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November 27, 2018 (Cleveland)

Tornado Scenario Tests Region’s Patient Evacuation Capabilities



Patient-Evacuation On Nov. 14, a tornado hit Northeast Ohio, requiring five area hospitals to evacuate a total of 1,000 patients. Or at least that was the scenario used in an exercise designed to test the region’s acute-care patient evacuation and transportation capabilities. The exercise, which was the second of its kind, was the culmination of a months-long planning process and included new tactics based on the first occurrence, including a workshop held Oct. 5.

The October workshop, planned by the Northeast Ohio Metropolitan Medical Response System (MMRS) Healthcare Coalition, drew together more than 35 individuals from five counties to discuss a multiple-hospital evacuation scenario, the resources that would be needed, and the roles of partnering agencies that would be utilized to ensure safety during a patient evacuation caused by a natural disaster. The workshop was organized by county and included players from emergency management agencies, emergency medical services, public health, and hospitals. Additional Centers for Medicare and Medicaid (CMS) healthcare agencies needed in this type of response, such as nursing homes, rehabilitation hospitals, behavioral health facilities, hospice, and home care agencies, were welcomed to attend the discussion.

Coalition Surge Test Exercise

The November event was a low-notice Coalition Surge Test (CST) exercise, which is a mandatory activity under the Hospital Preparedness Program (HPP) grant awarded through the U.S. Department of Health and Human Services Assistant Secretary for Preparedness and Response. This grant is administrated by the Ohio Department of Health and sub-granted to The Center for Health Affairs, which writes and coordinates the required exercise on behalf of the hospitals. Those hospitals participating and benefitting from the regional federal grant are required to at least minimally play in the exercise as their schedules allow.

With an average daily census across the region of 5,176, the goal was to test the evacuation of approximately 1,000 patients, which caused a subsequent surge scenario at the other participating facilities. Participants in the exercise included all 27 of the region’s hospitals, five of which volunteered to act as evacuating hospitals, along with public health, public safety, county emergency management and 29 other agencies required by CMS to engage in preparedness planning and community-based exercises.

As part of the CST exercise, the hospitals that were asked to self-designate as evacuating hospitals were called to their command centers on the day of the exercise and told they would need to evacuate in four hours. They were to activate their emergency operations plans and contact the agencies that would assist them, according to their written plan. All five hospitals were able to quickly identify beds and transportation modes for the patients who needed evacuation.

Collaboration & Training Are Critical to Disaster Response

Healthcare agencies play a variety of roles in responding to disasters, including providing emergency medical care, providing temporary shelter and expanding primary care services to meet increased community needs created by damage to other health facilities. Healthcare agencies may also provide mental health services to disaster victims and serve as a conduit for information dissemination to affected communities.

Since hospitals and other healthcare organizations are not equipped to respond definitively to all disasters and their roles may be constrained by limited resources as well as by the impact of the disaster on their facilities, planning with partner agencies that will assist with response is vital. 

Planning, training and testing different scenarios are the backbone to good emergency management and emergency preparedness. By validating written plans, policies, agreements and procedures, and addressing gaps in those plans utilizing drills and exercises, the expectation of the roles and responsibilities of each agency involved in a healthcare disaster can be readily called into action and relied upon to save lives.

For more information about this patient evacuation exercise and other Northeast Ohio hospital emergency preparedness activities, contact us.