Hospitals know how to treat human misery, but responding when their own walls, rooms, employees and patients are threatened by calamity is another matter.
Disasters such as Hurricane Sandy last week and the Joplin, Mo., tornado of May 2011 are reminders that nature throws a powerful punch. They also provide lessons from which local hospitals and other institutions can learn.
Nevertheless, chaos comes in many forms — tornadoes, ice storms, earthquakes and gunmen — and there is no way to thoroughly prepare for each.
Though some New York hospitals suffered because backup power equipment was swamped in flooded basements, the backup generator at St. John's Regional Medical Center in Joplin was on the roof and was destroyed by tornado debris, hospital spokeswoman Angie Saporito said.
No one plan, no set of plans, no drill or amount of repetition will prepare staffers for the infinite array of disaster circumstances that may occur.
“You prepare for everything that you can identify, and you go from there,” said Roberta Coffman, a safety compliance specialist with Alegent Creighton Health. “I think the key is to learn.”
Scott Kaminski, vice president of support services at Children's Hospital & Medical Center, gave a realistic assessment of preparedness.
“One never knows how that plan will come out until a situation actually presents itself,” Kaminski said. “I'm confident that we have the plan in place, that we have people here who can adapt to the changes in situations. ... The one thing we really can't test is how well we can do if we have to be in a situation for three, four, five days.”
Numerous hospitals in the metropolitan area will participate this week in communication and evacuation exercises overseen by the Omaha Metropolitan Medical Response System and the Center for Disaster Preparedness, which is run by the University of Nebraska Medical Center and Creighton University.
The exercise, which has been in the works for months, will involve a disaster scenario that officials declined to disclose.
While hospitals for years have trained for serving communities when disaster hits, they are focusing more than ever on what to do when they are struck themselves. That happened last year when St. John's in Joplin took a head-on hit from an immense tornado.
Area hospital officials said they learned these lessons from the Joplin tornado and other calamities:
» To have patients' shoes or slippers ready for use when a tornado warning is issued, so patients don't have to walk across shattered glass in bare feet.
» To give nurses head lamps, like those coal miners wear, or at least flashlights. Some nurses at St. John's resorted to using cellphones as lights.
» To move patients not into hallways but to inner corridors, such as meeting rooms, elevator areas and surgical suites, to protect them from debris flying through halls.
» To acquire medical sleds — plastic devices that wrap around extremely ill patients and enable staffers to move them easily through halls and down stairs.
» To move at least some emergency equipment off the hospital grounds so it isn't destroyed.
“Anticipate the worst,” advised Ronald Muecke, vice president of facilities at Mercy Medical Center in Des Moines. Muecke said his hospital decided after the Joplin tragedy to move its large mobile medical tents off the hospital premises. That way, if the hospital is struck, the medical tents will remain available.
Sandra Vyhlidal, emergency preparedness coordinator for the Methodist Health System, praised the Omaha Metropolitan Medical Response System for helping area hospitals devise plans and bringing hospitals together to share ideas and coordinate plans.
The system was founded in the late 1990s. The organization has assembled public health officials, local governments, fire and law enforcement leaders, businesses and other entities for a unified medical response if a natural disaster, major chemical spill or terrorist attack were to occur here.
Hospital representatives said they practice disaster preparedness at least twice a year and meet more frequently.
Shelly Schwedhelm, the Nebraska Medical Center's director of emergency preparedness, said her hospital is well drilled and ready. For instance, she said, the hospital has “multiple redundancies to the redundancies” when it comes to preserving power on the campus.
Five circuits from an Omaha Public Power District substation are available; central utility plants in two locations on campus and additional portable generators would help power continue to flow to the hospital, she said.
But a direct, intense hit from a tornado, as occurred in Joplin, could smash all redundancies. “I don't know that anyone could ever sustain something of that magnitude,” Schwedhelm said. “I mean, our problems would be far worse than just the power.”
It “scares me a lot” to think about evacuating sick people in medical sleds down stairwells, she said. “We would get it done, but it would be very challenging with how sick the patients are these days.”
The Joplin hospital did good work under the circumstances, Schwedhelm said. Five patients in the hospital and one visitor died in that tornado. Overall, about 160 people died and 1,000 were hurt.
Today, St. John's is in a concrete and steel modular structure. Its name has been changed to Mercy Hospital Joplin. A permanent replacement hospital will be completed in 2015.
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