homeland Security are directed to coordinate regularly on threat assessments, including potential emergency health security threats. By coordinating more closely, ASPR will have the critical information to guide decisions about which medical countermeasures should take priority in development and acquisition for the Strategic National Stockpile and the National Pre-Pandemic Influenza Vaccine Stockpile.

Strengthening response

The law reauthorizes the authority giving states and territories the ability to reassign federally funded personnel temporarily in public health emergencies to support the response. When the HHS Secretary declares a public health emergency, states may request temporarily deployment of state personnel whose salaries are funded by HHS in whole or in part under Public Health Service Act programs. Under PAHPAIA, the National Disaster Medical System (NDMS) received direct hire authority which streamlines the federal hiring process for NDMS, making it easier and faster to hire new personnel. The law also authorizes benefits under the Public Safety Officers Benefit program for NDMS personnel which addresses a concern of NDMS personnel. NDMS personnel have jobs in the private sector and are called into federal service during disasters, and these provisions are expected to improve NDMS recruitment, which in turn increases the number of NDMS personnel available to support state and local healthcare emergency operations.

The Hospital Preparedness Program received enhanced authority under the reauthorized law. Coalitions funded under this program now can use the funding for response activities, and work with state health departments and other healthcare coalition members on greater accountability; with the new authorization, ASPR has two years to work with grantees and sub-grantees on coalition success rates; ASPR now could withhold a percentage of program funds from awardees that fail to meet required benchmarks.

PAHPAIA also authorizes ASPR to establish guidelines for the Regional Disaster Health Response System. Under the provisions, ASPR is authorized to use HPP funds to support demonstration projects related to the development and implementation of these guidelines. The Government Accountability Office is required to assess the program within three years and provide Congress with specific findings on success, limitations, and challenges.

Improving medical countermeasure development for emergency preparedness and response

Project BioShield received an increase in its authorized funding levels with appropriations authorized for 10-years. This longer timeframe means Congress can provide funding for a decade rather than on an annual basis. Given that a single medical product can take 10 years or longer to develop, long-term funding like this gives biotech and pharmaceutical companies an incentive to work with our Biomedical Advanced Research and Development Authority (BARDA) on advanced development, manufacturing and acquisition of medical countermeasures.

Programs to develop medical countermeasures for pandemic influenza and other emerging infectious diseases now are authorized to receive annual funding from Congress. In the past, funding to develop medical countermeasures for pandemic influenza and emerging infectious diseases came largely from supplemental appropriations after public health emergencies occurred, such as the H5N1 pandemic in 2009 and the Ebola responses in 2014. Having a standard budget line allows federal and private partners to undertake research, development and manufacturing before a disease spreads. Not waiting having to wait on supplemental budget funding is important because developing medical products takes years and to save lives in public health emergencies every moment counts.

These are exciting changes, and we look forward to working with our partners under the new and reauthorized authorities to protect the American people from modern health threats.

Aug 11
Review: Steps for when a worker is exposed to bloodborne pathogens


The focus in Week Two is on infection control. This excerpt is from The Infection Control Manual for Outpatient Settings, authored by Gwen M. Rogers, DBA, RN, CIC.

Her book explains the steps that physicians and staff at outpatient facilities should take to protect patients, employees, and the environment and to prevent the spread of infectious diseases, though safety pros who work at hospitals may also find this excerpt useful. It looks at the OSHA Bloodborne Pathogen Standard and what should be done when one of your employees is exposed to blood or other potentially infectious material (OPIM).

Are your employees familiar with the Bloodborne Pathogen Standard from OSHA? They should be; it is one of the key documents for healthcare best practices in preventing the spread of and bloodborne pathogens (BBP). It is important for you to maintain a safe work environment for yourself and your employees, and to provide documentation that you have done so, especially because agencies such as OSHA and The Joint Commission are narrowing their scrutiny of the physician's office environment. Representatives from these and other groups want to see whether physician practices have a plan in place to educate and train employees in enacting an infection control plan.

The goal of OSHA's Bloodborne Pathogens Standard, published in 1991 in the Federal Register, is to guide you in minimizing exposure. A good way to introduce employees to the concept of the standard is simply to tell them that they must assume that any needle and any specimen (i.e., anything relating to blood or bodily fluids) should be considered infectious. The standard applies to all employees who have occupational exposure to blood or other potentially infectious material. Occupational exposure is defined as “reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or OPIM that may result from the performance of the employee's duties."

