[BCM] [NUHS] [ERM] [C5] Key BCM Areas in Healthcare

Chapter 5

Key BCM Areas in Healthcare

In the healthcare sector, Business Continuity Management (BCM) must address a broad and complex array of operational dependencies—ranging from clinical functions and critical IT systems to supply chains and human capital.

Effective continuity planning is vital not only for sustaining operations during disruptions but more importantly, for preserving patient safety, ensuring quality of care, and maintaining public trust.

This chapter explores the essential domains of BCM within a healthcare setting, emphasising real-world relevance to NUHS institutions.

CBF Identification: Critical Business Functions in Healthcare

Business Continuity planning begins with the identification of Core Business Functions (CBFs)—the services and operations essential to patient care and institutional resilience. In healthcare, these typically include:

• Clinical Services: Emergency, ICU, surgery, outpatient and inpatient care. Downtime impacts can be life-threatening.
• IT Systems: Electronic Health Records (EHR), diagnostic systems, imaging systems (PACS), and appointment scheduling.
• Laboratory Services: Blood tests, diagnostics, and pathology services are time-sensitive and often critical to treatment decisions.
• Pharmacy Services: Includes in-hospital drug dispensing, speciality medications, and outpatient prescription support.
• Administrative Services: Billing, patient registration, and inter-facility coordination.

Each CBF should be mapped with its Recovery Time Objective (RTO) and Recovery Point Objective (RPO), establishing clear prioritisation for continuity and recovery.

IT & Cybersecurity Continuity: Ransomware and EHR Failures

Healthcare institutions face escalating threats from cyberattacks—particularly ransomware that can render critical systems inoperable. Key concerns include:

• EHR Outages: Disruptions affect clinical workflows, patient access to records, and medication orders.
• Cybersecurity Gaps: Legacy systems, third-party integrations, and poor cyber hygiene are common vulnerabilities.
• BCM Measures:
  • Redundant off-site backups and immutable storage
  • Downtime procedures (paper-based fallback workflows)
  • Cyber incident response plans with IT recovery playbooks.

Case Insight

During recent ransomware events in Asia-Pacific hospitals, patient care was severely delayed due to EHR inaccessibility. Proactive BCM would have reduced this impact through better IT redundancy and staff training on fallback procedures.

Supply Chain Continuity: Medical and Pharmaceutical Dependencies

Healthcare supply chains are intricate and fragile. COVID-19 starkly demonstrated the consequences of unpreparedness, as personal protective equipment (PPE), ventilators, and even basic pharmaceuticals ran short.

• Risk Areas:

• Single-source suppliers
• Global disruptions (e.g., China lockdowns)
• Just-in-time inventory practices

• BCM Tactics:

• Identify critical supply dependencies and minimum stock thresholds
• Establish alternate supplier relationships
• Internal prioritisation protocols for critical resource allocation

Hospitals must develop a supply chain continuity plan tied into their ERM framework, integrating early-warning mechanisms and supply risk indicators.

Staff Availability: Contingency Planning for Clinical Personnel

Healthcare is human-resource intensive. Surge events (e.g., pandemics, mass casualties) can strain clinical capacity. Risks include:

• Workforce Absenteeism: Due to illness, quarantine, or transport disruptions
• Burnout: Staff morale and mental well-being during prolonged crises
• BCM Strategies:
  • Cross-training of clinical and support staff
  • Redeployment plans (e.g., non-ICU staff to ICU roles under supervision)
  • Standby rosters, flexible scheduling, and telemedicine capabilities

Institutions should conduct staff dependency analyses and simulate scenarios involving high absenteeism to refine surge staffing models.

Facility Access and Utility Failure: Ensuring Operational Infrastructure

Infrastructure failures, such as power outages, HVAC system failures, or disruptions to water and oxygen supplies, can have immediate and catastrophic consequences in clinical environments.

• Vulnerable Areas:
  • Intensive care and operating theatres
  • Neonatal units and medication refrigeration zones

• Continuity Measures:
  • Backup generators, UPS for critical equipment
  • Redundant HVAC systems for infection control
  • Facility access control protocols in case of evacuation or lockdown

Healthcare facilities must regularly test and validate the resilience of their critical infrastructure to ensure patient and staff safety during extended power outages.

Patient Safety & Communication

During disruptions, patient safety must remain the highest priority. Continuity planning must ensure:

• Ongoing Care for High-Risk Patients: Patients requiring dialysis, oncology, neonatal, or post-surgery care require uninterrupted treatment.
• Internal Communication: Rapid information dissemination to staff via secure channels
• External Communication: Transparent updates to patients, families, media, and regulators

BCM Essentials

• Mass notification systems and alert protocols
• Pre-developed communication templates
• Escalation matrices for decision-making and media response

Example

During the COVID-19 pandemic, some hospitals deployed telehealth and digital updates for families restricted from visiting—an adaptive continuity approach rooted in patient-centred care.

Summing Up ... Building a Resilient Healthcare Ecosystem

Identifying and safeguarding key BCM domains is foundational to healthcare risk management.

By aligning clinical, technological, logistical, and human capital considerations within the BCM framework, NUHS institutions can ensure preparedness and resilience in the face of disruption.

These BCM areas are not standalone silos; they must be integrated into the broader ERM system, with clear ownership, regular review, and proactive adaptation.

In doing so, the NUHS community can protect patients, empower staff, and uphold institutional trust—even during the most trying times.

More Information About Business Continuity Management Courses

To learn more about the course and schedule, click the buttons below for the BCM-300 Business Continuity Management Implementer [B-3] course and the BCM-5000 Business Continuity Management Expert Implementer [B-5].