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Ice storm fails to freeze smooth ED operations
Pre-planning ensures adequate staffing
While a recent severe ice storm in Owensboro, KY, held most of the city in a standstill for several days, well-laid plans for just such a disaster helped keep ED staffing at adequate levels in the Owensboro Medical Health System.
"We had a couple of days' warning. We thought we would get an ice storm and that it could be significant," recalls Debbie Enoch, RN, BSN, MBA, CEN, the system's director of emergency services. "One of the things we do in such a situation is to set up rooms at local hotels."
This setup is designed to ensure that people who live 10 or 15 miles away from the hospital will be able to get to work, notes Enoch. "We call the staff members and inform them that the weather looks bad, we see they're on the schedule, that we have rooms available at several hotels, and that they are welcome to take advantage of them," she says. More than one-third of the staff members live out of town. "We encourage them to come in, but we can't force them to," she adds.
The calls were made by the department secretary. "We have a database that shows where everyone lives and how far away they live," notes Enoch, adding that drivers were sent to pick up intown staff that could not make it in on their own.
Several other strategies were used to ensure adequate staffing, adds Diana Hopson, an ED tech who was there during the entire event. "The first day the ice started to hit, on a Tuesday, volume was low. It was not even a normal day," she recalls. "Then, when things got bad on Wednesday, a lot of staff called in and asked if we needed them."
While the hospital had emergency power, Enoch says, the system's convenient care center did not; nor did local physician's offices, which put added strain on the ED. "On Thursday, the hospital command center opened, canceled elective surgery and cardiac catheterizations, and reallocated four staff members to the ED," she recalls. "We were fortunate this included a nurse who used to work in the ED and others from outpatient surgery and recovery that used to be ED staff, so they knew the system." The command center also allocated other staff, such as transporters, to smooth flow, she says.
'Oxygen bar' eases pressure on ED
The ED and hospital command center in the Owensboro (KY) Medical Health System used several creative strategies to ensure smooth operations during a recent severe ice storm. For example, a large conference center next to the ED was drafted to handle an influx of patients on oxygen who lost the electric power they needed to run their tanks.
"It's an area to which we typically take ED overflow for more minor treatment," says Diana Hopson, an ED tech, who noted that during the storm this area became known as the "oxygen bar." Because the conference room was not available to the ED for more typical overflow, "we used our office area and our own conference room for extra treatment areas," Hopson says.
On a typical day, the department sees about 180 people, reports Hopson. On the second day of the storm, it saw 230. Hopson used her sense of humor to buoy the spirits of patients who had to wait to be seen. "I tried to keep them in a better mood by telling them we were playing a new game," she shares. Hopson asked the patients if they were familiar with the "Dating Game." She proceeded to ring a bell every 15 minutes, at which time patients had to change seats and meet someone new. Apparently the strategy worked well, as the patients began to joke around with the staff.
Between those improvisations and careful pre- planning, patient flow went smoothly during a very trying time, says Debbie Enoch, RN, BSN, MBA, CEN, the system's director of emergency services. "Our staff responded terrifically. They worked really hard," she says. "Doctors worked extra hours, and the command center did an awesome job."