Ten years ago, 9/11 took a terrible toll on America's sense of security. To increase citizen safety, many changes were made to the workforce to accommodate. In addition to the creation of the Department of Homeland Security and the Transportation Security Administration — which provide personnel trained in reacting swiftly and appropriately in the event of a national emergency — hospitals and other healthcare facilities also found it necessary to create jobs geared toward emergency management and preparedness.
A heightened sense of security awareness was evident after the 9/11 attacks. The ED, which is the gateway to our safety-net hospital, is an especially vulnerable service. Many organizational changes have been implemented. Some of these initiatives include additional security posts at the main entrance and in the ED, card access for inpatient units and other areas of the campus and door alarms on exits.
Two hundred security cameras were added, and the security command post was moved to the middle of the building. There is a new system being worked on that will identify all people other than employees using the hospital. Finally, we have an interdisciplinary Emergency Management Committee that works closely with the Office of Emergency Management and North Shore-Long Island Jewish Health System. Staff awareness, communication and education are key. It truly is a collaborative effort.
he events of 9/11 and other major disasters such as Hurricane Katrina and the Joplin, Mo., tornado highlight the critical role healthcare facilities play in the community. Those events strengthened the commitment of our health system in ensuring continuity of operations while recovering from any effects we might feel from these types of situations. As a result, additional positions have been added to our corporate emergency management division.
There also has been an expansion of roles and involvement by clinical staff in emergency preparedness efforts at all of our facilities, and an enhancement of relationships with other healthcare facilities and municipal response partners with a greater emphasis on employee resiliency. Recent efforts have revolved around increasing our individual employee’s personal preparedness through training and mass communication campaigns.
As we reflect on the events of 9/11, healthcare organizations have altered the planning for disasters. Emergency preparedness has expanded to include natural events. Unfortunately, hospitals have had the need to activate these plans, as evidenced recently in Joplin, Mo. NYU Langone Medical Center has expanded the department of emergency management in the past year.
The director of emergency management is responsible for coordinating the development and implementation of the organization’s emergency management plan, educating other departments and partnering with city, state and federal agencies. Recognizing that one person alone cannot accomplish everything that is required, two additional positions were added to the department to facilitate the needs of the organization. An emergency management specialist and an emergency management coordinator were hired in 2010. Together, this team maintains that NYU Langone Medical Center hospital system is ready to respond to internal and external events.
Since 9/11, Sound Shore Health System, which includes Sound Shore Medical Center, Mount Vernon Hospital, Helen & Michael Schaffer Extended Care Center and Dorothea Hopfer School of Nursing, has become far more vigilant about emergency preparedness. We have addressed the increased need for preparedness with a multidisciplinary approach. Every department is schooled on individual requirements, which results in seamless responses to in-house mock disaster drills.
In June, we held an unannounced, systemwide emergency preparedness drill, which required a timed, safe evacuation of mock patients to ensure readiness for real-life situations. We accomplished our goal of evacuating 175 mock patients in less than four hours.
In a recent educational event, “Don’t Be Scared — Be Prepared,” we drew upon the expertise of many departments, including engineering, biomedical, radiology, security, staff development, occupational health and communications, and staff learned about possible issues and potentially life-saving responses to an array of situations.
In my role, I focus on internal responses by developing educational programs and mock exercises, and I focus on external responses by working with federal, state and local agencies to make sure there is cooperation and support when real-life emergencies occur.
Westchester Medical Center has created several new positions to enhance preparedness efforts within its facility and throughout the lower Hudson Valley region.
The initial change occurred when the center was awarded a New York State Department of Health/Hospital Preparedness Program grant in 2002 to develop a regional resource center. A disaster specialist was hired, and the RRC was created to assist all hospitals in the region, develop plans, conduct exercises and provide a wide range of training and education for hospital staff.
The most recent addition was a vice president to oversee a combined department that includes emergency management, RRC, life safety, EMS and several other related departments. The RRC receives funding that allows ED nursing staff to attend many disaster preparedness classes free of charge. The department routinely participates in disaster drills, and disaster management has been added to nurses’ competency requirements.
In the wake of 9/11, a key area of concern for all burn centers is the likelihood of having to care for hundreds of patients at a time when available burn beds are rapidly declining.
As New Jersey’s only designated burn treatment facility, The Burn Center at Saint Barnabas invited burn centers throughout the northeast region to come together and address this issue. Twenty-seven centers have joined to form the Eastern Regional Burn Disaster Consortium. A first of its kind in the nation, members meet quarterly to focus on joint communications, patient tracking and resource-sharing during disasters.
New Jersey hospitals, consortium members and The Burn Center at Saint Barnabas also created a new Web-based Burn Center Transfer Network to coordinate the triage and transport of patients with local and regional EMS.
Overseeing and implementing these disaster initiatives is the responsibility of a new burn emergency preparedness coordinator. The nurse educator serves as a liaison for all emergency personnel and healthcare providers statewide, educating them about how to effectively integrate with The Burn Center in the event of a mass casualty incident.
Ten years ago, 9/11 was a wake-up call for EDs across the nation. As a large hospital just north of the city, we received patients who were in the city as the towers fell. Our colleagues lost husbands, brothers and neighbors. At WPH, an area was commandeered to meet the needs of the EMS and fire personnel who were involved in the rescue. Gallons of blood were donated within the first week.
Since 9/11, we have re-examined and revved up our disaster management. Working closely with our emergency management coordinator, we hold drills to test our capabilities. On a yearly basis, we require staff to renew their knowledge of burns, along with their ACLS and PALS certifications. Staff have been sent to venues such as the U.S. Military Academy to gain knowledge of their disaster management systems. We created a stockpile of equipment and retrofitted our ambulance entrance to include decontamination for potential victims of radiation and other biologic hazards.
As manager, I attend regional meetings and work closely with the county to maximize our coordination of resources. While our job still is to take care of each patient as he or she enters our ED, we are much more prepared to deal with the “what ifs” of an uncertain world.
Tracey Boyd and Janice Petrella Lynch, RN, MSN, are regional reporters. Send letters to editorNY@nurse.com or post a comment below.