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Lessons learned from one hospital's disaster plan

Accreditation Connection, June 11, 2004

The scenario

On Thursday, February 12, an anhydrous ammonia leak from a 3/4 in x 2 in pipe was discovered at a pork-processing plant with 1,800 workers, located within 2 miles of Avera McKennan Hospital in Sioux Falls, SD.

The leak expelled 19,000 lbs. of the chemical and produced a coffee-colored cloud above the plant. At 11:48 a.m., the hospital received its where an estimated 19,000 lbs of the chemical was expelled first alarm, followed by a disaster code 10 minutes later.

Thirty-eight of the 66 injured plant workers sought treatment at Avera McKennan Hospital.

Lessons learned

Even though its first disaster response went well, there are still many incidents during the event that Avera McKennan Hospital couldn't plan for, says David Kapaska, DO, senior vice president of medical affairs. He shared the following lessons his facility learned and what adjustments it will make to its disaster plan for the future:

Be prepared to set up a family center somewhere in your hospital. Avera McKennan staff selected its cafeteria, but underestimated patients' families' emotions and the need for communication. "Thinking ahead about a communication center where you can hook up 10 phones would've helped," he says.

Create a standard response for family members searching for their relatives. Family members of workers showed up at the hospital wondering whether their relatives were harmed. The Health Insurance Portability and Accountability Act of 1996 made this particularly challenging for the hospital when dealing with family members who wanted to know whether their relative was even in their hospital since it couldn't divulge who had been admitted or to which hospital, says Kapaska.

Order different colored vests or hats to denote different roles in emergencies. While Avera McKennan had ordered different colored vests, they hadn't arrived yet. The color coding can allow staff to easily tell what job someone does should an emergency professional need, for example, a nurse or phlebotomist.

Prepare for an influx of staff who want to help. "Everyone was anxious to do something," he says. "Controlling human resources is a challenge-as far as making sure you have the right people."

Know your community demographics. Be certain you have interpreters on staff or on contract should you need them in a disaster.

Think ahead about dealing with the media. If patients were exposed to a certain chemical, make sure to print out information about the chemical and its side effects immediately. This way you can speak intelligently about the incident and how the hospital is responding.

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