Influenza, commonly called the flu, is a highly contagious viral infection of the respiratory passages causing fever, coughing, severe aching, excessive mucus buildup, and in extreme cases, death. Every year in every hemisphere, when the cold spell of winter sets in, the flu takes on an epidemic proportion, as the flu is easily spread by sniffling victims venturing out into public. Usually, there is a weeklong escalation period where reported cases begin to increase, followed by a peak, then a two-week downturn.
The winter of 2012-2013 saw a unique strain, H3N2, that was especially virulent, and after five weeks of escalating cases, medical experts saw no peak in sight.
Dr. Mandy Hollander is the Director of Operations at the Lamont Memorial Hospital located outside of the nation’s capital. She became increasingly concerned as the flu sent more and more patients to her Emergency Room.
The hospital was running out of beds, vaccines, masks, and staff. Many of her staff became sick themselves, unable to tend to victims. As the cases increased, her facilities began to be overwhelmed. To complicate matters, the Presidential Inauguration was scheduled to take place in a matter of weeks, which usually brought a million visitors to town to celebrate the most recent national election. Dr. Hollander saw a perfect storm brewing.
Hospitals in other parts of the country had to expand their urgent care centers by propping up tents outside in order to provide additional space for flu victims. These tents provided little comfort during the icy cold of January, but seemed necessary in order to quarantine flu victims from other patients in the hospital who might be especially vulnerable to the virus. What if patients staying in the tents happened to perish because of inclement weather or insufficient attention from overwhelmed medical staff?

Dr. Hollander considered turning away all but children, elderly, and immune-compromised flu victims in order to manage the patient load of the hospital and to avoid the need for tents. However, she feared instructing the medical staff to follow anything but their professional judgment about patient care. What if a patient who ~
was turned away due to lack of space happened to die at home—would this lead to reputational harm or liability for the hospital? Could Dr. Hollander risk requiring her staff to work overtime, if doing so might expose the staff to increased risk of illness?
Dr. Hollander also considered prioritizing local victims over tourists, as opposed to admitting patients on a first-come, first-serve basis. However, she was hesitant to allow operational concerns to override her staff’s best medical judgment as to the proper care for patients. With every day seemingly a Monday, Mandy was overworked, stressed out, and not getting enough sleep. She eventually contracted the flu herself and was bed-ridden at home just one week prior to the Presidential Inauguration. She had to make some tough decisions and provide instruction to her diminishing medical staff before another million potential flu victims arrived in the capital.
In addition to the questions raised in this case, answer the following questions.
1. To what risks is the hospital exposed? Qualitatively describe the risk level of the risks you identify.
2. What risk responses are available for the Lamont Memorial Hospital?
3. How can the Enterprise Risk Management continuum improve the hospital’s risk response in time for next flu season?