Hospital Preps

Administration/ Medical director should be working with heads of depts, nursing,respiratory, environmentals (housekeeping, maint.,laundry), radiology , lab, pharmacy, dietary, accounting, voluteers, clergy. LOTS OF THE LAST TWO!

One of the biggest problems has always been security. Every new disaster has more and more CRAZIES -HOODLUMS- DOPE ADDICTS-PEOPLE THAT WANT ATTENTION-PEOPLE AFRAID-WORRIED- ANXIOUS-PEOPLE THAT WANT TO DESTROY JUST BECAUSE THEY CAN-- they will need at least 50 national guard at each facility, for each shift.

kr105 wrote: . I've never seen a well stocked supply department.  They rarely have more than two weeks worth of supplies in at any given time -- and to date it's not been a problem with Fed Ex and UPS overnight.    That being said, if this hits according to the forecast models - we probably won't have Fed Ex and Overnight UPS.    They need to get supplies in NOW.

Glad to see this post..I had heard it was less than a week.
    

Hospital adm know what they need to do and order. The problem is they cannot justify the expences on a "maybe" H5N1 will become a pandemic N95 masks are not even being bought 

Hi Janet,

Interesting Question.

It is  only  interesting   in  the   theoretical however,  because   healthcare   in  even  a 1918  style  pandemic   is not  going  to happen.

 My   wife  works  at a  major  HMO. Her  facility  does  not  have  more   than a   weeks  supply  of   things. The  other  day, her floor   was  out   of  beds, patients in the hallways. There  really  are  no  beds  available, most of the   time   they  run     around  90%. We live in Southren California. On an average day ER visit can take hours. In a pandemic waits will take days, In a pandemic people will be dying in line, people will be panicing, riots and violence  are almost a given.

 I can remember dropping her off to work in the final days of the LA Riots with  the National Guard with M16's outside the hospital. Security is going to be enough of a problem alone to shut down most hospitals, in a major pandemic. At the moment you could not guarantee even getting healthcare workers into the hopital safely, let alone working there.

Hospitals need money to prepare for a pandemic, they would need to be ordered to spend the money on pandemic preparations. They would need someone who actually had a concept of what it might be like in  a pandemic to marshall the additional resources.

I was brainstorming what it might take to make my wife's hospital capable to handle a disaster like BF.

The very first thing you would need are supplies, container freight after container freight of supplies.
You  could use these( container freight boxes) to cordone off the hopital and create a flow path in and out of the hospital. You woud need the National Guard and police as well as private security personal there 24-7. someone would need to be coordinating these people.

You are going to need a temporary morgue with huge capacity, and a way to get the bodies there.

You are going to need lots of temporary housing for the staff and security personal. It is not going to be safe or even possible to go back and forth from home in alot of cases.

If your employees are going back and forth to work how are they going to get fuel? Even if they ration fuel to essential workers only,  how will they get fuel in their cars? How are all these people going to eat? If your workers are all prudent and have two weeks worth of supplies stored at home, what is going to happen when your employees and families run out?

You would need a whole communication system for your triage staff, they may have to function blocks away from the hospital. Imagine triage people like Mcdonalds on a busy day where they take your order with a clip board and headset, but instead they have colored arm bands to hand out. Triage is going to need a security staff and lots of security people. Imagine a block long line, people with all various stages of Bf or other problems, Your triage person says "you need to care for  your child at home" the people with the sick child have been waiting for days. If it all works out security escorts them away after they refuse to leave ,if it does not other people start yelling saying I have been waiting all day and your telling me   I have to go home with my sick "child relative"  and riots break out. Where are the people in line going to get food and water? What about sanitation (restrooms, trash)

You are going to need tons of forms in carts, and mobile computing stations and data entry people. Admitting people will be a nightmare, it is very likely that your computer system will go down  anyway, do you have back up paperwork system? do you have someway to triage patients, Armbands,colored markers. Is there a  flow path to get people in and out of the hospital, is there a flow path for those turned away. You would need a PA system and messages going 24-7 about who should get care, who should leave, how long the wait might be.multi language fliers( hand outs to people explaining the admitting process and  criteria.

I could go on and on, It is not going to happen, healthcare will cease to exsist. A  Plan does not constitute being prepared.  Someone said they should look at hopitals that are well prepared to act as a model, there are no hopitals that are well prepared !

