Modern Healthcare – August 19, 2019

August 19, 2019 | Modern Healthcare 29

A collaborative ‘all-hazards’ planning process

brings the best response to the worst situations

By Michael Wargo

T

his is a column I wish I were not writing. On back-to-back weekends recently,

HCA Healthcare hospitals in San Jose, Calif., and El Paso, Texas, provided

trauma care to victims of mass shootings.

Michael Wargo

is vice president

of emergency

preparedness at

HCA Healthcare.

Amid the mayhem, our Regional Med-

ical Center of San Jose (which treated

victims from the Gilroy Garlic Festival)

and Del Sol Medical Center in El Paso

worked hip to hip with their everyday

competitors in a coordinated, collabora-

tive race to save lives.

While the response was immediate,

our mutual trust was long in the making,

thanks to the 3Cs that guide sound com-

munity disaster preparedness—com-

municate, coordinate and collaborate.

Because of our geographic reach and

scale, HCA benefits from comprehen-

sive emergency planning shared across

a 184-hospital system that includes a

dedicated enterprise emergency re-

sponse team and cutting-edge com-

munications technology. Every HCA

hospital also individually prepares for

worst-case scenarios, and that prepa-

ration has saved lives after events in-

cluding natural disasters, major traffic

accidents and mass shootings.

Whether a stand-alone facility or part

of a larger system, every hospital should

take steps to be in the best possible po-

sition to respond to its community’s

needs. This starts with the right mind-

set. Caring for the victims of a tragedy

is an essential community responsibil-

ity that hospitals and their physicians

and nurses bear alongside emergency

responders, public health officials and

political leaders. Hospitals must con-

template threats and prepare. These

threats could be man-made intentional

events (shootings), man-made unin-

tentional events (car accidents), natural

events (hurricanes), or even technolog-

ical events (cyber events). A unified or

“all-hazards” process brings the best re-

sponse to the worst situations.

Leadership should make emergency

operations a top priority and participate

in planning and drills. To be most effec-

tive, duties for emergency operations

must be worked out in advance so a

leadership structure is in place.

Adequate preparedness is not an

individual activity. When tragedy strikes,

collaboration is key, even among fierce

competitors. There is rarely time for in-

troductions. This is why hospital leaders

must be fully engaged in regional health-

care coalitions dedicated to emergencies

before a disaster strikes.

Run under the aegis of HHS’ Office of

the Assistant Secretary for Preparedness

and Response, regional coalitions con-

vene key actors to plan a community’s

response. These include hospitals, EMS

providers, emergency management or-

ganizations, public health agencies, and

others in a defined geographic location.

Hospitals share information about capa-

bilities, including personnel, equipment

and crucial supplies such as blood.

Many hospital leaders hesitate during

emergencies because they might not

know what is allowed or legal. But with

mutual aid agreements and legal ex-

emptions in place, you can focus on

doing what is right for patients without

hesitation. The collaboration lets public

authorities know in advance who is best

equipped to care for whom.

That is how EMS personnel in El Paso

knew without asking to take children

to our competitor, University Medical

Center, also a trauma center, which has

a children’s hospital on-site, and bring

older victims to Del Sol Medical Center’s

Level II trauma unit. Through standing

agreements, military physicians from

William Beaumont Army Medical Cen-

ter were integral participants at the El

Paso trauma centers, and surgeons from

across our Las Palmas Del Sol Health-

care system treated patients in our Del

Sol Medical Center.

Finally, planning for the next disaster

should begin as soon as the most recent

one ends. Immediately following the

shooting in Las Vegas in October 2017,

HCA’s Enterprise Emergency Opera-

tions and our colleagues at Sunrise Hos-

pital and Medical Center, who cared for

more than 200 victims from that tragedy,

began compiling lessons learned. That

is taking place already in California and

Texas. Leadership will look at best prac-

tices and areas for improvement. HHS’

website also shares lessons dedicated to

disaster preparedness.

America’s hospitals must be prepared

for the worst emerging scenarios and

pray they never happen. But when they

do, community cooperation made pos-

sible by communication, collaboration

and coordination saves lives. l