Catastrophe And The Cure
After the mass shooting event that occurred in Las Vegas, you wonder how well is your hospital prepared to handle a disaster?
Hospital leaders should think about the unthinkable, practice the unthinkable, even in a limited way (Fink, 2017). And yet no matter how well prepared and equipped a hospital can be, it is difficult to handle a high influx of critical patients coming in at once. In Nevada, they only have one comprehensive trauma center (UMC) and because of the high volume of patients, many were transported to other hospitals. Level II and Level III trauma centers in the Vegas area could only be equipped for a certain amount of patients so those who were critically injured had to be transported to UMC. However even with 11 trauma bays, three operating rooms, a CT scanner, a trauma intensive care unit and a pediatric intensive care unit all under one roof, the trauma center had never faced a torrent like this (Fink, 2017). The amount of patients coming in was something of war zone and every single medical staff were working for hours on end.
Since 9/11 and Hurricane Katrina, all hospitals have a newly enhanced disaster preparedness plan set in place for WHEN a disaster occurs, not IF. A 2009 survey of hospital directors found that 94% of hospitals hold mass casualty training exercises (The Hartford, 2014). UMC Trauma Surgeon Dr. John Fildes said his team participates in two major disaster drills each year and does other internal drills too (Harasim & Munks, 2017). Whenever a disaster occurs, hospitals from around the country pay close attention as to how the surrounding facilities in the area handle the influx of victims and casualties. It's unforunate given the situation, but these disasters play a role as a learning lesson for WHEN the disaster happens in their area. UMC spokeswoman Danita Cohen said staff had discussed with Orlando, Florida medical staff recently how they dealt with the Pulse nightclub shooting last year as part of training (Haramism & Munks, 2017). In fact, as a lesson learned from a training session after the Pulse nightclub shooting, the hospital decided to have the staff roll the gurneys and wheelchairs outside so they weren't taking up the space inside. Although due to the high demand, the patients were taking up much of the space in the hallways but this tactic allowed for them to control the crowds and space. Not only that, they opened up more places- a recovery room, a preoperative area and an ambulatory surgery center for them to receive more patients and they divided the space for those with life threatening injuries who are unable to make it and for those who had minimal injuries (Fink, 2017).
What happened in Las Vegas was a devastating event and we will never understand why it happened. However, it is extremely important as a hospital, as an administrator, as a medical employee- to be trained for these situations because they WILL happen. There is no such thing as being too prepared, there is no such thing as being too cautious. After I had heard about the shooting, I was reading articles and watching videos/interviews of the victims who had survived. What stood out to me the most was that many of them said "you never think it will happen to you, until it does". And that is the truth.
*A huge thank you to all of the medical staff who worked diligently throughout the night and to first responders who risked their lives to save patients. My heart goes out to all of the victims, families and those affected by this tragedy.*
Fink, S. (2 October 2017). Controlled chaos at las vegas hospital trauma center after attack. Retrieved from https://www.nytimes.com/2017/10/02/us/vegas-shooting-hospital.html
Harasim, P., & Munks, J. (2 October 2017). Las vegas-area hospitals like 'war zones' after strip massacre. Retrieved from https://www.reviewjournal.com/crime/shootings/las-vegas-area-hospitals-like-war-zones-after-strip-massacre/
The Hartford. (October 2014). Hospital disaster preparedness: worker safety. Retrieved from http://www.thehartford.com/sites/thehartford/files/healthcare-white-paper.pdf
Hospital leaders should think about the unthinkable, practice the unthinkable, even in a limited way (Fink, 2017). And yet no matter how well prepared and equipped a hospital can be, it is difficult to handle a high influx of critical patients coming in at once. In Nevada, they only have one comprehensive trauma center (UMC) and because of the high volume of patients, many were transported to other hospitals. Level II and Level III trauma centers in the Vegas area could only be equipped for a certain amount of patients so those who were critically injured had to be transported to UMC. However even with 11 trauma bays, three operating rooms, a CT scanner, a trauma intensive care unit and a pediatric intensive care unit all under one roof, the trauma center had never faced a torrent like this (Fink, 2017). The amount of patients coming in was something of war zone and every single medical staff were working for hours on end.
