Located in Sendai, Japan, Tohoku University Hospital played an important supporting role after the Great East Japan Earthquake in March 2011, having dispatched many medical staff and accepted many patients from affected hospitals in the coastal area. Although it did not suffer major human or property damage, the hospital experienced issues such as long-term disruption of lifelines and elevator stoppages. The episode revealed the importance of establishing proactive measures for resources related to the continuation of hospital functions and culminated in the formulation of a Business Continuity Plan (BCP), initiated in November 2016. The first edition of BCP was compiled in November 2017 through the following steps: 1) Establishment of the BCP committee; 2) Review of critical operations/estimated Recovery Time Objective (RTO); 3) Investigation of human and material resources; 4) Risk analysis, assessment, and measures; 5) Development of a proactive measures list/damage assessment; 6) Reexamination of action plan, report of BCP documents; and 7) Development of the first edition of BCP. A formulated BCP requires Business Continuity Management (BCM) because, over the years, dissociation occurs between the items in the initial plan and the actual situation. Business continuity is focused more on the ability to make and modify plans than on the format of the plans. In this sense, based on the experience with the Great East Japan Earthquake, the hospital has established the premise that, in order to continue its medical activities and fulfill its social responsibilities even in the event of a disaster, its facilities and equipment must remain in operation. As part of BCM activities, the hospital has been carrying out emergency facility/equipment inspection training since 2018. A checklist has been created to efficiently inspect the ward building equivalent to the 21st floor above ground and underground without using an elevator, and this checklist is updated with each training. In response to the request for temporary school closure due to the spread of the new coronavirus in February 2020, the hospital's BCM activities have been successful, leading to a prompt survey of hospital staff attendance. A steady BCP formulation process, which includes investigating resources, prioritizing operations, and considering alternatives, requires considerable time and effort, but the awareness of each department in TUH was increased, leading to the formation of an organization capable of responding quickly and flexibly to irregular situations.
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