PC3037: Pediatric Hospital Readiness- minding the Gap

Purpose/Objectives: Abstract: The lack of pediatric preparedness capabilities in non-pediatric hospitals has consistently been an identified gap in the realm of emergency management. Hospitals across the country are ill prepared for meeting the needs and challenges of caring for this vulnerable population during a disaster. Being the sole pediatric hospital in a county with 713,000 children located within a 10-mile radius of Disneyland and Knott’s Berry Farm further amplifies this gap. Preparing for large scale disaster events requires the implementation of innovative training and exercise techniques to improve hospital disaster response planning effectiveness.

Overview: “Stressing the system” is the approach we utilized in preparing to fill the identified gaps by expanding our capabilities. Collaborating with our city and county stakeholders, planning, and conducting an integrated enterprise-wide exercise at two separate locations simultaneously posed many challenges. Stressing our capabilities resulted in identifying improvements that could only be discovered by conducting an exercise of this magnitude.

Objectives:
• Identify key planning strategies in preparing for a large-scale disaster response
• Define the pertinent stakeholders in expanding response efforts
• Demonstrate the improvements and lessons learned to enhance capabilities

Design/Methods: Two concurrent full-scale exercises were conducted to evaluate on-scene medical coordination, pediatric patients transport, patient tracking, surge capabilities and the hospital's mass casualty incident response. The process included the establishment of an external triage and treatment area in under 15 minutes to receive a minimum of 50 victims. This exercise included 109 nursing student volunteer victims that were triaged, treated and transferred to appropriate departments in our facility. This exercise also included the integration of the Trauma department to establish secondary and tertiary triage to identify highest priority patients.

Results: Many strengths and areas for improvement were identified through the conduct of an exercise of this magnitude.
Strengths included; Treatment area was established in under 9 minutes exceeding previous "best times". Hospital Command Center (HCC) established < 15 minutes and the assumption of roles and responsibilities.
Areas for improvement; Communication from treatment area to the HCC. Supporting roles were unclear and supplies and equipment were inadequate to meet the large number of victims. All identified improvements have since been implemented.

Conclusion/Discussion: “Stressing the system” is the approach we utilized in preparing to fill the identified gaps by expanding our capabilities. Collaborating with our city and county stakeholders, planning, and conducting an integrated enterprise-wide exercise at two separate locations simultaneously posed many challenges. Stressing our capabilities resulted in identifying improvements that could only be discovered by conducting an exercise of this magnitude.