Thursday, February 11, 2016

Security and Emergency Management in a Major Hospital

Today, we had the great pleasure of hosting Mr. Thomas, Lynch, the Director of Security and Emergency Management at Baystate Health in Springfield, Massachusetts. This is a big level 1 trauma hospital, which, on some days, as happened last week with 397 patients, is the busiest hospital in terms of emergency room visits in Massachusetts. He has been the Director of Security at Baystate Health since 1995 and the Chair of the Emergency Management Committee for the Baystate Medical Center since 1997.  Prior to his arrival at Baystate, he served for 11 years as the Assistant Director of Security at Mt Sinai Medical Center in Manhattan and also served for 10 years as an officer in the Army Military Police Corps.

The title of Mr. Lynch's  presentation to my Humanitarian Logistics and Healthcare class was: Healthcare Emergency Management. 

Mr. Lynch emphasized the very dynamic, integrated process that is used in the hospital setting with an all hazards approach to emergency management. The challenges in such a setting are immense and his team, the hospital staff, and, of course, the medical professionals are constantly drilling and continuously improving their processes. He noted the importance of table top exercises and real drills.

He shared with us the following scenario: how an evacuation was handled from an Operating Room during surgery because there was smoke. Practicing fire drills had helped and the patient that was being operated on was moved safely to another room and the surgery completed. Think of the associated issues of sterility, for example.  

Mr. Lynch shared with us his wealth of experiences including the handling of VIP patients while he worked at Mt. Sinai Hospital in Manhattan. The VIPs, patients at separate times, included  a close relative of the Saudi king and a renowned Orthodox rabbi, whose supporters created surges. It was interesting to see, given that it was July, that there were men in raincoats around the hospital for the former (clearly with armaments beneath).

He emphasized all phases of disaster management, which we have been covering in class, and especially risk mitigation and the lessening of exposure to risk, with preparation and planning so that you can adequately respond. He said that more efforts should be spent on recovery. He noted how hospitals are accredited and the accrediting body shows up unannounced every three years (a bit different from the forthcoming AACSB team visit for the accreditation of our business school later this month). He also noted that Baystate Health in Springfield is one of three designated Ebola treatment units in Massachusetts and that unit is now complete after 1 1/2 years of planning and work.

Federal law requires that patients are treated according to the EMT law and the medical center has to prepare for surges of patients, as well. Sometimes, police assist in stopping influxes at the perimeter because there are only so many patients that can be handled. He spoke of surges, post 9/11, due to fears about anthrax.  At times, when there are casualties family members and friends can also cause congestion in the emergency rooms.

He emphasized "serving the most people that you can save" when it comes to a hospital evacuation and, ideally, one hopes just for a horizontal evacuation - to another part of the building, for example, rather than a vertical one (down stars). He mentioned a flood in Houston a few years back during which it took 8 staff members to carry patients down 6 flights of stairs.  We've learned from Superstorm Sandy that generators should not be in basements, which can flood.

He emphasized 3 things that are very important to remember and respond to in the order below:

1. Take care of yourself (this is hard sometimes for medical professionals who are always trying to save lives),

2. Take care of other people, and only then

3. Take care of property.

One has to manage the disaster and keep the hospital running, too. By federal law, a hospital is required to be self-sufficient, post a disaster, for 96 hours.

Mr. Lynch also noted the criticality of Medicare and Medicaid for the financial survival of a hospital and that immediately after an incident, the team gets together and identifies what can be done better. The focus on continuous improvement, I am sure, resonated with the Operations and Information Management and Industrial Engineering students in the class. He noted that similar incidents continue to happen so one must learn and improve and that could include getting a badge maker on site so that you can identify people promptly.

He also told the class that relationships matter with your partners and it makes matters so much easier and more seamless if you have good working relationships with the police and fire departments, the Department of Public Health, and also Homeland Security. He also emphasized that the Public Affairs department is crucial in dealing with the media since a hospital's reputation is very important.

The incidents that one worries about are so different from issues in the commercial space: mass casualties, which the hospital deals with on a regular basis, infant abductions, and, of course, surges, cases of violence, etc. I was also impressed that the incident commander can change from incident to incident depending on the situation and even time of day. The Chief Operation Officer, who is a female, would be in charge of many emergencies but the VP of Facilities would be in charge of those having to do with his responsibilities. At night, an administrator would be on call.

Mr. Lynch's presentation was very informative and fascinating and I am so grateful that such a professional would take tie out of his very busy schedule to share his experiences with my students. Having such guest speakers is invaluable for education.

His lecture can be downloaded here.