Safety

When your hospital becomes the pinch hitter

Hospital Safety Insider, October 29, 2015

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Emergency management experts stress the importance of training and preparing to be self-sufficient and ready for just about any emergency that could strike your hospital.

But what happens when you are faced with a disaster so overwhelming that you not only have to resume your own normal operations, but also take on the role of a lifeboat for a hospital that's been left in shambles?

That happened in Joplin, Missouri, on May 22, 2011, when a huge EF-5 twister, now characterized as perhaps the worst to ever hit the U.S., rumbled into town and completely destroyed St. John's Hospital.

Just six blocks away, the staff of Freeman Hospital, who had just escaped a close call by the monster tornado when it turned unexpectedly to the north at the last second, found themselves in a frantic race against time to help not only those affected by the direct hit at St. John's, but also a steady stream of incoming patients from the surrounding community. Here are some takeaways from the experience.

Find out what you're up against. Tornadoes are unpredictable, as they can destroy houses on one side of a city street while leaving the other side completely untouched. A slight change in direction can mean the difference between missing your hospital or a direct hit. Because communications were down, staff at Freeman had no idea how bad the situation was until horribly injured patients began walking into the ER.

Know who your friends are. Hospitals from miles away sent supplies, nurses, and volunteers to help with the response effort, and took in some of the most critically injured patients. In addition, other hospitals helped out logistically. When the tornado knocked out water pressure in Joplin, Freeman Hospital could not sterilize medical equipment and had to send it to a hospital 20 miles to the south by couriers.

Have an alternate supply route
. It's been said many times: In an emergency, you have to know where you will get your supplies replenished. Just like in a war zone, if your vendors can't get to you, you'll have to either have the supplies stockpiled yourself or find another way to get them restocked.

Know when to break the rules
. Chances are, your facility has a lot of written policies, procedures, and checklists that dictate what will happen and who will do what during a disaster. In some cases, those documents will go in the trash, and you have to be flexible enough to know when it's time to do that. In many cases, patients were being transferred to Freeman with no patient records, since all communications by phone or computers were down. Security cameras didn't work, and the only way to get a cell phone signal in some cases was to go to the roof of the hospital.

You don't practice nearly enough. You've heard this one too many times as well. Emergency drills are a critical way to test your emergency response plan, and they are required by The Joint Commission, CMS, and other regulatory agencies. In too many cases, emergency managers and safety professionals complain that they can't get the CEO or other administrators to take drills seriously, and make them as real as possible, mostly due to budget constraints.
 

This is an excerpt from the monthly hospital safety resource Briefings on Hospital Safety. Subscribers can read the rest of the article here. Non-subscribers can find out more about the journal, its benefits, and how to subscribe by clicking here.


 



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