As employers, physician practices are required by OSHA to take precautions to protect staff members likely to be exposed to blood or OPIM while on the job. Separate but dependent sets of rights and responsibilities were established for both employees and employers within the OSHA standards. Employees are obligated to follow office rules, wear personal protective equipment (PPE), and report hazardous conditions. Meanwhile, employers are required to become familiar with all OSHA standards, communicate them to employees, and enforce them in the workplace.

So, what steps must be taken when an employee is exposed to BBP?

Employees should follow a certain protocol after bona fide BBP exposure has occurred. Protocols for evaluation and management of an employee or patient exposure to the blood (or other potentially infectious material) of a patient need to be outlined in the exposure control plan. Any response should begin with providing immediate first aid.

What information must the employer provide to the healthcare professional following an exposure incident? The healthcare professional must be provided with a copy of the standard, as well as the following information:

  • A description of the employee's duties as they relate to the exposure incident
  • Documentation of the route(s) and circumstances of the exposure
  • The results of the source individual's blood testing, if available
  • All medical records relevant to the appropriate treatment of the employee, including vaccination status (which are the employer's responsibility to maintain)

What serological testing must be done on the source individual?

The employer must identify and document the source individual if known, unless the employer can establish that identification is not feasible or is prohibited by state or local law. The source individual's blood must be tested as soon as is feasible, after consent is obtained, to determine HIV and HBV infectivity. The information on the source individual's HIV, HBV, and Hepatitis C testing must be provided to the evaluating healthcare professional. Also, the results of the testing must be provided to the exposed employee. The exposed employee must be informed of applicable laws and regulations concerning disclosure of the identity and infectious status of the source individual.

What if consent cannot be obtained from the source individual?

If consent cannot be obtained and is required by state law, the employer must document in writing that consent cannot be obtained. When law does not require the source individual's consent, the source individual's blood, if available, shall be tested and the results documented.

When is the exposed employee's blood tested?

After consent is obtained, the exposed employee's blood is collected and tested as soon as is feasible for HIV and HBV serological status. If the employee consents to the follow-up evaluation after an exposure incident but does not give consent for HIV serological testing, the blood sample must be preserved for 90 days. If, within 90 days of the exposure incident, the employee elects to have the baseline sample tested for HIV, testing must be done as soon as is feasible.

What information does the healthcare professional provide to the employer following an exposure incident?

The employer must obtain and provide to the employee a copy of the evaluating healthcare professional's written opinion within 15 days of completion of the evaluation. The healthcare professional's written opinion for hepatitis B is limited to whether hepatitis B vaccination is indicated and whether the employee received the vaccination. The written opinion for post-exposure evaluation must include information that the employee has been informed of the evaluation results and has been told of any medical conditions resulting from exposure that may require further evaluation and treatment. All other findings or diagnoses must be kept confidential and must not be included in the written report.

What type of counseling is required following an exposure incident?

The standard requires that post-exposure counseling be given to employees following an exposure incident. Counseling should include U.S. Public Health Service recommendations for transmission and prevention of HIV. These recommendations include refraining from blood, semen, or organ donation; abstaining from sexual intercourse or using measures to prevent HIV transmission during sexual intercourse; and refraining from breastfeeding infants during the follow-up period. In addition, counseling must be made available regardless of the employee's decision to accept serological testing.

What should be done with an employee's confidential medical records?
Records of all employees with occupational exposure must be maintained for 30 years after the employee terminates employment. These records should be stored separately from patient records, and access to the records requires the employee's written permission. The medical records include a copy of the employee's vaccination status and copies of the results of all medical examinations and tests. Post-exposure records must include the employee's name, Social Security number, hepatitis B vaccination status, results of follow-up procedures to exposure incidents, and a copy of the evaluator's written opinion.

exerpted from Hospital Safety Insider

Aug 11
Medical sprayer kills all HAI bacteria, study finds

Written by Megan Knowles | August 08, 2018 

After a team of engineers and physicians created a device that diffuses potent disinfectants into the air, the device effectively eliminated 100 percent of bacteria that often cause hospital-acquired infections, the research team reports in Applied Microbiology and Biotechnology.

Researchers constructed the device using smartphone parts that make acoustic waves.

They used the smartphone components to create sound waves at high frequencies, making fluid capillary waves that emit droplets and generate mist — a process called atomization.

