Riverbend City: Hospital Emergency Mission

Riverbend City: Hospital Emergency Mission

Introduction Modal: Welcome to Riverbend City

Expository Text

Riverbend City Medical Center has just hired recent DHA graduate Jodi Lundquist to be the hospital’s first Emergency Management Coordinator. This turned out to be a fortuitous decision, as three days after Jodi started the job a train derailed and caused a major chemical disaster. Unfortunately, the hospital’s Emergency Management Plan has not been fully updated to account for Jodi’s role-and the hospital personnel themselves are not all receptive to letting a rookie get to work right away under these circumstances. Jodi’s going to be having quite a day.

Instructional Text:

What would you do if you were the Emergency Management Coordinator for Riverbend City Medical Center during a chemical disaster? Watch how Jodi Lundquist takes on her new role. Evaluate how well she is following procedure and doing her job, and when appropriate, think of alternative strategies she might employ.

Characters in this Mission

• Eugene Pittman – Chief Executive Officer, RCMC
• Edmond Yee – ER Medical Director
• Beatriz Garcia-Chavez – MSN, Chief Nursing Officer, RCMC
• Samantha Carter – Registered Nurse
• Jodi Lundquist – Emergency Management Coordinator of RCMC
• Keith Lively – Director of Security
• Michael Blaine – Supervisor, MedAir Rescue
• Amanda Sherman – Executive Assistant to CEO
• Harold Essex – Chief Operating Officer

Scene 1: Riverbend City Medical Center, CNO’s Office

Expository Text

An early morning meeting between Eugene Pittman, CEO of Riverbend City Medical Center and Beatriz Garcia-Chavez is interrupted by news of the train derailment and the request for assistance. With time in short supply, Beatriz must determine how best to utilize her personnel resources.

Dialogue 1: An incoming call alerts Eugene and Beatriz to the disaster.

Communication and Organizational Effectiveness Essay

Beatriz Garcia-Chavez
This is Beatriz, how can I help you?

Amanda Sherman
Hi, this is Amanda. Is Mr. Pittman still with you? There has been some kind of incident in town and someone from EMS is trying to reach him.

Beatriz Garcia-Chavez
Yes, he’s here. I’ll put him on the line.

Beatriz Garcia-Chavez
Eugene, you’ve got a call from EMS. Apparently some type of emergency just occurred.

Eugene Pittman
Put him on speaker. This is Eugene Pittman. You’re on speaker phone with my chief nursing officer and my emergency room medical director. Who am I speaking with?

Michael Blaine
This is Michael Blaine from EMS. We’ve had a train derailment and chemical spill just west of the Clellen Bridge. Engine 9 has established the incident command and they’re assessing the situation. They’ve asked for additional medical help at the scene, though.

Eugene Pittman
I’ll activate the HICS and get the hospital command center up as soon as we’re done with this call.

Michael Blaine
Good. Apparently there is a chemical cloud that’s moving towards Ruby Lake. We’ve started evacuating the areas downwind, but I don’t know yet exactly what we’re dealing with … it looks like there could be a lot of casualties. We just don’t know yet.

Beatriz Garcia-Chavez
What are they asking for in terms of additional resources?

Michael Blaine
Emergency personnel-doctors and nurses. We’ve dispatched three ALS ambulances, but Captain Goodman wants at least five more nurses and a couple docs on site.

Eugene Pittman
We’ll have to take a look at our staffing. Beatriz – can you check on the nursing side of this and get back to Michael?

Beatriz Garcia-Chavez
Sure. Let me check with the unit nurse managers and I’ll get back to you as soon as I can.

Michael Blaine
Thanks. I’m also pinging Peggy Truman at the public health department for help in this area.

Edmond Yee
I’ll go ahead and pull Corey Gamble in. Michael, he would be replacing me this evening in here. I can send him to the site and if need be, I’ll pull a double here.

Michael Blaine
Thanks everyone.

Dialogue 2: The hospital leadership quickly move to implement the Emergency Operations Plan.

Eugene Pittman
Right then! I’ll have Amanda activate the emergency operations plan. I’ll see you both in the command center as soon as possible, yes?

