Safety First At Hospitals

February 20, 2006
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GRAND RAPIDS — In health care facilities, there isn't always a place for everything, yet everything must be kept in its place. Hospitals must be designed to grow and change in order to accommodate a constant influx of new technologies and new equipment. Although it's hard to say what the emergency room of 2015 may look like, all three of West Michigan's major health systems are designing new facilities with the flexibility to adapt to the changing technology and changing methods of medicine. And all three are designing their facilities around one central concept: safety.

While safety has always been a primary concern for hospitals, the word has taken on a new meaning in the last five years. Not only do hospitals plan for the best clinical care and a safe work environment for employees, they are also looking at disaster preparedness in a new light.

"If you were building a new center and a new emergency department five years ago, disaster management might be pretty low on your priorities from a design standpoint," said Mark Iverson, manager of organizational integrity at Saint Mary's Health Care. Later this year, Saint Mary's will break ground on the HauensteinCenter, a new multi-use facility that will house several specialty practices and a dramatically larger emergency department. Iverson said that the design of that department has been greatly influenced by the need for disaster readiness.

"So now, we make sure we include decontamination protocols in our design. We make sure we include specific air-handling issues in our design. We make sure we have a specific place for our (decontamination) tent, that we have access, that we have showers. Again, five years ago? That's a much lower priority," he said.

The decontamination tent is one of many new pieces of equipment that have become standard issue in dealing with potential terrorist or natural disasters. Through federal Homeland Security funding, all of the local hospitals have received portable disaster readiness equipment, including decontamination tents. However, even when collapsed, the tents take up a substantial amount of space — a precious commodity in a crowded emergency room. The federal grants do not include extra funds for building closets to accommodate the equipment.

"Right now our emergency department has virtually no storage," said Iverson. "Well, we've got a huge decontamination tent. We've got generators. We've got heaters. We've got (personal protection) suits. Where are we going to keep this stuff? We don't want it across the campus from the E.D. We want it accessible."

Not only will Saint Mary's new emergency department have more storage space for personal protection suits and other safety equipment, it will have some disaster readiness equipment built in. Decontamination showers and, eventually, radiation detection equipment will be in place at the downtown facility.

That's reassuring to Tim Bulson, regional preparedness coordinator for KentCountyEMS. Bulson helps local hospitals, law enforcement agencies and first responders work together to prepare for disaster response.

"One thing we're always interested in with hospital remodeling and expansion is whether or not they are including any enhanced decontamination facilities. There's kind of a trend these days that hospitals — whether they're expanding and remodeling an emergency department or building anew — are very conscious of that need," he said. "When it comes down to joint planning and preparation, and protection of staff, that's one of the big things we look for. We're encouraged to see that."

Facility design is one major factor in disaster readiness, but it is worthless without proper training. Bulson and his colleagues have helped ensure that West Michigan's health care personnel are ready to face any number of emergency situations.

"There have been a number of things that have been instituted since 9/11. We have practiced dealing with biohazards, with bioterrorism," said Bruce Rossman, a spokesperson for Spectrum Health. He said that Spectrum has even been considering these factors in the design of its new Helen DeVos Children's Hospital. Dealing with potential terrorist threats and other large-scale hazards means reconsidering the nature — and the location — of medical treatment. "We've coordinated well at the state and federal level to get not only training, but additional materials here in KentCounty and at the hospitals — like biohazard suits, and decontamination tents that can be set up quickly so people can be partially decontaminated before they get to the hospital. So we have practiced dealing with those sorts of things."

Having portable equipment means that instead of taking disaster victims to the hospital, the hospital can come to them.

"Our equipment is a lot more mobile. So we don't have to solely depend on facilities and having those facilities available," said Jamie Crouch, safety officer for Metro Health. "We have the equipment in a 16-foot trailer. We've got decontamination, personal protective equipment. And with that 'de-con' unit, you've got a portable water heater and a generator. The only thing that you would have to plug into is a water source. That's it. It's self-sufficient."

That self-sufficiency has also caused Metro to take a slightly different attitude toward disaster readiness in its new WyomingMetroHealthVillage facilities. He said that instead of building decontamination facilities into the new hospital, Metro will rely more on its portable equipment, setting up a decontamination perimeter in the case of a disaster.

"It's kind of a different mindset," Crouch said. "A lot of facilities try to build those features in. What we got to thinking about, especially with a lot of terrorism education, is that we really need to look at having this outside. Because if we've got a situation, say, on the north side of the state and they need the resources, and we're not affected by it, they can pick up these trailers and take them up there."

In all of the making ready for potential terrorist strikes, the local health care community has realized that its newfound equipment and training comes in handy for other potential disasters as well. Bulson said this is an unexpected upside.

"What we've all learned in the past couple years is that all of the equipment and the technology and the training that we've gleaned from grant dollars for potential terrorism response — those lessons apply to all disasters," he said. "They could work for a terrorist event, but they could also work for an accidental chlorine gas release, or the needs resulting from an ice storm or a power outage or a tornado. … Those would be dollars that hospitals would really struggle to find on their own, and the grants have really helped to fill that gap."    

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