The phone components use Lithium Niobate, which produces more energy-efficient and reliable ultrasonic vibrations, allowing the device to atomize the most viscous fluids into a fine mist that can drift in the air for over an hour.

The team used the device to atomize disinfectants onto contaminated environmental surfaces, showing it could effectively get rid of HAI-causing bacteria. The device works on disinfectants that have never been atomized, including Triethylene glycol.

"This device will make it much easier to keep hospital rooms clean," said corresponding author Monika Kumaraswamy, MD, physician scientist at UC San Diego.

The technology could be harnessed to deliver a new class of medicines to patients through inhalers, the research team said. "Our goal is to make injectable treatments inhalable," said paper author James Friend, professor of mechanical engineering at UC San Diego.

Researchers are working on an updated prototype to use in hospitals, and the device could also be used in airports and public transportation vehicles during flu season

from Becker's Clinical Leadership and Infection Control

Aug 11
Bacterial contamination of 6 frequently touched hospital objects

Written by Anuja Vaidya  August 07, 2018 

A study, published in Antimicrobial Resistance & Infection Control, examined the bacterial contamination of common objects frequently touched by patients, visitors and healthcare workers in a hospital in Nepal.

Researchers collected 232 samples from various sites, including the surface of biometric attendance devices, elevator buttons, door handles and staircase railings. They isolated, identified and conducted antibiotic susceptibility testing of the isolates using standard microbiological techniques. They recovered 219 bacterial isolates from 181 samples.

The study shows bacterial contamination for the following objects:

Elevator buttons (researchers collected 48 isolates)

S. aureus: 22.9 percent
S. epidermidis: 20.8 percent
Enterococcus species: 8.3 percent
Diphtheroids: 10.4 percent
Micrococcus species: 14.6 percent
Escherichia coli: 6.2 percent
Pseudomonas species: 4.1 percent
Acinetobacter species: 4.1 percent

Biometric attendance devices (researchers collected 24 isolates)

S. aureus: 33.3 percent
S. epidermidis: 25 percent
Enterococcus species: 20.8 percent
Diphtheroids: 16.6 percent
Micrococcus species: 20.8 percent
Escherichia coli: 8.3 percent
Pseudomonas species: 12.5 percent
Acinetobacter species: 12.5 percent

Door handles (researchers collected 80 isolates)

S. aureus: 16.2 percent
S. epidermidis: 13.7 percent
Enterococcus species: 10 percent
Diphtheroids: 8.7 percent
Micrococcus species: 10 percent
Escherichia coli: 5 percent
Pseudomonas species: N/A
Acinetobacter species: 5 percent

Telephone sets (researchers collected 30 isolates)

S. aureus: 20 percent
S. epidermidis: 13.3 percent
Enterococcus species: 20 percent
Diphtheroids: 26.6 percent
Micrococcus species: 36.6 percent
Escherichia coli: 10 percent
Pseudomonas species: N/A
Acinetobacter species: 16.6 percent

Railing (researchers collected 20 isolates)

S. aureus: 15 percent
S. epidermidis: 5 percent
Enterococcus species: 10 percent
Diphtheroids: 20 percent
Micrococcus species: 10 percent
Escherichia coli: 5 percent
Pseudomonas species: N/A
Acinetobacter species: 5 percent

Water taps (researchers collected 30 isolates)

S. aureus: 10 percent
S. epidermidis: 6.6 percent
Enterococcus species: 10 percent
Diphtheroids: 23.3 percent
Micrococcus species: 13.3 percent
Escherichia coli: 6.6 percent
Pseudomonas species: 6.6 percent
Acinetobacter species: 13.3 percent

Staphylococcus aureus was the most common bacterial isolate. Of the S. aureus isolates, 29.5 percent were multidrug resistant and 31.8 percent were biofilm producers.

from Becker's Clinical Leadership and Infection Control

Aug 11
Pt. 1-Woman found dead in stairwell of San Francisco hospital building

Written by Alia Paavola  May 31, 2018 

A 75-year-old woman who had been missing for 10 days was found dead in the stairwell of a locked power plant building at Zuckerburg San Francisco General Hospital May 30, according to the Los Angeles Times.

A hospital staff member found the woman's body around 1 p.m. in a stairwell that is usually locked and only accessible to maintenance workers.

"We don't know how this woman gained access to the area where she was found, and we are absolutely looking into that," Rachael Kagan, a spokesperson for the San Francisco Health Department, which operates the hospital, told The LA Times.

