[CM] [WH] [E1] [C9] During Crisis - Crisis Response and Decision-Making

Chapter 9

Woodlands Health

When a crisis strikes, the speed, clarity, and effectiveness of response actions determine not only the operational continuity of Woodlands Health (WH) but also the trust and safety of patients, staff, and the community.

This chapter details the structured approach WH adopts during a crisis, ensuring decisions are informed, communication is coordinated, and actions are aligned with ISO 22361’s principles of preparedness, response, and recovery.

Crisis Activation and Escalation Protocols

A well-defined activation and escalation process ensures the timely initiation of WH’s crisis management framework.

• Trigger Points for Activation

  • Threats to patient safety (e.g., infectious disease outbreaks, critical infrastructure failure).
  • External events impacting operations (e.g., floods affecting access roads, regional healthcare network disruptions).
  • Security incidents (e.g., cyberattacks on patient data systems).
    
    

• Activation Process

  1. Incident Detection – Frontline staff or monitoring systems report anomalies or incidents to the Operations Command Centre (OCC).
  2. Initial Assessment – On-duty supervisors conduct rapid situation analysis.
  3. Escalation – If severity exceeds departmental control, the OCC informs the Crisis Management Team (CMT) Chair.
  4. Declaration of Crisis – The CMT Chair (or delegated senior leader) officially activates WH’s Crisis Management Plan (CMP).
     
     

• Escalation Levels (aligned with NHG guidelines)

  • Level 1 – Localised incident, managed within the department.
  • Level 2 – Multi-department disruption requiring central coordination.
  • Level 3 – System-wide emergency affecting WH and possibly the NHG network.

Incident Command System (ICS) for Woodlands Health

WH adopts a modified Incident Command System to provide a scalable, flexible, and standardised command structure during crises.

• Core Roles

  • Incident Commander (IC) – Usually the CMT Chair or CEO, responsible for strategic decisions.
  • Operations Section Chief – Oversees immediate tactical actions and clinical/non-clinical service continuity.
  • Planning Section Chief – Gathers intelligence, forecasts incident progression, and develops action plans.
  • Logistics Section Chief – Manages resource allocation (staff, equipment, supplies).
  • Finance & Administration Section Chief – Tracks costs, manages contracts, documents legal and insurance aspects.
  • Safety Officer – Monitors staff and patient safety protocols.
  • Public Information Officer (PIO) – Coordinates internal and external communications.
  
  

• Command Centre Setup

  • Located within WH’s OCC with backup at a remote site.
  • Equipped with redundant communications, real-time dashboards, and decision-support tools.

Crisis Response Procedures for Different Scenarios

ISO 22361 emphasises scenario-based readiness to ensure flexibility and applicability. WH maintains scenario-specific response playbooks, which include:

Infectious Disease Outbreak (e.g., COVID-19 resurgence)

• Activate outbreak control teams.
• Implement isolation protocols, PPE usage escalation, and infection control audits.
• Coordinate with MOH and NHG for patient load redistribution.

Critical Infrastructure Failure (e.g., power outage)

• Activate emergency generators and redundant systems.
• Relocate critical patients to unaffected areas.
• Coordinate with facilities management and external contractors.

Mass Casualty Incident (MCI)

• Implement MCI triage protocols at the Emergency Department.
• Mobilise additional medical teams and convert areas into surge wards.
• Liaise with SCDF and other hospitals for patient transfers.

Cybersecurity Breach

• Isolate affected networks and systems.
• Implement manual patient care documentation processes.
• Engage NHG IT Security Incident Response Team.

Flood or Access Disruption

• Activate alternate staff and patient transport routes.
• Stockpile critical medical supplies in high-risk seasons.

Crisis Communication Execution (Internal & External)

Effective communication is essential for building trust, reducing misinformation, and guiding stakeholders through the crisis.

• Internal Communication

  • Use mass notification systems (SMS, email, intranet alerts).
  • Provide clear role-specific instructions to staff and volunteers.
  • Maintain regular situation briefings (every 2–4 hours, depending on severity).
  
  

• External Communication

  • Patients & Families – Update service status, visiting policies, and safety instructions through WH’s website, social media, and hotlines.
  • Public & Media – Public Information Officer issues verified statements, avoiding speculation.
  • Authorities & Partners – Maintain real-time information flow with MOH, NHG, SCDF, and other agencies.
  
  

• Key Principles (ISO 22361-aligned)

  • Accuracy over speed – ensure verified facts are communicated.
  • Consistency – maintain a single source of truth.
  • Transparency – acknowledge uncertainties and outline next steps.

Summing Up ...

During a crisis, WH’s adherence to ISO 22361’s structured approach ensures that activation, command, scenario-specific procedures, and communication are executed with precision.

By combining disciplined decision-making with compassionate patient care, WH safeguards operational continuity, protects lives, and maintains public confidence even under the most challenging circumstances.