Disaster brings new meaning to safety, quality

Staff members perform non-medical services

The recent flooding in America's heartland made lots of headlines, but in the health care facilities of the region much was going on behind the scenes that the public never got to see. And, despite having run disaster drills during the year, many quality professionals and their colleagues found themselves in situations or performing duties they would never have imagined.

For example, medical staff from Olmsted Medical Center in Rochester, MN, found themselves tearing out carpet and removing equipment from one of their system's clinics that had been flooded. In Blanchard Valley Hospital's Findlay (OH) Campus, some staff stayed on shift for 24 hours, while others set up a shelter in the local recreation center.

The disasters also shone light on unique patient safety strategies that will be spread to other facilities in the future. For example, when patients from a flooded Wisconsin nursing home arrived at Prairie du Chien Memorial Hospital, they were not only accompanied by their medical charts, but by photographs, to ensure proper identification. "It was part of their records," notes Prairie du Chien COO Connie Achenbach, MBA, who says that in the future her facility will do the same.

"This is good for any hospital that needs to transfer patients," she says, "And it's something that's easy to do in this day and age. When we bed patients, we should have a system in place to take their pictures."

After the flood

When floods hit the area around Olmsted on Sunday, Aug. 19, its St. Charles clinic, flooded with two feet of water, was forced to close (it remains closed today). "We routed the patients to other locations and physicians to our other clinics," notes Lois Till-Tarara, MA, assistant administrator for Olmsted. A temporary clinic was set up outside the hospital in the parking lot, in trailers provided by Satellite Shelter of Minneapolis.

Some staff could not get in to work, as they had their own flooding problems and personal crises, but staffing was not a problem "because we shuffled physicians across [to other facilities]," says Tarara.

However, in the flooded St. Charles clinic, "we had to tear out carpet, vinyl tile, get the medical records, the equipment, which was all electronic, and pharmaceuticals out," she continues. "As soon as things got wet, we really had to move out fast."

In light of this "need for speed," she says, her medical staff worked alongside a construction company to remove records and equipment. "The best thing we did was to get the area cleaned out," says Tarara.

In order to preserve the paper records, the staff bagged them and turned them over to Thunder Restoration of Golden Valley, MN, which freeze-dried them and treated the bags with a preservative chemical.

Helping the community

The floods hit Blanchard Valley on the morning of Aug. 21. "At about 6:30 a.m. they called a code yellow — a disaster," recalls Nancy Proctor, MeD, director of service excellence, whose role includes "measuring patient satisfaction and improving processes to create a better experience for patients."

But her role, and that of her colleagues, expanded that day to encompass the surrounding community. For example, a nursing home in nearby Cary had been flooded and about 16 residents were transported to Blanchard Valley. "We needed to make space for them, while at the same time we had associates calling in who couldn't get there," says Proctor. "So, with increased census and decreased staffing, we switched into disaster mode."

Some staff agreed to stay on for 12 and even 24 hours, she recalls. "We set up an incident commend center in our administration area, started communicating with the Red Cross, sent associates to EMA, and also sent a lot staff out to the 'Cube,' our local recreation center, where we set up a shelter."

Blanchard Valley pharmacists, nurses, and physicians stayed there around the clock until the following Monday. "The majority of those people were leadership staff," Proctor explains. "The docs took turns doing shifts."

The staff supplied residents with tetanus shots, medicine, and anything else they needed — including information about what was happening in the community, provided by the Red Cross. "It was a real community effort," says Proctor.

To help serve the patients and optimize satisfaction during the disaster, "we tried to round on the floors and talk with families who were anxious about what was going on at their homes or happening here — we tried to keep them completely informed and in the loop," says Proctor.

Transportation an issue

"A lot of our requests dealt with transportation," adds Kelly Shroll, Blanchard Valley's support services and safety director, who actually called the "code yellow."

"I had received a call at 4 a.m. that the nursing home would be transferring 16 patients," she says. "I arrived at the hospital around 5."

Shroll worked in the incident command center, from where she coordinated the transfer. "The nursing home residents were admitted to our facility for food and shelter, and were there about eight hours. We used empty beds, and had enough to accommodate them."

Shroll had asked the nursing home to bring staff with them, as well as medicine carts and records. "They brought one LPN and two nurse's aides," she says.

In terms of making up for staffing shortages, says Shroll, buses were sent out to bring in stranded providers. "We also worked with law enforcement to get critical staff members to the hospital," she says.

At one point it appeared that the local water treatment center's water would not be safe, and Shroll was prepared. "We had bought supplies for a boil alert for potable water, but it actually did not become necessary," she says.

Plan worked well

Shroll says the disaster preparations her hospital made during the year paid off when disaster struck. "The incident command center worked very well," she says. "Our strength was having the right people in the right spot — people who were well trained in the roles they needed to fulfill. There was not any hesitation or confusion about what to do; we made a request and they did it."

The team had purposely established a single phone number for external requests and that worked very well, too, she says. "We also had a pharmacist go out to the shelter and managed the meds; they contacted local pharmacies who provided seven-day supplies."

The hospital had conducted one disaster drill in 2007, and always does two per year, says Shroll. "This absolutely helped in terms of preparation," she asserts.

Still, she plans to tweak her disaster response plan. "We're still working on activation and de-activation; we still need to work on communication," she says. "Currently, we can notify via pager, but not by multiple ways. We will purchase a system, because we need to be able to get the message out in a 'mass' method."

[For more information, contact:

Connie Achenbach, MBA, Chief Operating Officer, Prairie du Chien Memorial Hospital, Prairie du Chien, WI. Phone: (608) 357-2238.

Nancy Proctor, MeD, Director of Service Excellence, Blanchard Valley Hospital, Findlay Campus, 1900 South Main Street, Findlay, OH 45840. Phone: (419) 423-5163.

Kelly Shroll, Support Services and Safety Director, Blanchard Valley Hospital, Findlay Campus, 1900 South Main Street, Findlay, OH 45840. Phone: (419) 423-5245.

Lois Till-Tarara, MA, Assistant Administrator, Olmsted Medical Center, Rochester, MN. Phone: (507) 529-6614.]