The woman, identified as Ruby Anderson, was not a patient at the Zuckerberg San Francisco Hospital. Ms. Anderson's daughter, Charlene Roberts, said her mother had dementia and vanished from a nearby mental health facility May 20, according to CBS.

The May 30 discovery is similar to an incident that occurred at Zuckerberg San Francisco Hospital in 2013, in which a 57-year-old patient was found dead in an emergency stairwell 17 days after she vanished from her hospital room.

After an autopsy in 2013, a medical examiner determined the 57-year-old patient died from dehydration and complications from alcoholism. After that patient's death, San Francisco General revamped its security efforts to prevent similar incidents.

"That was a terrible tragedy. We've made many, many changes since that time, and we have no reason to believe that this case and that case are connected, but we don't know very much about this situation yet," Ms. Kagan told CBS.

from Becker's Clinical Leadership and Infection Control

Aug 11
5 Joint Commission hospital requirements most commonly cited as "not compliant" in 2017

Written by Anuja Vaidya April 17, 2018 

The Joint Commission identified the requirements most commonly cited as "not compliant" during surveys for various types of accreditation and certification for calendar year 2017.

Here are the top five requirements identified as "not compliant" for hospital accreditation surveys.

Note: The figures represent non-compliance percentage for each standard.

1. The hospital provides and maintains systems for extinguishing fires — 86 percent

2. The hospital manages risks associated with its utility systems — 73 percent

3. The hospital provides and maintains building features to protect individuals from the hazards of fire and smoke — 72 percent

4. The hospital reduces the risk of infections associated with medical equipment, devices and supplies — 72 percent

5. The hospital established and maintains a safe, functional environment — 70 percent

from Becker's Clinical Leadership and Infection Control

Aug 10
Safety before Selfie--Managing Crisis & Disaster in a Connected Digital World

​the following is commentary from the Domestic Preparedness Journal posted at:

by Wayne P. Bergeron

#SafetyBeforeSelfie – Please make sure to exit the burning building before texting, tweeting, posting, or live streaming about it. Surprisingly, the current security and emergency management (EM) environment that exists both in the public and increasingly in the private sector may necessitate such emergency warning statements as part of EM organizations’ risk communication planning.

In an increasingly interconnected world, vast knowledge that the world has produced is available in an easily accessible and on-demand format from almost anywhere. Combined with the ability to constantly connect with any past friends and acquaintances (or those one desires to know) through social media and online communication platforms, people are living in a time and age that has no real historical parallel. Of course, what is actually done with that capability on a daily basis generally does not reach society’s full potential.

Opportunities & Challenges

The current environment should enable EM capabilities that far exceed anything that has ever been seen before, with a level of achievability and economic affordability that should satisfy most public managers. However, the truth is much more nuanced. Therefore, the very capabilities, technologies, and breakthroughs that provide these advantages also potentially create or expose a set of challenges, vulnerabilities, and liabilities that most have likely not seen or not fully considered.

This interplay of opportunities and challenges creates a unique security environment and ecosystem that demands a level of understanding and a comprehensive security and EM approach that, in many cases, is only in its infancy in most organizations for routine operations and conditions, and is likely nonexistent for crisis/disaster and response situations. This reality needs to change quickly given the potential enormity of the consequences.

Social Media in Crisis & Disaster

For better or worse, social media and the digitally connected world have in many ways changed the nature of how humans interact and communicate. These changes also have a profound effect on what are currently considered the necessary elements of good living and reasonable quality of life. In many developed countries, internet access and broadband connectivity are being increasingly prioritized and regulated as a form of public utility akin to water and electricity versus a luxury commodity. Highlighting this was this 2016 U.S. judicial majority opinion:

Over the past two decades, this content [internet] has transformed nearly every aspect of our lives, from profound actions like choosing a leader, building a career, and falling in love to more quotidian ones like hailing a cab and watching a movie.

Beyond the domain of individuals, many forward-thinking companies and organizations are also beginning to realize the value of social media technology. These technologies and approaches are becoming a critical part and, in some cases, an existential part of business models and organizational structures. Although many of these approaches are being “hard-wired” into organizational structures and cultures, the security considerations and potential threat and vulnerability impacts are, in many cases, lagging behind. This then creates significant hazard exposure for many EM organizations, with the true nature and extent of risk being largely unknown.

