[BCM] [NUHS] [ERM] [C3] Introduction to Business Continuity Management (BCM)

Chapter 3

Introduction to Business Continuity Management (BCM)

What is Business Continuity Management (BCM) and Its Relevance in Healthcare

Business Continuity Management (BCM) is a holistic management process that identifies potential threats to an organisation and the impacts to business operations that those threats—if realised—might cause.

It provides a framework for building organisational resilience and the capability for an effective response that safeguards the interests of key stakeholders, reputation, brand, and value-creating activities.

In the healthcare context, the stakes are particularly high. Interruptions to core healthcare services—whether due to natural disasters, IT failures, pandemics, or supply chain breakdowns—can directly affect patient outcomes, safety, and public health.

Unlike many industries, recovery delays in healthcare may result in loss of life or long-term harm to patients.

In Singapore, where NUHS operates within a highly integrated national healthcare ecosystem, BCM ensures the continuity of critical clinical and non-clinical functions, thereby reinforcing patient trust and facilitating compliance with regulatory mandates.

Key Standards and Frameworks in Healthcare BCM

A blend of international standards and local governance requirements guides BCM in healthcare. The following frameworks are most relevant to NUHS and its institutions:

ISO 22301:2019 (Security and Resilience – Business Continuity Management Systems)

This is the international standard for BCM and forms the foundation for globally recognised best practices. It provides a systematic approach to creating, implementing, and continually improving a Business Continuity Management System (BCMS).

Ministry of Health (MOH) Guidelines

In Singapore, the MOH prescribes specific directives to healthcare institutions, including the need for pandemic preparedness plans, infrastructure resilience, and IT system redundancies. These are critical for regulatory compliance and operational readiness.

Joint Commission International (JCI) Accreditation

These frameworks provide structure and credibility to BCM efforts and are often subject to audit or review, especially for large healthcare clusters like NUHS.

Core Components of a Healthcare BCM Programme

A comprehensive BCM programme comprises several interrelated components, each of which contributes to ensuring resilience and operational continuity during disruptions.

Risk Analysis and Review (RAR)

Risk Assessment complements the BIA by identifying threats and vulnerabilities that could disrupt healthcare services.

It involves evaluating the likelihood and impact of various threat scenarios, such as:

• Ransomware attacks on EMR systems
• Infectious disease outbreaks (e.g., COVID-19)
• Fire, flood, or infrastructure failure
• Disruptions in the pharmaceutical or blood supply chain

Through the RA process, NUHS institutions can implement proportionate risk mitigation controls and develop contingency plans for high-risk scenarios.

Business Impact Analysis (BIA)

BIA is the foundation of BCM. It identifies the healthcare organisation’s Core Business Functions (CBFs) and assesses the potential operational, clinical, financial, and reputational impacts of their disruption over time.

In NUHS, typical CBFs include:

• Emergency and inpatient care
• Pharmacy and laboratory services
• Electronic Medical Records (EMR) systems
• Medical imaging
• Critical administrative functions (e.g., patient registration, admissions, finance)

BIA helps prioritise which functions must be recovered first, guiding recovery time objectives (RTOs) and maximum tolerable downtimes (MTDs).

Business Continuity Strategies (BCS)

After identifying critical functions and risks, healthcare organisations must formulate continuity and recovery strategies. These may include:

• Redundancies in clinical infrastructure (e.g., backup power, dual data centres)
• Alternate treatment sites or mobile medical units
• Telemedicine platforms to enable care during mobility restrictions
• Manual fallback procedures for digital systems, such as paper-based clinical records

Strategies should strike a balance between cost, feasibility, and operational effectiveness, aligning with institutional priorities and patient safety goals.

Plan Development (PD) and Testing and Exercising (TE)

Continuity plans translate the above analyses and strategies into actionable procedures for staff. These include:

• Emergency response plans (e.g., fire, mass casualty)
• IT disaster recovery plans (DRPs)
• Staff mobilisation and communication plans
• Continuity of care protocols (especially for chronic or vulnerable patients)

Regular testing—via tabletop exercises, functional drills, or full-scale simulations—is crucial for validating assumptions, identifying gaps, and training staff.

For example, NUHS hospitals may conduct annual blackout or cyberattack drills to test their operational readiness.

Summary and Takeaways ...

• BCM ensures the continuity of critical healthcare services, directly impacting patient safety and public trust.
• It is an integral part of the healthcare ERM framework and is guided by standards like ISO 22301, MOH policies, and JCI requirements.
• Key components include BIA, RA, continuity strategies, and plan testing—each of which supports a resilient and responsive healthcare environment.
• For NUHS, embedding BCM into daily operations and organisational culture strengthens its capacity to handle both routine and extraordinary disruptions effectively.

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More Information About Business Continuity Management Courses

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