For Small Businesses, There's No Such Thing as a Small Disaster

Clint Kelly

A Thorough Plan Can Make a Big Difference

None of us go to work thinking this will be the day of disaster. But not even small businesses, such as clinics and private family practices, are immune from risk and loss. In reality, a small practice operating with fewer patients and narrower margins can be more vulnerable to loss than a large health-care provider with a network to help absorb unexpected losses.

A thoroughly prepared disaster plan in place before disaster strikes can be as important to the long-term success of a small practice as is the operational balance sheet is.

No one starts the day thinking this is when the computers will go down, the clinic will catch fire, or a burst pipe will disrupt the ability to serve patients. But to have anticipated what could go wrong, and to have practiced our response to those scenarios, will go far in ensuring we don’t become a grim statistic.


The US Small Business Administration reports that most small businesses are not fully prepared for disaster. Those unable to reopen within just a few days following a disaster have a much higher chance of business failure. The inability to recover and to maintain patients’ confidence after business interruption and property loss leads to permanent closure. SBA statistics say that at least a fourth and as many as half of small businesses never reopen their doors after a disaster. When that happens, not only do you lose, but so does the community that has come to trust in you and to rely upon your services.

The Seattle Office of Emergency Management lists the three most common reasons people give when asked why they don’t plan for disasters:

  • It won’t happen to me.
  • It might happen, but it won’t be that bad.
  • It will be so devastating that it won’t matter what I do.

This head-in-the-sand way of managing a business is doomed to fail. There is nothing small about whatever incident cuts you off from your patients and the quality of service they experience in your care. The assumption that planning is expensive, say the experts, can blind practice administrators to the reality that lack of planning costs more in the end.

Digestive Health Specialists (DHS), a gastroenterological practice based in Tacoma, Washington, since 1972, made the creation of a corporate disaster response plan a business priority. With 40 providers and more than 300 staff members at seven clinics, five endoscopy centers, a lab, a scheduling call center, and a billing department, senior leadership recognized it made good business sense to be prepared, especially when their business mantra is “patients first.”


“The disaster preparedness plan was a collaboration between operational leaders,” says Jack Schwartz, director of Information Systems and Innovation at DHS. “It was in response to gaps in our ability to provide care for our patients in the event of a loss of some or all of our facilities and/or our key information systems.”

DHS identified areas of vulnerability, and in leadership meetings developed hypothetical scenarios which will soon include more formalized review procedures and tabletop exercises accessible to all employees. Key is building awareness of what could happen and how to respond in specific situations.

DHS has also built redundant clinical work-flow procedures and computer systems capabilities. Alternative emergency facilities for patients and staff are in place to prevent interruptions in the quality of care.

“For smaller disasters, we execute our communication and incident management plan,” says Schwartz. “Impacted on-site frontline managers take the lead. Communication includes all practice leadership, with guidance provided as necessary.” Resolving a recent water leak on the floor where billing and scheduling were located, for example, was handled by the software manager and the building site manager. They kept the clinical and finance directors informed, and it was decided to relocate staff, move work stations, and reroute phones while building maintenance workers made repairs.

“For larger disasters affecting multiple facilities, key information systems, and major impact to patient care,” says Schwartz, “we set up a command center in a conference room, complete with computer and telecom equipment. We maintain an off-line phone list to contact any leader or key staff member to assist with the recovery, as well as to provide progress updates to all of our leadership and the Board of Directors.”

When DHS experienced an enterprise-wide phone outage late one afternoon, leadership followed their disaster protocol. An alternative communications department was established to inform patients via social media that facilities remaine open. The incident took several hours to resolve, yet interruption to patient service was minimized.

Again, says Schwartz, anticipating an incident before it ever takes place helps boost everyone’s confidence level. “Designated people take charge. You follow recovery checklists to maintain key work-flows. Regular updates on the recovery process keep people informed. Everyone jumps in and does their job, and that greatly reduces the urge to panic.”


Not only does DHS employ a simple matrix for categorizing disasters and appropriate responses—minor incident, small disaster, large disaster—but following an incident,there is a root cause analysis and mitigation phase in which leadership gathers input from all key staff members.

In his previous position at Seattle Children’s Hospital,Schwartz saw the power of preparation and creating a plan in case of emergencies. “When you have 500 to 600 nurses charting patient care electronically and that system goes down, it can have an incredible impact on patient care. You need to have ways in place to restore service as soon as possible.”

Schwartz acknowledges that with busy schedules, it can be difficult to devote time to a disaster recovery/business continuity plan. But as disasterprepared small business owners will tell you, it’s better to be ready for the unexpected today than to be a casualty of neglect tomorrow.