Although individual platforms depicted in Figure 1 may change or increase/decrease in use and popularity, the fundamentals of social media use are largely universal. As such, organizations, agencies, and businesses must consider these fundamentals in their crisis and disaster planning as well as daily operations – in terms of providing core services and functions, as well as security for the organization and its employees. For crisis and disaster situations, social media provides a robust set of communication tools – with some inherently unique capabilities – that have mostly been unavailable outside the realm of the largest and most capable EM organizations.

Fig. 1. The platforms of social media.

Fig. 1. The platforms of social media.

Beyond two-way communication capabilities – when combined with aggregation, analytical tools, and data mining – social media can become a valuable source of intelligence information and situational awareness without the need to deploy sensors or reporting assets. In response to disasters, a simple capability such as geolocation (with some limitations and caveats) can assist in search and rescue operations, and geolocated photos provide real-time damage assessment capability that can far exceed traditional methods.

Beyond immediate response and recovery operations, social media platforms provide capability for just-in-time training for protective action procedures as well as video coverage of events. All of these capabilities, when properly integrated, greatly enhance an organization’s crisis and disaster response capability.

Social Media Management Strategy

When integrating these capabilities, though, the challenge for many agencies and organizations is developing a suitable social media strategy that fits particular organizational needs. Although platforms and technologies may be new, novel, or different, a social media strategy is still a media management strategy that must adhere to the basic tenets of the organization’s outcomes and objectives. Key components for social media in crisis and disaster include:

  • Degraded connectivity and communications capability in crisis and disaster situations must be assumed and planned for. Graphic-rich formats, embedded video, etc. that work well during normal operations generally become an impediment to effective communication during periods of degraded and limited communication capability. Having a pre-configured plan to switch to alternate lower bandwidth, less graphical, and text-based formats should be considered and planned for.
  • A social media and internet communications strategy is more than just a website or social media page. The strategy must be comprehensive and encompass the breadth and range of platforms that constituents and customers are likely to use on a daily basis and likely to default to in crisis and disaster.
  • EM agency and organizational social media operations must be monitored, updated, and moderated to be effective. Discovering months-old information on a platform when searching for relevant organizational information during a crisis or disaster impedes response.
  • Organizations need to communicate on multiple platforms. To reach disparate audiences, organizations must utilize multiple messages and multiple formats appropriate to both situation and desired outcome.
  • In terms of management and implementation, even in small organizations, social media should not be considered merely an additional duty given to the newest or youngest employee. The social media management strategy should garner as much attention as other core operations functions.
  • Social media messaging in crisis and disaster must be relevant and consistent. This includes messaging across platforms and media types and synching organizational objectives and desired outcomes.

The Good, the Bad & the Ugly (of Social Media)

For individuals, the self-oriented world can lead to comments and online attention contributing to perceptions of importance, status, fame, etc. For organizations and many high-profile individuals, more clicks, comments, “likes,” “pokes,” and shares do not necessarily equal overall effectiveness in the social media world. An organization is as likely to have viral content related to lapses, mistakes, indiscretions, and bad behavior of the organization, its employees, and associates as it is for outstanding performance activity.

Additionally, unlike face-to-face interaction, the impersonal and sometimes anonymous nature of online communications and interactions can lead to bad behavior and encourage the emotionalization and escalation of events that might otherwise be easily handled if conducted in person. In some cases, “people” online may not be who they say they are and, in some cases, may not be people at all – for example, “botnets,” automated responses, and “clickbait” server farms.

The strengths of social media engagement for organizations can also be the greatest potential weaknesses and vulnerabilities. Although a robust social media strategy and active engagement allows organizations to “speak” directly to constituents, customers, and stakeholders, in crisis and disaster, many organizations find that, as the level of engagement and number of followers explodes exponentially, their capability to effectively and efficiently manage those interactions become incredibly difficult. In such situations, the increased social media presence becomes a double-edged sword and can be particularly difficult for small and lean staffed organizations to handle.

An additional challenge in the social media world is the increasing propensity for self-selection and filtering of content, particularly in daily and pre-crisis environments. This can also be exacerbated by the algorithmic nature of many social media network operating systems and policies, which tend to steer members toward similar sites such as those that they have already shown a propensity to favor. However, this is not as big of a consideration in the immediate aftermath of a crisis and disaster situation as users tend to search for relevant content that reaches their perspective needs and is not the case with all social media platforms. This can also be mitigated with multi-platform engagement.

