Hospital preparedness for public health emergencies was the topic of conversation for the final session of our webinar series entitled: “7 Ways to Master Operational Efficiencies in Your Hospital” hosted by Maria Romano, Clinical Product Consultant at TeleTracking.

The webinar began with a look back on the shootings at the Century Movie Theater in Aurora, CO. on Friday, July 20, 2012 at 12:38 AM, a mass casualty incident which led to a surprise and sudden increase in patient volume for the University of Colorado Anschutz Medical Center.

Aurora police arrived at the scene of the shooting within three minutes of the emergency call.

Five and a half minutes later, police made their first request for an ambulance.

Police: Metro 10, Lincoln 25, do I have permission to start taking some of these victims via car? I got a whole bunch of people shot out here, no rescue.

Police: Yes, load them up, get them in cars, get ’em out of here.

-Excerpt of Transcription provided by CNN-

Has your hospital ever been called upon to respond to a mass casualty incident (MCI) such as this one, the Boston Marathon bombings, the Central Texas fertilizer plant explosion, or the Newtown CT tragedy? Or even natural disasters such as earthquakes, floods, tornados, tsunamis, wildfires, hailstorms, heat waves, hurricanes, epidemics and others that are occurring more often?

Here’s how one hospital reacted to this surprise and sudden increase in patient volume.

University of Colorado Anschutz Medical Center Reacts to Aurora, CO Shootings

University of Colorado Anschutz Medical Center is a level 2 trauma center, located 3.5 miles away from the shooting, with a bed count of 407. At the time of the shooting, the Medical Center’s emergency room was on “divert” – with patients in 49 of their 50 emergency room beds, and another 11 in the waiting room — even before the shooting started.

The hospital was notified at 12:56am and told to expect 3 to 5 patients. One of the ER physicians, however, intuited there would be more than expected and activated their mass casualty plan. Within one hour, 7 OR rooms were prepped and ready for patients. Within 5 minutes, at 1:01am, the first patient arrived.

Because of the large number of critically wounded, police chose to transport victims to hospitals in squad cars instead of waiting for ambulances to arrive at the scene. This vital decision, which likely saved lives, also bypassed a key part of the hospital’s mass casualty plan. Because ambulances were not used in every case, there was a communication disconnect with the hospital, and initial treatment and stabilization that would typically occur during transport was not available.

The hospital received 23 patients within 30 minutes of the initial gunshot and only 3 by ambulance. Once the wounded arrived, the hospital staff quickly went into action:

  • Non-trauma patients were moved out of the emergency room to pre-op and recovery rooms.
  • Safety officers and other non-healthcare personnel moved the wounded from squad cars to the emergency room beds.
  • Each trauma room received 4 patients instead of 2 and those less seriously injured were treated in the hallways.
  • The ICU made room for the seriously injured by transferring the less sick from the unit to beds on regular medical floors.

Although many patients were unconscious and did not have proper identification, registration staff entered all the information they could find on each patient and by hour 6, a comprehensive list was compiled of all victims. In order to keep family and friends aware of their loved ones’ status, the hospital transformed a large conference room into a holding area for people to gather. They also established a hot line, which received over 2000 calls from people trying to find their loved ones.

Paige Patterson, Hospital Manager for Patient Throughput and Capacity Management at the University of Colorado Hospital, said during the webinar: “It was a bit chaotic, but everyone got treated.”

Each patient was given a “disaster patient attribute” in their electronic medical record (EMR), and the hospital command center used TeleTracking’s Capacity Management applications to track these patients. Once the attribute was designated, Patterson and other personnel had an enterprise-wide view of everyone being treated and could develop concise reports of the current status and location of the disaster patients. Patterson said what saved her in the ED chaos was being able to differentiate which patients were actually a part of the shooting vs. others waiting to be seen. She could not have done it without TeleTracking’s system.

The importance of hospital disaster preparedness training

Most of the senior level executives, hospital managers and safety officers took disaster preparedness training as early as 2008 because of the Democratic National Convention.

Since then, University of Colorado hosts monthly “table top” discussions for not only their hospital, but others in the area, to discuss disaster preparedness for cases like the movie theater shootings. Patterson says, “What you can prepare for and what actually happens is never the same. At least you don’t panic because you know you’ve had some training.

University of Colorado Anschutz Medical Center’s “5 Tips to prepare for Mass Casualty Incidents” include:

1) Be Prepared!
  • Encourage your staff to take HICS training or local emergency preparedness classes
  • Involve EVERYONE
  • Run a drill & review scenarios
  • Practice “what-if” scenarios with staff
 2) Classify Patients
  • Encourage your staff to take HICS training or local emergency preparedness classes
  • Involve EVERYONE
  • Run a drill & review scenarios
  • Practice “what-if” scenarios with staff
 3) Implement a Workflow process to maintain an accurate “Call Down List”
  • Encourage your staff to take HICS training or local emergency preparedness classes
  • Involve EVERYONE
  • Run a drill & review scenarios
  • Practice “what-if” scenarios with staff
 4) Provide an environment of inclusion for all employees
  • Know that everyone working in your hospital is able to do amazing service when called on
  • Make sure all of your employees feel valued and a “part of the team”
 5) Debrief
  • All staff (whether they are involved or not), need to talk about the situation
  • Bring mental health representatives in so employees can seek services if needed
  • Let your employees cry

The TeleTracking Advantage: Disaster Preparedness

TeleTracking provides hospitals with an operational platform to maximize resources, make additional beds available, and address staff and patient logistics. This is central to efficiently managing day-to-day operations, and becomes vital when it comes to responding to surge capacity. Although the “tangible” benefits of TeleTracking solutions enhance efficiency, save cost and generate revenue for hospitals, our most noble mission is in support of our nation’s hospitals, health systems and caregivers in helping ensure that patients get to the right place at the right time with the right resources for optimal care.

The webinar concluded with a few final thoughts from Patterson: “It was an astonishing event that transpired over days and I think that like Boston, Texas and Newtown… the best in each of us comes out at a time like this and we do what we do best, individually and as a group. It is a tribute to the human spirit and we can all benefit from learning from each other.

On behalf of the TeleTracking family, we would like to extend our deepest sympathies to those who have been directly affected by these tragic events.

Dennis Morabito

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