Staring Down Disaster: How Access Leaders Maintain Business Continuity During Emergencies

By Elizabeth W. Woodcock, DrPH, MBA, FACMPE, CPC

Emergencies don’t just interrupt daily operations—they amplify the challenges of patient access, creating ripple effects that extend far beyond the immediate disruption. Whether due to wildfires, hurricanes, or unexpected infrastructure failures, healthcare leaders must be prepared to pivot rapidly, ensuring patients continue receiving care despite the chaos.

In a recent episode of the Patient Access Collaborative’s podcast, The All Access Pass, we sat down with three seasoned access leaders who have faced these emergencies head-on:

• Aimee Corke, Director of Emergency Management and Business Continuity at Northwell Health
• Connie Lee, MPH, FACHE, Senior Director of Patient Access at UCLA Health
• Leigh Bouskila Turk, MHA, Director of Practice Development and Support Services at Nicklaus Children’s

Their experiences offer key lessons in resilience, adaptability, and strategic planning when disaster strikes.

The Unique Challenge of Business Continuity in Ambulatory Care

Unlike other industries, where temporary closures may result in financial setbacks, disruptions in patient access have life-altering consequences. Missed appointments have far-reaching effects, including undiagnosed conditions, postponed treatments, and deteriorating health.

Corke highlights the importance of having a solid business continuity plan in place prior to a disaster.

 “The interconnectedness of patient access means that even a single-day closure can result in thousands of delayed appointments,” she explains. That’s why healthcare organizations must be deliberate and proactive to mitigate these risks.

 “it’s not just about keeping the lights on,” she continues. “It’s about maintaining life-saving services.”

Wildfires and the Digital Lifeline

For UCLA Health’s Connie Lee, the disastrous wildfires in Los Angeles underscored the importance of setting up a versatile, modern workplace. Transitioning to a hybrid workforce and employing a suite of digital access tools have laid the foundation for business continuity.

In this episode of The All Access Pass, Connie shares a harrowing tale of emergency evacuation. “When the fires forced clinic closures,” she says, “we redirected patients to immediate care centers and virtual visits rather than simply canceling their appointments.”

The innovations of at UCLA Health serve a twofold purpose: not only does the flexibility of these systems create business continuity in tumultuous, but they also facilitate equitable access in the interim.

Connie explains the recent success of continuity planning in the face of disaster: “we rely heavily on remote capabilities, MyChart messaging, and text-based communication to keep patients informed.”

Hurricanes and the Urgency of Business Continuity

This year, fires in L.A. County raged at an unprecedented scale. However, some of America’s most prestigious academic health systems face disasters year-in and year-out. Nicklaus Children’s of South Florida is no stranger to hurricanes – and they’ve honed a proactive approach to mitigate the impact of severe weather events.

Through the power of the Command Center—a centralized crisis response team that includes both specialized emergency management leaders and department heads—they’ve achieved remarkable business continuity despite the impacts of hurricanes like Helene, Irma, Harvey, and many more.

“As soon as a storm is on the radar, we begin meeting multiple times a day,” says Leigh. “We shift in-person appointments to telehealth where possible, coordinate staffing, and work closely with community partners to ensure continuity of care.”

With proper preparation and fearless leadership, a well-conceived business continuity plan can alleviate the impact of even the most devastating of disasters.

Learning from Other Industries

Beyond healthcare, organizations like financial institutions and tech companies have long embraced rigorous recovery planning. Corke suggests access leaders look to these industries for inspiration.

“Retail and banking have mastered redundancy planning and digital-first strategies,” she highlights.

Although leaders in other industries face a unique array of challenges, the core goals remain the same. The central concepts – like redundancy and versatility – can be leveraged to facilitate patient access.

Corke explains, “Healthcare can adopt similar frameworks by leveraging automation, cloud-based systems, and cross-training staff to handle multiple roles in a crisis.”

Post-Disaster Recovery: Managing ‘Access Debt’

One of the most pressing issues following an emergency is the growing backlog of unmet patient needs—a concept we’re calling ‘Access Debt.’

Access Debt exists as the result of an imbalance of supply and demand, and it grows when patients can’t access care. The lack of continuity that results from a disaster can exacerbate the existing imbalance and create a host of issues for our patients. A strong business continuity plan prevents the problem of ‘kicking the can down the road:’ a scenario where patients’ needs continue to go unmet, and the Access Debt grows larger.

“At UCLA Health, we’re analyzing appointment cancellations, tracking which patients haven’t rescheduled, and proactively reaching out,” says Lee. “We’re also working with clinicians to create flexible scheduling options that accommodate higher volumes.”

For Nicklaus Children’s, ensuring continuity involves prioritizing care based on urgency. They’ve implemented an ambitious, data-driven plan to address the most pressing patient needs in as short a window as possible following a disaster event.

“We have a policy to reschedule patients within three weeks whenever possible,” Turk explains. “We leverage data to prioritize high-risk cases and open additional clinic slots as needed.”

In doing so, they’ve managed to minimize the weight of Access Debt, and ensure reliable care—even in the face of severe weather events.

The Future of Business Continuity in Patient Access

As natural disasters and unforeseen crises become more frequent, business continuity must be a foundational element of strategy for the ambulatory enterprise. By placing the patient at the center of the plan, we can rise above disaster and adapt in uncertain circumstances.

Digital tools, cross-functional planning, and data-driven decision-making are no longer optional—they are essential for maintaining patient access in turbulent times.

For access leaders, the key takeaway is clear: Plan ahead, leverage technology, and remain adaptable. As Leigh Bouskila Turk eloquently describes, “It’s not a matter of if an emergency will happen—it’s a matter of when. And when it does, preparation is the difference between disruption and resilience.”

CLICK HERE to listen to the Podcast!

*A special shoutout to Dr. George Ruiz of Geisinger, who dubbed this term in our December 2024 podcast.