Beatriz Garcia-Chavez
Absolutely. I’m going to have Ramona pull the staffing and acuity information right now and then I can get a sense of what we’re dealing with.

Edmond Yee
Good luck … I don’t know if I’d be willing to spare five people. Not when we’re likely to be getting hit with incoming patients ourselves.

Beatriz Garcia-Chavez
I wish I had a better sense of the situation at the accident. If people are critically injured, then nurses on site will save lives. On the other hand, prompt treatment in hospital could mean better recovery for the victims. I need more information!

Edmond Yee
I’ll get out of your hair and let you do what you need to do. See you in the command center.

Scene 2: Riverbend City Medical Center, Hospital Command Center

Expository Text

In the command center, the command staff attempts to prioritize problems, answer initial questions, and address the concerns of patients, staff, the media, and the general public. Unfortunately, they quickly realize that their Emergency Management Plan doesn’t account for Jodi Lundquist, the newly hired Hospital Emergency Management Director.

Dialogue 3: Eugene Pittman attempts to define working strategies and tactics for RCMC’s response to the train derailment – but fails to acknowledge the role of the new Emergency Management Coordinator.

Eugene Pittman
Alright then-we have a lot of work to do. Since it’s been a while since our last tabletop exercise, I think our first order of business needs to be reviewing our roles. We need to get right on the task of assessing operations and security considerations. Harold, that’s obviously you and your folks.

Harold Essex
Right. I’m emailing Keith Lively in security right now to get down here. I want him to alert his team now so that they can support the units-particularly the ER. People get panicked and they start acting like idiots. We need to make sure our people can do their jobs.

Jodi Lundquist
Well, that’s part of my role. Hi, everyone, I don’t know if you know me….

Beatriz Garcia-Chavez
That and they will need to be able to identify who should or shouldn’t have access. Depending on how staffing looks, we may be issuing staff privileges on an emergency basis. Keith’s people need to know how to deal with authorized personnel who aren’t in the system.

Eugene Pittman
That leads to you, Beatriz. You’re the planning section chief. That includes handling the medical staffing pool, which is why I want you on it. Obviously you’ll want to work with Ramona closely.

Beatriz Garcia-Chavez
Can do.

Jodi Lundquist
Um, Eugene, I…

Eugene Pittman
Edmond -you’re the medical care director, yes?

Edmond Yee
That’s right.

Eugene Pittman
Okay. First order of business is for you to get in touch with each of the departments and have them start assessing patients for possible discharge. I want to open up as many beds as reasonably possible. Allison Leighton up in PA is our Public Information Officer-she’ll need to be here. But you’re right-the last thing we need is for PA to be fielding calls in the command center.

I’m going to get Amanda down here to help us with some of these admin issues including handling the Job Action Sheets and the position vests. Marcus just emailed that he’s on his way in-I am going to have him wearing both the finance and logistics hats. I’m not sure who we have covering for the liaison officer since Toby is out on short-term disability-obviously me for now, but I am going to want to delegate that. I just don’t remember off the top of my head who the alternate is. Alright then … let’s get to work! Edmond, Harold-let’s huddle for a minute and talk about first steps here.

Jodi Lundquist
Eugene, I really hate to interrupt, but please here me out, everyone! You may not know me yet, but my name is Jodi Lundquist, and I’m the new Hospital Emergency Management Coordinator. I just started three days ago. I know that the official Emergency Management Plan doesn’t account for my role yet, but I was hired to coordinate situations like this.

Eugene Pittman
Oh, that’s right. I’m sorry. Everyone, this is Jodi Lundquist, our brand new Emergency Management Coordinator. You’ve been here three days, huh? I guess we’re going to be putting you to work right away.

Dialogue 4: Edmond Yee asks about emergency supplies.

Edmond Yee
The ER needs emergency supplies. We don’t know yet what kind of chemicals we’re dealing with, but we definitely need to make sure we have enough IV fluids, oxygen, bronchodilators, and pain medications. We also need decontamination suits for all medical personnel who might come in contact with a skin contaminant. Jodi, do you know the procedures for getting emergency supplies?

