Out­sourc­ing pres­sure builds

N.M. hos­pi­tal puts dis­as­ter plan to the test

Modern Healthcare - - Front Page - F. Cur­tis Smith F. Cur­tis Smith is in­terim CEO of Los Alamos (N.M.) Med­i­cal Cen­ter.

Dis­as­ter plans. All hos­pi­tals have them, but few of us, thank­fully, are forced to im­ple­ment them. At Los Alamos (N.M.) Med­i­cal Cen­ter, the im­mea­sur­able value of a good dis­as­ter plan was demon­strated re­cently as fires threat­ened to con­sume our hos­pi­tal and com­mu­nity.

It be­gan on June 26, a Sunday, when a tree fell on a power line, sparking the first flames of what is known as the Las Con­chas fire, the largest in New Mex­ico his­tory. Dur­ing the next 36 days, the fire would char nearly 160,000 acres sur­round­ing Los Alamos.

As the fire be­gan, phone calls poured in to our hos­pi­tal. Where was the fire go­ing? Could the hos­pi­tal stay open? Our team ac­ti­vated the ini­tial stages of our dis­as­ter plan. We sent our ven­ti­la­tor pa­tients to other fa­cil­i­ties, con­nected with au­thor­i­ties mon­i­tor­ing the blaze and be­gan pre­par­ing for the worst.

On Mon­day morn­ing, the flames were spread­ing out of con­trol, and it be­came clear: The Las Con­chas fire was headed straight for our town. We held meet­ings ev­ery two hours to en­sure ef­fec­tive com­mu­ni­ca­tions, moved our re­main­ing pa­tients to safety, and co­or­di­nated with Los Alamos County to evac­u­ate the com­mu­nity. By 3 p.m., the hos­pi­tal and all of Los Alamos were of­fi­cially closed.

Over the next week, we held daily meet­ings and news con­fer­ences to keep com­mu­nity mem­bers in­formed and up­dated our staff via a 24-hour hot­line. We or­ga­nized food and shel­ter for the county’s cri­sis team, firefighters and emer­gency med­i­cal ser­vices unit. We worked with the state of New Mex­ico to turn our emer­gency room into a triage unit.

Once the fire was con­trolled, we part­nered with our com­mu­nity and our par­ent com­pany, Life­Point Hos­pi­tals, Brentwood, Tenn., to co­or­di­nate a mirac­u­lous hos­pi­tal restora­tion. The county could not lift the manda­tory evac­u­a­tion or­der un­til our hos­pi­tal re­opened. In just 36 hours, we re­placed all med­i­ca­tions ex­posed to im­proper tem­per­a­tures, re­cal­i­brated ev­ery piece of equip­ment and scrubbed our floors and walls of smoke. At 6 p.m. July 3, an­other Sunday, the hos­pi­tal passed state in­spec­tion and the county lifted the or­der.

Los Alamos Med­i­cal Cen­ter could not have weath­ered this dis­as­ter so well without prepara- tion. For starters, we col­lab­o­rated with our com­mu­nity. Our dis­as­ter plan in­volves mul­ti­ple fed­eral, state and lo­cal agen­cies. We cre­ated our plan with the feed­back and in­volve­ment of these par­ties, which helped us to be seam­less, pre­pared part­ners in pro­tect­ing our com­mu­nity.

We prac­ticed. Each year, we par­tic­i­pate in a coun­ty­wide, multi-agency drill to re­hearse our dis­as­ter plan, and our fa­cil­ity con­ducts a sec­ond, live drill with hos­pi­tal per­son­nel. This ex­pe­ri­ence was cru­cial.

Our plan was up­dated. A dis­as­ter plan has to be honed based on ex­pe­ri­ence, prac­tice ses­sions and the lessons of oth­ers. Our re­verse-911 evac­u­a­tion and com­mu­ni­ca­tion strat­egy, as well as our em­ployee hot­line, are based on our ex­pe­ri­ences with the Cerro Grande fire in 2000.

In the aftermath of the Las Con­chas fire, we are tweak­ing our plan. Dur­ing the cri­sis, we were threat­ened with an evac­u­a­tion of our emer­gency head­quar­ters, where the county’s only dis­as­ter re­sponse phone line was lo­cated, so we have added a mo­bile phone num­ber to our plan. We also are re­or­ga­niz­ing our phone tree for the county’s dis­as­ter team.

We planned to stay con­nected. We estab­lished a team of hos­pi­tal lead­ers who main­tained con­stant com­mu­ni­ca­tion with em­ploy­ees and med­i­cal staff. Our com­mu­ni­ca­tions plan­ning helped us keep ev­ery­one in­formed of what was hap­pen­ing on the ground and al­lowed us to mo­bi­lize teams quickly.

Los Alamos Med­i­cal Cen­ter es­caped the blazes of Las Con­chas and is now op­er­at­ing nor­mally. I am grate­ful to the fire bat­tal­ion that worked to en­sure our safety. I am also grate­ful for the hos­pi­tal em­ploy­ees and med­i­cal staff who worked with the au­thor­i­ties to see our way through this dis­as­ter. To­gether, we nav­i­gated the smoke and are bet­ter pre­pared for the fu­ture.

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