Families found support in Sunnybrook after rampage
Centre based on model created after Sept. 11 terrorist attacks
Within a half-hour of getting the call about the van rampage on Yonge St., staff at Sunnybrook Health Sciences Centre had transformed an auditorium into a hub for family members trying to find loved ones injured or killed at the scene.
The Family Information and Support Centre (FISC) is based on a model created after the Sept. 11 terrorist attacks in New York to reunite families during a disaster. It was activated for the first time last week when Sunnybrook called a code orange for mass casualties.
“I would have to say that we sprung into action very quickly not knowing the specifics,” said Sunnybrook’s Illana Perlman, who led the co-ordination efforts.
Ten patients were killed last week when a van mounted the sidewalk near Yonge St. and Finch Ave. and began striking pedestrians. Sixteen others were injured. About two dozen response vehicles were dispatched to Yonge St. on April 23, with most emergency runs routed back to Sunnybrook.
Perlman, a social worker with 26 years of experience, said she heard the code orange called on the hospital’s overhead system and rushed to the emergency department. “When we saw the numbers of ambulances arriving and the numbers of people being brought in through the doors — because we were all stationed in the emergency (room) — it was clear to me that we needed a FISC.”
She called in staff and they immediately cleared out the auditorium, which was being used for an education event. They set up large tables, snacks and water bottles, registration desks and room dividers for privacy.
The FISC is more than just a waiting room, Perlman said.
“(It’s) an interprofessional group of people that focuses on the psychological, the emotional, and the social needs of the family members, which at the very onset of such a mass casualty really speaks to the need to know where their loved one is and how they are. Bottom line.”
Social workers, psychiatrists, chaplains, occupational therapists and volunteers filled the space and tended to dozens of families, who began surging in a couple hours later. They gave them the most up-to-date information on the whereabouts of victims and provided support for those waiting for updates on their loved ones. But it was not without its challenges.
While having a central information hub for families sounds straightforward, there were limits to the kinds of information different hospitals could communicate to each other due to patient privacy concerns.
“There were also a number of patients at area hospitals, and although we liaised with those hospitals, there were privacy implications that prevented them early on in disclosing who those family members were,” Perlman said.
A number of families were waiting for several hours for information on victims who were later determined to be killed at the scene.
“That was very challenging, because to waste half an hour, let alone two or three … waiting and not knowing, and us not being able to tell them … We could see a number of them escalating, understandably, emotionally and feeling very upset,” she said. “It was heartbreaking to watch.”
The hospital will soon have a debriefing on how it handled the code orange, and identify improvement areas for the FISC.
Perlman said she had to resort to using her own cellphone to take photos from family members of possible victims, and pass them along to the Hospital Emergency Operations Centre to see if police on that team could help make identifications from the crime scene. This is one of the processes that can become more sophisticated going forward, she said.
“Given the circumstances, I was extremely impressed with how every part of our team worked, and it really flowed seamlessly considering we’d never done it before for real,” Perlman said.
There isn’t currently a FISC plan set up to include integrating information among all GTA hospitals.
“I can’t just blame it on a Canadian thing,” said Alan Dick, a Toronto social worker who specializes in disaster medicine, referring to patient privacy laws that make information sharing between hospitals a challenge.
“This exists across North America … It is a generally setup belief system and they don’t have any central portals anywhere that I know of.”
Dick, who has spearheaded past FISC efforts, witnessed the need for centralization in disaster situations while working with families during the 9/11 attacks. “I was taking people to Ground Zero three weeks afterwards, and for … some of those families, they had gone to every hospital in Manhattan and New Jersey, which is about 60 hospitals,” he said.
Though there is limited academic research on psychosocial responses to mass disasters, Dick said, “There is a lot of anecdotal information out there that shows that families go looking for their loved ones no matter what.”
In Toronto, he helped create a FISC plan in preparation for the G20 conference in 2010. That plan included co-ordinating information among 10 hospitals plus one reception centre in the GTA. All the hospitals had to sign onto the reunification plan to facilitate the sharing of information, which happened at 11 p.m. the night before the conference and was only valid during its duration.
“Hospitals are fast becoming aware that they need to be prepared to deal with families and psychological casualties, and those kinds of things, and not just the injured patients.”