Jodi Lundquist
Well, there’s some information in the Emergency Management Plan. I could use a briefing on…

Edmond Yee
This is something we need to do right now. Eugene, we need to get our designated runners activated to get emergency supplies from our vendors and from other hospitals.

Eugene Pittman
How does that procedure work?

Jodi Lundquist
Well, according to the Emergency Management Plan, “The Hospital has established arrangements with its vendors to supplement routing supply/equipment needs during an acute or prolonged disaster situation…”

Edmond Yee
Jodi, I’ve read the disaster plan. I’m going to take care of this.

Dialogue 5: Jodi asserts herself and takes charge as the Emergency Management Coordinator.

Jodi Lundquist
Okay, with all due respect, everyone needs to work with me here. I know I’m brand new and that you don’t know me, but I was hired to be the Emergency Management Coordinator. If you let me do my job and work with me to fill in the details that I don’t know, I can help you all work more efficiently as a team.

Eugene Pittman
I’m sorry, Jodi. I’m afraid we’re all assuming the job duties we were assigned by the Emergency Management Plan before you joined us. We need to let you take charge. I know this must be quite an overwhelming situation to find yourself in.

Jodi Lundquist
That’s okay, Eugene. This is what I was hired for. Okay, so like I said, the Emergency Management Plan doesn’t account for my role and clearly needs to be updated when this all is over, but we need to work with what we have. Dr. Yee, when this meeting is over, can you supply me with a list of vendors and give me the information I need to secure emergency supplies?

Edmond Yee
I can take care of contacting the vendors.

Eugene Pittman
Let Jodi do her job, Edmond. I need you back in the ER. I’ll be checking back with her to make sure she doesn’t run into problems.

Jodi Lundquist
Thank you, Eugene! Dr. Yee, don’t worry. I’ve done this before-not for a disaster of this magnitude, but I do have some experience. I’ll let you know right away if things don’t go smoothly. Now, there’s also the issue of personnel and surge capacity. Beatriz, do we have enough nurses?

Beatriz Garcia-Chavez
I’m afraid we’re already short-staffed. I’m going to have to call in everyone who’s available and probably bring in nurses from area hospitals and clinics.

Jodi Lundquist
I can take care of bringing in nurses. I’ve already pulled up that information on my computer.

Beatriz Garcia-Chavez
Oh, good! That’s one less thing I need to worry about. I’ll be sure to update you on our nursing needs throughout the crisis.

Jodi Lundquist
Absolutely. But let me get started on contacting additional nurses right away because it sounds like we’re definitely going to need extra hands. I’m also going to be taking care of emergency credentialing. Volunteers can make a huge difference with surge capacity, but if they’re not coordinated well, they can actually make the situation worse. There are procedures for issuing emergency credentials to appropriate medical personnel in the Emergency Management Plan. Are those up to date?

Eugene Pittman
Yes, that part of the plan was updated about a month ago. It’s very important that these are followed closely or the hospital could be in a world of trouble. You’ll want to work with Keith Lively and the security team to make sure everything is in order. And let me know right away if you have any questions.

Jodi Lundquist
I will, Eugene!

Downloadable Files

• Riverbend City Medical center Emergency Management Plan
• RCMC Good Samaritan Policy

Scene 3: Riverbend City Medical Center, ER Waiting Room

Expository Text

With the Riverbend City Emergency Management Plan in hand, Jodi gets to work coordinating the disaster response.

Dialogue 6: Jodi coordinates with Keith Lively, the Director of Security, to arrange for emergency credentialing for appropriate medical professionals.

Jodi Lundquist
Okay, Keith, so the Emergency Management Plan says that we need to set up a credentialing center to process volunteers in the Graduate Medical Education office. Is there someone you feel confident to handle the credentialing?

Keith Lively
I sure do. I’ll call Earl Sanders and John Berger right away.

Jodi Lundquist
Great! I’d like to sit down with them to make sure they understand the emergency credentialing procedures in the Emergency Management Plan. Eugene Pittman made it clear that it’s very important for us to follow these procedures for liability reasons.

Keith Lively
I’m glad to see you’re taking this seriously. In addition to liability problems, unqualified medical personnel can pose a major security risk.

