Recent flu epidemics and natural disasters across the country are a reminder that emergency preparedness at healthcare facilities is critically important. In the face of these disasters, the ability of hospitals to provide care to impacted communities can quite literally make the difference between life and death. Ascension Health has created a force of specially trained clinicians ready to travel to the site of a disaster at a moments notice to help. Infection Control Today spoke with Suzann Bylund, director of workers' compensation, disability management and emergency preparedness at Ascension Health; Jennifer Elliott, nursing director of emergency services, critical care and patient access at Baptist Hospital in Nashville, Tenn., and Stacy Douglas, emergency department manager at Baptist Hospital in Nashville, Tenn.
ICT: What is Ascension Healths PREP program?
Suzann Bylund: In order to enhance emergency preparedness efforts, Ascension Health established a core group of clinicians who are ready and willing to immediately go to the site of a disaster to support an Ascension Health hospital in need following a disaster or epidemic. The Prepared Responders Emergency Pool or PREP teams include registered nurses, physicians, chief medical officers, chief nursing officers, respiratory therapists, emergency department staff and pharmacists. Many within this group have special training and certification in healthcare disaster response and some have real-life disaster response experience.
Ascension Health employees sign up to participate through an online database. All PREP team members are screened to make sure they have all the qualifications necessary to respond to a disaster, and the database lists the employees skill set and certifications. Each volunteer is cleared by their supervisor to participate and the database tracks any limitations on the individuals time. For example, one of the volunteers is an emergency room physician who was also an expectant father, so the database was able to note a four week period when he would not be available.
There are periodic calls and email communications with PREP volunteers to ensure the team members are engaged. Furthermore, alerts are issued and shared with the volunteers. Last year alerts were issued when Hurricane Irene was threatening the east coast with potential impact on several Ascension Health hospitals and also during the severe fires that struck across Texas.
ICT: Why was the PREP program created?
Suzann Bylund: During the H1N1 outbreak, Seton Healthcare Family in Austin, Texas, a member of Ascension Health, sent a request for healthcare professionals throughout the System who could help ease the burden during the emergency situation. Baptist Hospital in Nashville answered the call, providing five staff members who could assist. Within 24 hours, the team flew to Austin and was on the ground helping at Seton. We had provided volunteers for similar situations in the past, but this sparked the idea to create a formal PREP program. The positive results are why everyone recognized the need and opportunities available as our health system is in 21 states and Washington, D.C.
ICT: What happened while you were in Austin for the H1N1 outbreak?
Stacy Douglas: The staff at the hospital had been stretched thin, they were tired and some had become sick, so we were able to give them a much-needed break. Seton made it very easy for us to provide that important assistance. It was so easy that the patients had no idea we were from another hospital. We treated the patients just as we would treat our patients back at Baptist Hospital. Part of what made this experience seamless was our shared Mission. Both organizations share the same Mission, Vision and Values, which directly translate to our approach to patient care. We spent three full days on the ground, working from 11 in the morning until 11 at night. After that, the volume of flu cases dwindled to a level that the Seton staff could handle, so we went back to Nashville.
ICT: How did that experience translate once you returned to Nashville?
Jennifer Elliott: Due to the patient overflow, there were tents set up around Seton so that patients could receive care. This is one example of something we brought back with us from our time in Austin; afterward, we had tents made as preparation for a disaster. We used the experience to redesign Baptist Hospitals disaster plan. We have had drills for the new plan, but fortunately have not yet had to execute it.
ICT: Are you now able to measure the organizations readiness for future emergency situations?
Suzann Bylund: Preparing for these types of emergencies is very complex and can be hard to quantify. While the Joint Commissions 96 hour rule requires all hospitals to determine whether they can be self-sustaining for a 96-hour period in case of a disaster, and if they cannot, to take steps to meet that standard, there is not a process to measure this. Ascension Health felt it was critical to quantify its preparedness and identify opportunities to improve, so it created an innovative internal measurement system to measure its preparedness across departments and facilities. Once these metrics were established, we conducted a survey to gauge effectiveness in H1N1 responses and that was followed up with another survey to measure progress and determine any further gaps. EPIC, Ascension Healths online emergency management portal, was redesigned and continues to serve as a central emergency management resource for Health Ministries.
ICT: What should other organizations consider when planning for disasters such as pandemic flu?
Suzann Bylund: There is no way to predict when events like a pandemic flu outbreak will take place. When a widespread emergency occurs it is critical for hospitals to be ready to save lives and that can be done with plans in place. This program, in coordination with other emergency preparedness strategies, has resulted in a significantly higher level of preparedness for Ascension Health. These programs can serve as a model for other large health systems in the future.