June 20, 2024

How to Prioritize Business Continuity at Your Organization

By Marc Aiello, Communications and Marketing Specialist, HIROC
Reposted with permission from HIROC. See the original post here.

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In healthcare, we have an obligation to ensure continuity of care. Because an emergency occurs, that doesn’t mean we’ll shut our doors. We want to ensure we are a resilient organization that can maintain continuity of our critical services in the event of a disaster.” – Joshua Marshall, Emergency Management Specialist, Niagara Health.

Unlike practicing and training for emergency codes, which focuses on an immediate response, or disaster recovery, which looks at restoring operations post-crisis, business continuity is all about maintaining and quickly resuming critical services.

With an increasing number of emergencies affecting or overwhelming healthcare services and systems, such as cyberattacks and natural disasters like wildfires and floods, it’s important for organizations to prioritize business continuity to ensure uninterrupted care. However, despite its importance, business continuity often takes a backseat in some emergency management programs.

As your proactive partner in risk, safety, and insurance, we at HIROC aim to share knowledge across the healthcare system. Because we’re deeply connected to our dedicated HIROC Subscribers across the country, we can see just how they’re driving change. We know their expertise is in high-demand, and as such, we take pride in being an Education Partner at a variety of sector events.

Most recently, at the Emergency Preparedness in Healthcare Conference, hosted by Spark Conferences, we had the pleasure of hearing and learning from the unique experiences and stories of HIROC Subscribers.

Knowing how critical it is to get leadership buy-in and organizational engagement to prioritize and facilitate business continuity planning, Joshua Marshall and Simon Bridgland, Emergency Management Specialists at Niagara Health, shared key lessons from their experience in accomplishing this vital task.

Here’s what the team at Niagara Health had to say:

Get Leadership Buy-in

Building a comprehensive business continuity program at Niagara Health involved several key steps. First, Marshall and Bridgland secured the crucial support of their executive leadership team. They did this by highlighting the importance of emergency preparedness, particularly in light of recent events like the COVID-19 pandemic. With the pandemic serving as a stark reminder of how quickly and unexpectedly emergencies can unfold, they were able to emphasize the need for robust and updated plans to ensure continuity of care.


COVID-19 created those additional resources to help support our emergency management program,” said Marshall. “As terrible of a situation as it was, we were able to use that as leverage and highlight the importance of emergency preparedness and business continuity.

When Marshall and Bridgland began building out their program, Niagara Health was also undergoing accreditation. They decided to strategically align their business continuity efforts with required accreditation standards to continually have their leadership’s attention as their journey progressed. Accreditation standards often have specific requirements for business continuity planning, so they were able to demonstrate a clear return on leadership’s time investment by addressing both preparedness and regulatory compliance.

With leadership buy-in, Marshall, Bridgland, and their team were able to create a culture prioritizing business continuity within emergency preparedness that permeated all of Niagara Health.

Leverage Existing Resources

Although their older plans required updating, Marshall and Bridgland were still able to use various facets of them to include in their new templates and plans wherever possible. For example, they included resources from their current downtime policies and procedures, the 2020 Niagara Health Pandemic Plan, and even information from older business continuity plans.


“When we started, we did an environmental scan – looking at what we had and what other organizations, those who are a similar size to ours, were doing,” said Marshall. “We knew it was important to take an all-hazards approach to developing our new templates.”

This practice saved a lot of time and effort, while still ensuring they captured valuable historical knowledge. For instance, their 2020 Pandemic Plan offered key insights on surge capacity, identifying which units could take on additional patients in the event of a crisis. By incorporating these existing resources, they were able to ensure their new plans addressed a wide range of potential disruptions and provided clear guidance for navigating them.

Ensure Organizational Collaboration and Engagement

A core tenant of the team’s approach was collaborating with every department on top of securing engagement from leadership. One of the ways Marshall and Bridgland did this was by holding consistent meetings with directors and managers to review their new plans and templates throughout the process. They held meetings with their Risk Management and Human Resources departments and various physicians at different levels to gain valuable insights not just from the theoretical side of things, but also from the operational side.

“We met with both directors and managers – directors first, to make sure they were good with the new plans and templates, and then managers, who had more of that operational knowledge,” said Marshall.

This strategy was key to ensuring they were on the right track with their new plans and that they were developing user-friendly and actionable documents that can be used by anyone in leadership in the event of an emergency. Knowing that, due to competing priorities, leadership may not always be fully up to date with current emergency preparedness protocols, the team focused on including clear guidance and in-depth explanations within their plans.


“We were always thinking of the perspective of a leader who may not be so familiar with a program, like a doctor on call, who may need more guidance to support them,” said Marshall. “In theory, anyone can now pick up another program’s plan and at least have an understanding of the main challenges, services needing to be prioritized, and how to go about doing it.”

Practice Your Plans with Tabletop Exercises

Business continuity plans are living documents that require ongoing maintenance and testing. To continually engage their staff, Marshall and Bridgland developed an annual review plan which incorporated scaled-back tabletop exercises to test the new plans and identify areas of improvement. This practice ensures the plans remain relevant and effective, especially in the face of evolving threats.

For one of their exercises, named “Horton Can’t Hear You,” a play on the famous Dr. Seuss story, the team simulated a total loss of information and communication technology (ICT) caused by a cyber breach. This exercise not only tested Niagara Health’s clinical team’s ability to function under these conditions, but it also highlighted the need for improved communication strategies and the importance of including external groups like breach coaches, insurance like HIROC, and law enforcement in response to a cyberattack.


“This is where that culture of business continuity comes in,” said Bridgland. “We want to get to a point where when leaders hear a code, they will now come prepared with continuity plans because you don’t know what will happen after that code.”



If you’re looking to implement a similar business continuity program at your healthcare organization, check out these key takeaways from the Niagara Health team below to assist you in your planning:

  • Utilize existing resources wherever possible: Don’t reinvent the wheel; leverage existing policies, procedures, and plans as a foundation as you build new templates.
  • Provide ongoing support to leaders throughout the process: Leaders have competing priorities, so offer clear guidance and include user-friendly materials to make plan review and implementation more effective and efficient.
  • Engage department leaders, physicians, and other stakeholders to gain valuable insights: Different departments have unique perspectives and needs that can strengthen your overall plans.
  • Build a culture of business continuity prioritization through education and awareness: Go beyond code training exercises and emphasize the importance of continuity of service.
  • Regularly test and update your plans: The healthcare landscape is constantly changing, so plans need to be updated to adapt to and reflect current threats and best practices.

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