Jodi Lundquist
I know. However, it’s also important to mobilize qualified volunteers during a disaster. Does the hospital have an established list of disaster volunteers to call?

Keith Lively
No. At least not that I know of.

Jodi Lundquist
Shoot. I know a lot of states have disaster volunteer registries and Disaster Medical Assistance Teams that can be mobilized. I haven’t been here long enough to know what this state does. I’d better call Public Health to see what’s available. Also, I need to call Beck University Medical School to see if they can send us some volunteers.

Keith Lively
There’s an Army Reserve unit stationed in Fort Ventura. You might give them a call and see if they have anyone.

Jodi Lundquist
Good idea!

Keith Lively
We have one volunteer already. A family practice doc from out of state was coming in to the hospice to visit his aunt. He showed me his medical license and driver’s license, so he’s set.

Jodi Lundquist
Good. But let’s get him up to the credentialing center once we have it set up. We should make sure everyone gets officially registered.

Dialogue 7: Edmond Yee discusses the need for emergency supplies with Jodi.

Edmond Yee
Jodi, what’s the situation with emergency supplies?

Jodi Lundquist
Well, I just spoke with the state emergency preparedness team, and they were very helpful. They’re sending over blankets, saline solution, and dust masks. I think I have everything you asked for on the way. Oh, except… I don’t know what a brocco… bronco? Bronchodilator? Is that a large piece of equipment?

Edmond Yee
No, Jodi, bronchodilators are a type of medication. They facilitate airflow in patients who are having trouble breathing. The hospital has enough on hand right now but will almost certainly need more soon. You need to contact other hospitals and clinics in the region to see what they have available.

Jodi Lundquist
Okay then. I’ll do that right away, Dr. Yee. What other supplies does the ER need?

Edmond Yee
We need more calcium gluconate gel. That’s used to treat chemical burns.

Jodi Lundquist
I know what that is. I think we can get that by calling the Department of Environmental Health and safety.

Edmond Yee
Good. We need it as soon as possible, so let me know right away if there’s a problem.

Jodi Lundquist
I will. Dr. Yee. Oh… before you go, I just want to update you on the emergency credentialing. Keith Lively is setting up an emergency credentialing center in the Graduate Medical Education office. If any volunteers find their way to the ER…

Edmond Yee
I’ll send them up. I need to go, Jodi.

Dialogue 8: Samantha Carter, a nurse in the medical surgical unit, tells Jodi that she needs to leave the hospital.

Samantha Carter
Excuse me. Are you the Emergency Management Coordinator?

Jodi Lundquist
Yes, I’m Jodi Lundquist. What can I do for you?

Samantha Carter
I’m Samantha Carter. I’m a med surg nurse. Someone told me I should talk to you because you handle family issues during a disaster?

Jodi Lundquist
Yes, that’s part of my job.

Samantha Carter
Well, I need to leave. My supervisor says I can’t because it’s a disaster situation. But I don’t know where my son is.

Jodi Lundquist
What do you mean?

Samantha Carter
My son Logan… he goes to afternoon kindergarten at the elementary school right by where the train derailed. They brought a bunch of kids from that school into the ER who got exposed to the chemical cloud, and one of them died!

Jodi Lundquist
Oh no! Was he at the school?

Samantha Carter
I don’t know! He doesn’t go to school in the morning and stays home with my mom. But sometimes my mom gets called in to work and drops Logan off at the morning care center in the school. And I think she might have gotten called in, but I don’t know. She doesn’t have a cell phone, and I’ve been calling her home phone and work phone over and over again and I don’t know where they are.

Jodi Lundquist
And Logan’s father?

Samantha Carter
There’s just me. That’s why I need to go! I have no idea where my baby is. But I can’t lose my job either because no one else supports us. Does the hospital have any rules that might apply to me so I can leave?

Jodi Lundquist
I’m so sorry, Samantha! This is a tough one. Hospital personnel are not supposed to leave during a disaster, and I know the med surg unit is short staffed. But we do have contingency plans for emergency child care situations.

Samantha Carter
This is an emergency. Please, Jodi, I don’t know what else to do.

Jodi Lundquist
You should go take care of your son. Take care, Samantha.