In my experience staffing is one of the biggest challenges hospitals face when trying to sustain a Hospital Emergency Response Team (HERT) program.  Staff members get selected based upon their job description (e.g ED, security, facilities) or volunteer for training. Typically this is a “duty-as-assigned” and does not come with any compensation other than getting to wear Personal Protective Equipment (PPE) and sweat a lot.

After 17 years of volunteering as a fire-fighter paramedic, I’ve learned something about why people volunteer and, more importantly, why they continue to volunteer for years.  Some of these lessons translate well to building and sustaining your HERT for the long haul:

  • Interest
  • Ability to respond
  • Embrace the “team” aspect
  • Use Lessons Learned in Training
  • Reward participation

Interest – Just like joining the fire department, being a member of a HERT requires a certain level of interest in the topic. Members must have a desire for understanding the hazards of the environment they will work in, the necessary protective equipment, and how to perform tasks safely as a member of a team.  Offering an overview of HERT at your annual employee in-service fair may stir someone’s interest. Some people will agree to try HERT based upon their conversations with people already on the team. Give your current HERT members a great story to tell and to sell others other on the opportunity.

Ability to Respond – Selecting someone to be on your team based only upon their current job title is risky.  While I would never discourage anyone from seeking more education, hospitals must ensure that HERT members can actually drop what they are doing and show up to help.  Using staff with critical or unique skill sets on HERT are building in a predictable barrier to having a consistent HERT response.  A core group on all shifts who can respond quickly requires several things. First, there must be buy-in from supervisory staff since they will likely have a gap to fill once in awhile.  Second, hospitals need efficient operations. Your HERT should be able to spin up fast and demobilize quickly in order to get back to normal operations.  This ability to respond means using the Incident Command System — I will talk more about this in a later post.

Embrace the Team Aspect – If I were building a HERT from the ground up, I would look for staff who 1) have an interest in learning; 2) ability to respond; and, most importantly, 3) enjoy being part of a team. As I like to say, with HERT as in hockey, you win or lose as a team. Everyone has a role to fill and it takes different skill sets to get it done right. Finding the right niche for anyone who wants to be involved means you have the documentation (policies, procedures, and operational guidelines) in place to support the team structure.  We’ll talk more about the importance of documentation in a later post.

Use Lessons Learned in Training – Look, no one likes to ride the bench!  If staff show enough interest to join your HERT and attend the training, it’s the responsibility of HERT team leaders to make sure they get to use their skills on a regular basis. Nothing will cause team members to bail faster than not having a reason to use their new knowledge. Dole out monthly assignments to team members to research hazards close to your facility and develop simple one-page guides. Every quarter, practice a perishable skill set necessary to establish and operate your HERT. At least once a year, conduct an exercise. Lastly, review your documentation for criteria that triggers your HERT. If you can stand up and demobilize your HERT efficiently, you may find more cases to deploy staff.

Reward Participation – Reward does not necessarily mean in the financial sense. Many volunteer fire departments have a point system for attending drills and training as well as responding to calls. Points correspond to everything from mad money to breaks on a utility bill. While these perks are not why they volunteer, these small acts do acknowledge the time and effort put in by team members to provide a service for the community. Your hospital should also find ways recognize and encourage HERT members — a meal voucher in the cafeteria or a Starbucks card can buy a lot of good will.

Staffing can be one of the issues that really makes or breaks a HERT program.  I’d love to hear your success stories and ideas to help others.

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