Hospital covers all its millennial bases

Here’s what a good Y2K plan looks like

A typical model of year 2000 (Y2K) preparedness plans in use by leading hospitals and integrated health networks is at William Beaumont Hospital. Beaumont is a 929-bed facility in Royal Oaks, MI, a suburb of Detroit; it has a 189-bed satellite in Troy. Beaumont’s initiative involves equipment readiness and disaster preparedness. Plans have been in full swing for better than two years.

The equipment piece of the initiative consists of the search for computer programs and chips that might mistake the date code of "00" for the year 1900 instead of 2000.

Planning for disaster

The disaster plan involves preparations for failures among critical suppliers such as the local electric power company, as well as glitches in internal systems that slip by Beaumont’s preparedness initiative.

Beaumont’s 105,000 pieces of equipment came up for scrutiny. The plan was to identify which items needed upgraded computer chips and which should be replaced.

"We had to budget for unknowns," explains Larry Randolph, Beaumont’s associate hospital director. "We thought it would be prudent to put the money into a pool for the whole hospital instead of budgeting for Y2K by department. Right away, we ran into complications." On older equipment, they had to decide, case-by-case, whether to upgrade a computer chip or to buy a newer model.

Replacements are either charged to Y2K preparedness or to obsolescence. Decisions on when to replace big-ticket equipment depend on the patient care or customer service risk posed by a malfunction. The project actually became one of the most in-depth equipment inventories the hospital has had in some time.

The second part of Beaumont’s preparation is a department-level contingency plan. "That could be overwhelming," Randolph admits, "when everyone is so busy anyway. Contingency plans are easy to put off.

"But we’re trying to be sensitive to our workers by providing forums where people from each unit [functional area] can get together. If each department has something to start with, and if they can learn from one another, they won’t have to come up with their plans from scratch." Forums began with the ancillary units: labs, radiology, respiratory therapy, and facilities management. Next came the medical/surgical units, critical care, pediatrics, and emergency care.

To conserve time, Randolph and his team designed a template that units could tailor to their operations. Points of accountability for each unit include:

  • plans for equipment failures, starting with the lifesaving items, for example, IV drips and heart defibrillators;
  • projections of how long each backup plan would be sustainable;
  • provisions for staff training relative to backup plans;
  • vendor lists;
  • supply needs;
  • staff needs in-house and on call;
  • management support necessary to implement backup plan;
  • description of tests to be run at 12:01 a.m. on Jan. 1, 2000, before seeing patients.

    All departmental plans will be turned in to Beaumont’s disaster control unit before the end of the year. The unit, consisting of key managers, will be at the hospital on New Year’s Eve. (For a flowchart of the process, see diagram, above.)

    "Throughout the hospital, we’re trying to control the vacation leave at the end of this year and for the first two weeks of the new year," Randolph adds. And just to be safe, medical equipment technicians and information systems specialists are being asked to work during late December and early January.

    Living with the unknowns

    Y2K planning can overwhelm a facility unless you temper each move with a grain of common sense, Randolph says. For example, Beaumont’s plans are most detailed for Jan. 1 and 2 when the biggest jolts are likely to occur. Weather-related contingencies are factored in with Y2K possibilities — in Michigan a midwinter blizzard could complicate a Y2K-related power failure.

    As the 1999 calendar winds down, "we ask ourselves — what’s our level of confidence that this or that will happen?" Randolph says. In some ways, he adds, hospitals have an easier time of Y2K preparations because "we have a lot of home-grown systems that we know how to change." On those,"we’re way ahead. But then, you’re only as ready as those you do business with."

    Randolph admits to shaky confidence in some of the facility’s vendors. He says he wonders whether the regional water processing plant is ready, for instance. This summer, he plans to confer with them and review emergency plans. Based on confidence levels after that meeting, the hospital will finalize contingency plans for emergency water supplies.

    As for other vendors, Beaumont’s materials management department has issued a twofold request:

    1. to certify Y2K-compliance based on a set of hospital-specific criteria;

    2. to submit testing instructions so the hospital can double-check its equipment. To that request, Randolph says, the response has been poor, although more vendors are posting instructions on their Internet sites.

    When it’s all said, though, the real spirit of millennium preparedness should hold the hospital as a place where the community can turn to. To that end, Beaumont’s Y2K disaster plan will include a report on the readiness of various hospital buildings to shelter and feed employees and their families, and even patients’ families.

    "We need to focus on taking care of our patients and our community instead of just keeping ourselves out of trouble," Randolph says.