The time to figure out how to respond to a disaster isn’t while the event is bearing down on you. The time to prepare is now. With that in mind, the Johns Hopkins medical campus participated in two drills recently to test how we would respond to a mass shooting or the admission of a pregnant patient with a highly infectious disease.
Led by the Johns Hopkins biocontainment unit, the emergency departments and the Johns Hopkins Office of Critical Event Preparedness and Response (CEPAR), the drills also evaluated how various departments would handle communications, operations, security and other processes to ensure the hospital maintains business operations and patient care.
One drill involved a mock patient who had an unknown highly infectious respiratory illness, and was eight months pregnant and in labor. The patient presented to the Johns Hopkins Outpatient Center clinic, and the Lifeline team had to transport the patient by ambulance to the hospital’s biocontainment unit. There the clinical team simulated delivery of the baby using lifelike mannequins of the patient and child, while addressing how to keep staff members safe from infection.
“While it is unlikely we will ever encounter a laboring Ebola patient in the flesh, every little bit of preparedness helps,” says Dianne Whyne, director of operations for CEPAR. “Our goal was to be proactive. We need the staff on this unit to function at a very high level of readiness to care for patients with dangerous diseases like Ebola.”
The scenario of the second drill involved a mass shooting at a popular location in downtown Baltimore, which brought about 60 mock patients with varying degrees of injury to The Johns Hopkins Hospital emergency departments. Nearly 250 faculty and staff members and volunteers—including students from Eastern Technical High School and Paul Laurence Dunbar High School for Health Professionals, who wore wound makeup—came together to plan, respond and participate in the drill to test the hospital’s ability to deal with an influx of patients during a mass casualty event. This involved ensuring the hospital had enough physicians, nurses and staff members on hand, finding sufficient operating rooms and equipment, and planning how to communicate with distraught families looking for information on their loved ones.
Jim Scheulen, Johns Hopkins Medicine’s chief administrative officer for emergency medicine and capacity management, says, “You never know when an event such as this is going to happen. It’s critical that you test yourself and find out if you have flaws in your system, so you can fix them before a real event occurs.”
As with any emergency situation, the hospital’s incident command center, with staff members from patient care, facilities, security, marketing and communications and other departments, was activated for both drills. Robert Maloney, senior director of the Office of Emergency Management for the Johns Hopkins Health System, says, “Every opportunity to activate gives us a chance to practice developing incident action plans, situational assessments and communication strategies.”
Overall, drill organizers say, the exercises went well, but there were some takeaways for future planning, including the importance of patient- and family-centered care and patient empathy no matter how rushed the team is during an emergency. Organizers also plan further practice with the incident command system.
Maloney says the drills showcased the importance of timely and accurate information during each scenario. Two-way radios were extremely effective for communications, and Maloney’s team is looking at ways to expand their use throughout the incident command system.
Drills scheduled for February at The Johns Hopkins Hospital include an exercise involving the biocontainment unit and a separate hospitalwide pandemic flu tabletop exercise.