ARCATA 2018 -- The Wine Country Fires and the Las Vegas shooting are horrific, and compelled many of us imagine ourselves in the same situation. As we try to understand the causes, we must also review what our own response would be in the same situation. What would happen if dozens or hundreds of injured people needed immediate trauma care in Humboldt County? Are we ready, and how does a small rural healthcare community prepare for this kind of event? Mad River Community Hospital works on several levels to ensure we’re ready to meet that challenge should it ever arise. Revising and testing our plans, training and practicing our response, and collaborating with partners all improve our ability to manage crisis healthcare situations.
Mad River Community Hospital recently conducted a mass casualty drill to test our ability to manage this type of situation. Thirty simulated victims arrived at the hospital with different degrees of injury ranging from minor to severe. Each “patient” was evaluated and treated at appropriate patient care areas set up throughout the hospital according to the severity of injury. We practiced our ability to rapidly mobilize hospital resources, staff, and equipment; to rapidly open up patient care areas to accommodate new patients, and to track the distribution of patients from intake to transfer or discharge. The exercise also activated our Hospital Incident Command System (HICS), an organizational system that focuses incident management and resources on the areas of greatest need. Something that we have actually used during power outages.
The drill not only focused on patient care, but on assisting their families as well. Mass casualty incidents not only bring large numbers of patients to the hospital doors, but also many family members, friends, and other people seeking information their loved ones. Large numbers of concerned individuals can quickly overwhelm hospital resources and create confusion near the Emergency Department and other hospital operations which can diminish the ability of the staff to get or provide necessary information. Our exercise tested our family support plan, which provides a safe, comfortable location to communicate with hospital representatives about their family members’ status. We collaborate with our partner agency, Adult Day Health Center, to help provide services to this group under stressful and challenging circumstances. Our exercise demonstrated the need to provide this essential service to our patients, and significantly improved our Emergency Preparedness Program.
We continue to improve our ability to serve our community through other developments. MRCH recently became a Level 4 Trauma Center, which enables us to respond more quickly and efficiently to traumatic injuries. This important designation includes improved training, staffing, resources, and collaboration with other trauma centers, and enables us to utilize a network of hospitals out of the area for patients requiring specialized care. This network is essential for managing multiple patients in a rural environment.
Another important feature of our disaster readiness at MRCH is the use of the Hospital Incident Command System (HICS). Based on the National Incident Management System, HICS standardizes emergency response so that leadership and task management is streamlined, terminology is consistent across agencies, and resources are distributed more efficiently. HICS improves management of small local incidents, and can be scaled up to allow us to work effectively with local, state, and federal responders. It is a vital tool in communications, and interagency coordination that will enhance our ability to respond to major incidents.
Recognizing the long-term responsibility to improve our emergency and disaster readiness, Mad River Hospital employs an Emergency Preparedness Coordinator to oversee the emergency preparedness program throughout the hospital, which includes promoting training, policy development, coordinating exercises and drills, and improving the readiness culture. We seek out training and collaboration opportunities, and recently sent two employees to attend the annual California Hospital Association Disaster Planning Conference in Sacramento, California. This three-day conference allowed disaster planners to share information and lessons-learned from the disaster experiences of hospitals across the country, a valuable opportunity to advance our readiness through the challenges other healthcare systems have faced.
Mad River Hospital continues to work within and outside our organization to improve our readiness to face the challenges of our sometimes troubled society. Through painful reminders like Wine Country Fire and Las Vegas, we continue to review and improve our own ability to serve our patients and our community.
-- Angelina Gregorio, Disaster Preparedness Coordinator