[BCM] [NUHS] [E2] [C4] How Hospitals Can Overcome These Challenges

Chapter 4

How Hospitals Can Overcome These Challenges?

Introduction

Hospitals in Singapore face a unique combination of operational pressures, regulatory expectations, and public trust obligations.

While pitfalls in Business Continuity Management (BCM) are common, they are not insurmountable.

With deliberate strategies, strong leadership, and cross-functional integration, hospitals can transform BCM from a compliance exercise into a cornerstone of resilience and patient safety.

This section outlines practical approaches to overcoming BCM challenges within the Singapore healthcare context.

Secure Leadership Commitment and Embed a Culture of Resilience

Hospital boards and senior management must champion BCM—not left as a facilities or IT responsibility.

Leadership buy-in ensures adequate resources, visibility, and alignment with patient safety objectives.

• How to Overcome It:
  • Position BCM as part of clinical governance and patient safety.
  • Establish a hospital-wide BCM Steering Committee chaired by senior leaders.
  • Integrate BCM indicators into performance dashboards for leadership review.

• Singapore Example: Hospitals under SingHealth and NHG clusters already embed emergency preparedness into cluster-level governance; this approach can be expanded to BCM for cyber resilience, supply chain, and clinical continuity.

Conduct Comprehensive Risk Analysis and Review (RAR) and BIAs

A robust Business Impact Analysis (BIA) identifies critical clinical and support functions, their interdependencies, and the maximum tolerable downtime.

• How to Overcome It:

• Engage frontline clinicians, lab staff, pharmacists, IT, and facilities in BIA workshops.
• Use scenario-based BIAs that include cyberattacks, pandemics, and supply shortages.
• Prioritise life-supporting services (ICU, ER, dialysis, surgery, blood bank).

• Singapore Example: Lessons from COVID-19 show that supply chain continuity and surge capacity planning must be central to the BIA, not peripheral.

Break Down Silos with Cross-Functional BCM Teams

BCM cannot be managed in departmental silos. Hospitals must coordinate across clinical, administrative, and technical functions.

• How to Overcome It:
  • Form multi-disciplinary BCM teams that include IT, nursing, pharmacy, HR, facilities, and communications.
  • Conduct joint exercises that simulate multi-departmental crises.
  • Build cluster-wide BCM coordination across NUHS, NHG, and SingHealth for shared services and surge planning.

Go Beyond IT Disaster Recovery

While IT recovery is essential, it is only one part of the BCM equation.

Hospitals must ensure continuity of patient care delivery even when IT systems fail.

• How to Overcome It:
  • Develop manual fallback procedures (paper-based patient charts, manual test ordering).
  • Train clinical staff to switch seamlessly between digital and manual workflows.
  • Align IT DR drills with clinical continuity drills.

• Singapore Example: The 2018 SingHealth cyberattack demonstrated the need for manual fallback readiness while IT teams restored systems.

Regular and Realistic Testing and Exercising

Plans that are never tested will fail in practice. Hospitals should expand beyond compliance-driven drills to realistic exercises.

• How to Overcome It:
  • Run tabletop exercises for leadership and crisis communication teams.
  • Conduct live drills simulating cyberattacks, mass casualty incidents, or power outages.
  • Include external partners such as EMS, suppliers, and MOH in large-scale exercises.
  
  
• Singapore Example: During pandemic surge simulations at Tan Tock Seng Hospital (TTSH), exercises involving multiple functions helped identify gaps in ward expansion and staff rotation.

Allocate Resources and Build BCM Capabilities

Resource constraints are a common barrier, but hospitals must recognise BCM as an investment in patient safety and resilience.

• How to Overcome It:
  • Dedicate a full-time BCM coordinator or team in each hospital.
  • Provide ongoing staff training and awareness programs.
  • Secure budget allocation for continuity planning, drills, and technology investments.
  
  
• Singapore Example: Hospitals that integrated BCM into pandemic preparedness teams during COVID-19 were able to pivot resources more quickly than those that treated BCM as a separate compliance activity.

Strengthen Crisis Communication Frameworks

Effective communication is central to trust and confidence

Hospitals must have clear protocols for escalation, notification, and media response.

• How to Overcome It:
  • Establish a Crisis Communication Plan aligned with MOH directives.
  • Train designated hospital spokespersons for media handling.
  • Implement multi-channel internal communication (SMS, staff apps, overhead paging).
  
  
• Singapore Example: After the SingHealth cyberattack, timely, transparent updates helped reassure patients and preserve public trust. Hospitals must replicate such readiness.

Build Supply Chain Resilience

With Singapore’s dependence on imported supplies, hospitals must mitigate supply chain disruptions through planning and collaboration.

• How to Overcome It:
  • Maintain buffer stock of critical supplies (oxygen, PPE, essential drugs).
  • Secure multiple vendor contracts for high-dependency items.
  • Collaborate with MOH’s national stockpile framework while maintaining hospital-level resilience.
    
    
• Singapore Example: The national stockpiling of PPE during COVID-19 supported hospitals, but those with their own hospital-level stockpiles were better positioned during the first wave.

9. Keep BCM Plans Updated and Aligned with Innovation

BCM is not static. With the rapid adoption of telehealth, AI-driven diagnostics, and cluster-level healthcare integration, plans must evolve.

• How to Overcome It:
  • Review and update BCM plans annually or after major incidents/exercises.
  • Integrate emerging risks such as telemedicine outages or cyber-enabled medical device failures.
  • Align BCM with MOH and Smart Nation healthcare initiatives.
  
  
• Singapore Example: Telehealth surged during COVID-19, but many hospitals updated continuity procedures only after the fact. Future BCM must anticipate such service shifts.

Overcoming the pitfalls in hospital BCM requires more than compliance with audits or regulatory standards.

It requires leadership-driven, patient-centric resilience embedded in every layer of hospital operations.

In Singapore, where healthcare institutions serve as pillars of national confidence, the stakes are particularly high.

By securing leadership buy-in, integrating cross-functional teams, strengthening supply chains, and regularly testing plans, hospitals can transform BCM into a living system of resilience—one that ensures continuity of patient care and safeguards public trust during any crisis.

Avoiding the Pitfalls: Overcoming Key Challenges in Hospital BCM
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