Since 9/11 and Hurricane Katrina, all hospitals have a newly enhanced disaster preparedness plan set in place for WHEN a disaster occurs, not IF. A 2009 survey of hospital directors found that 94% of hospitals hold mass casualty training exercises (The Hartford, 2014). UMC Trauma Surgeon Dr. John Fildes said his team participates in two major disaster drills each year and does other internal drills too (Harasim & Munks, 2017). Whenever a disaster occurs, hospitals from around the country pay close attention as to how the surrounding facilities in the area handle the influx of victims and casualties. It's unforunate given the situation, but these disasters play a role as a learning lesson for WHEN the disaster happens in their area. UMC spokeswoman Danita Cohen said staff had discussed with Orlando, Florida medical staff recently how they dealt with the Pulse nightclub shooting last year as part of training (Haramism & Munks, 2017). In fact, as a lesson learned from a training session after the Pulse nightclub shooting, the hospital decided to have the staff roll the gurneys and wheelchairs outside so they weren't taking up the space inside. Although due to the high demand, the patients were taking up much of the space in the hallways but this tactic allowed for them to control the crowds and space. Not only that, they opened up more places- a recovery room, a preoperative area and an ambulatory surgery center for them to receive more patients and they divided the space for those with life threatening injuries who are unable to make it and for those who had minimal injuries (Fink, 2017).
What happened in Las Vegas was a devastating event and we will never understand why it happened. However, it is extremely important as a hospital, as an administrator, as a medical employee- to be trained for these situations because they WILL happen. There is no such thing as being too prepared, there is no such thing as being too cautious. After I had heard about the shooting, I was reading articles and watching videos/interviews of the victims who had survived. What stood out to me the most was that many of them said "you never think it will happen to you, until it does". And that is the truth.
*A huge thank you to all of the medical staff who worked diligently throughout the night and to first responders who risked their lives to save patients. My heart goes out to all of the victims, families and those affected by this tragedy.*
Fink, S. (2 October 2017). Controlled chaos at las vegas hospital trauma center after attack. Retrieved from https://www.nytimes.com/2017/10/02/us/vegas-shooting-hospital.html
Harasim, P., & Munks, J. (2 October 2017). Las vegas-area hospitals like 'war zones' after strip massacre. Retrieved from https://www.reviewjournal.com/crime/shootings/las-vegas-area-hospitals-like-war-zones-after-strip-massacre/
The Hartford. (October 2014). Hospital disaster preparedness: worker safety. Retrieved from http://www.thehartford.com/sites/thehartford/files/healthcare-white-paper.pdf
Our hospital, located in Boston, experienced the unfortunate impact of a mass casualty on the day of the Boston Marathon. As mentioned above, no one was prepared for such a tragic event and since then, our hospital and surrounding hospitals have made significant improvements upon disaster planning and allocating the appropriate resources. You're right, you can never be too prepared.
ReplyDeleteIf you don't mind my asking, what improvements did you make? I do remember the tragic event in Boston and I recall reading a few articles (one I believe was written by Atul Gawande) in which they praised Boston hospitals for how quickly and efficiently they were able to handle the incoming patients! They also credited medical and safety personnel that were already stationed at the event who had the quickest access to treat injured victims, however the next time we may not be so lucky.
DeleteI grew up in a town that has experienced 3 mass shootings (Killeen, Texas). I am not sure there is anyway to plan for these events. I'd like to see us being more proactive about avoiding them; however, we seem to live in I world where that is not a reality. I like the idea of have spaces that can change to suit the situation so they that they can be used for everyday use and then when tragedy eventually strikes, they can serve as needed. I work for an insurance company and know that when Harvey happened we worked diligently to make sure our member got the medicines and care they needed where ever they were. We have a plan for that, you can plan for a hurricane, how you plan for mass shooting is beyond me though.
DeleteMy experience with masscal planning is that you think about specific examples, but you plan generally for how to deal with your system being overwhelmed, whether the source is a mass shooting , a chemical spill, a large traffic accident, or an act of nature. The source often matters less than the fact that you don't have enough beds, doctors, or nurses.
ReplyDeleteI like the idea of switching from, "how do we prepare for a mass shooting?" to how do we plan for for our system to be overwhelmed. That is more creating scalability within your processes than concentrating on the tragedy and it transcends industry.
Delete