Fastcard has it right in his last paragraph.

Irene,

Everyone is going to be in the same boat stuck at home, I like your idea except they should just use the TV, in fact there should just be a health channel running 24-7 with info and training.

Information about caring for the ill could also be printed in the newspaper at first sign that the pandemic is starting. There are still a lot of people that do not have PC,s and they would have a source they they continually refer to and share.

I wonder about medical "experts" manning a phone bank so people could call in with specific questions and get answers tailored to their exact health situation.  It would have to be VERY large to attempt to handle the volume.  Perhaps it could include a call back / wait list feature so people can be  assured of getting an answer. 

Hi kr Thanks for the info. In my state if your at a facility [hospital LTC] and a replacement does not come to relieve you if you leave its considered abandonment. Thats how they will get away with charging nurses with a felony. I double checked this with the state nursing board and the gov. office. I hope your state is different. When I got the skinny I changed jobs toot sweet quick. with home care I have a shot at getting outta dodge.

steve 101 wrote: the Buzz Allen report for the govt  estimated that the USA would lose ALL internet and communication ability within day 4 of a pandemic starting. So look at no landline or mobile phones, internet, eftpos, creditcards, TV etc.

    Where did you see that report? I did a search on "Booze Allen" and pandemic or avian and
found nothing. Maybe in a news article?
The Internet is highly unlikely to go down. It at worst becomes fragmented, one part of it cannot
connect to another. In a typical hospital you have an INTRAnet that has a gateway to the INTERnet
and if the whole city's internet is down more or less the hospital still has its intranet which it can
use as usual, including dial up connections from anywhere in country. So I am looking for
more details. Public safety people tend to have multiple ways of communicating. You can
of course rig up a gateway between one hospitals intranet and another intranet in town
that does not rely on other nodes in town to be operational. At hospital drills I am at
they are finding new uses for computers to handle emergencies, and it is helpful to think of
as many problems as possible with communications to deal with. When I
worked for a systems provider for hospitals, all of our connections to the hospital were
duplicated over different kinds of facilites and different geographic routes, and we could
guarantee 99% hospital up time, and in real life do much better.
    

The whole report is at a link in the article, http://www.boozallen.com/media/file/Influenza_Pandemic_Simulation.pdf  where I found a lot of helpful ideas.  This simulation is in Europe by the way.

I guess I am the most pessimistic person here concerning hospitals.  I believe that within a week of the pandemic's arrival in town the hospitals will be worse than useless.  The vents will all be in use, the antivirals gone, the antibiotics soon to be gone, the housekeeping, and other support services non-existent.  There will be no beds available, the professional staff will be thinking they are showing up for no reason, and National Guard will be needed to control the angry crowd trying to get in, and the employees trying to get out.  I believe if this thing hits, the best, and only care any of us will get, will be home care. Hospitals will just be warehouses full of sick, and dying people.  I will avoid them like the plague. (Pun intended)

kr105 wrote: Hi Janet,  The law regarding patient abandonment requires you to have communication with the patient (saying Hi).  This became an issue in my clinic a few months ago.  Here is what happened:   --The provider was at another location for the afternoon.    --The women in charge of scheduling forgot to block her schedule and pt's were booked in   --Her nurse at the time is a real ding a ling (more than a few sandwiches shy of a picnice) and called the patients, vitaled them and roomed them.   -- Two hours later a patient came into my office (my office is next to hers) and asked where her doctor was?  She had a 1pm appt and has been sitting in the exam room for 2 hours.   (The clinic chief was called and the patient was seen by another provider.)   We were discussing this a few days later and the question of abandonment came up and because the provider never had communication with the patient, it was not applicable.

In a pandemic waits will take days, In a pandemic people will be dying in line, people will be panicing, riots and violence  are almost a given. ........................................................................................................................

Rather, measures will be taken by federal and state authorities to limit the movement of individuals within areas where cases of pandemic influenza have been discovered and to restrict travel to other areas.

 

from...

American College of Physicians. The Health Care Response to Pandemic Influenza.

Philadelphia: American College of Physicians; 2006: Position Paper. (Available from

American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.)

Copyright ©2006 American College of Physicians.