Somewhat related to the self-filtering phenomenon is that the nature of social media interaction – with its inherent “trusted relationship” status between social media “friends” and connections – in many cases, cultivates the perfect environment for creating, propagating, and circulating conspiracy theories. As a result, there are entire organizations, media outlets, and businesses that have been created just to debunk these theories – for example, Snopes,, and PolitiFact.

Social Media “Truths”

In social media and online interaction, the nature of the truth can change daily. However, organizations should consider some guiding principals when operating in the social media realm, especially during times of crisis and disaster. The first factor to consider is that, unlike traditional media sources and outlets such as radio, television, print, etc., social media is largely a “pull” medium. Thus, followers and users must specifically seek specific platforms, channels, and sites.

The idea of passive exposure to social media content is highly unlikely for most EM organizations. One caveat to this in crisis and disaster, however, is the increasing tendency of traditional media outlets (especially broadcast and online) to use social media postings from government, EM organizations, agencies, and even private individuals as primary sources in emerging crisis and disaster situations. This tendency provides a unique opportunity for an organization to position itself as an early authoritative source to fill the critical information void in the first minutes and hours after disaster and crisis. An additional advantage is that the organization can largely communicate directly with the public in an unfiltered manner. However, this capability could have unintended consequences, with the need to later counteract some of the unfiltered communications.

As mentioned previously, followers will increase rapidly both during the run-up to a pending crisis or disaster as well as in its immediate aftermath, which can seriously strain organizational resources dedicated to social media engagement activities. Of course, almost as quickly as followers are onboarded to social media sites and platforms during crisis and disaster, they often begin separating themselves soon afterward. Innovative organizations may be able to cultivate these followers as part of its social media base.

Finally, given the unregulated nature of social media and the online communication environment, EM organizations should anticipate being unable to fully control (or control at all) the information environment surrounding a crisis and disaster situation. Multiple players will have differing agendas, motives, and desired outcomes for engagement – and not all of them in the affected organization’s best interest. Criminals and scammers also occupy the social media space and may compete directly with legitimate organizations and entities.

Implications/Outlook for the Future

For social media in crisis and disaster, the only real constant is constant change. Users and followers likewise are constantly changing their likes, habits, and consumption patterns, which means organizations must tailor their communications to multiple audiences, multiple mediums, and multiple messages. While doing this, it is imperative that organizational information is planned for in an in-depth and comprehensive manner, with social media platforms complementing rather than replacing traditional media.

Another reality that goes beyond social media but is greatly enabled by it is the ubiquity of sensors and devices. Many people possess both a camera and the capability to instantly upload or broadcast images, videos, and audio. In many high-profile incidents, this ability has proven critical in defining and countering the narrative of EM agencies and organizations. As such, officials must assume that every interaction of its agents and employees will be captured, shared, and broadcasted in crisis and disaster situations, particularly when they are controversial or show the organization in a bad light. EM organizational social media strategy, policy, operations, and management simply cannot be an additional duty or part-time job, but rather planned for well before a crisis or disaster occurs and carefully managed once it does.

Some Final Thoughts

The EM world is always changing and evolving, but social media and emerging technologies tend to move faster and further than organizations can anticipate their impact and react to them. EM organizations must determine whether embracing these new systems and technologies would benefit their missions, goals, and objectives, and enhance organizational safety, security, and effectiveness of response, especially considering that many of these new additions come with significant staffing and manpower impacts, maintenance costs, and other possible unforeseen mandates, liabilities, and lifecycle costs.

In addition, a new technology or capability could increase expectations of the organization’s capability, which would be challenging especially in the early stages of adoption since many systems and technologies come with a significant learning curve and a gap between initial expectations and operational capability. Care must be taken to ensure that there is no lapse in organizational effectiveness in such circumstances.

Ultimately, some of the biggest opportunities when it comes to leveraging social media and emerging technology are likewise some of the biggest potential challenges and threats going forward within the EM realm, and even more so when crisis or disaster strikes. Ignoring or discounting potential challenges and threats could lead to critical vulnerabilities and points of failure, not only in terms of an immediate situation but even more so in the mid to long term. Now is the time to address them.

Dr. Wayne P. Bergeron, lieutenant colonel (ret.), retired from the United States Army in 2011 after a 23-year career within the Military Police Corps and Special Operations Forces. He currently serves as an assistant professor teaching both criminal justice and security and emergency management at the University of North Alabama in Florence, Alabama. His education includes undergraduate degrees in criminal justice and political science, a master’s degree in international relations from Troy University, and a Doctor of Science in emergency management from Jacksonville State University.

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