Drills keep Northern Montana Hospital ready in the event a fire or natural disaster strikes
By Ron VandenBoom
It's an emergency anytime a loved one is admitted to the hospital. But what happens if instead of a patient, it's the hospital that has an emergency?
What happens if a fire ignites at Northern Montana Hospital or Northern Montana Care Center? What would happen if a disaster, like a train wreck or tornado, caused dozens of victims to converge on the hospital at the same time?
Answering such questions is the job of the Northern Montana Health Care Safety Committee, buildings and grounds manager Dave Kulzer, and safety officer Tim VanderMars. It's a responsibility they don't take lightly.
Hospital and care center personnel are required by code to have drills to prepare them for either eventuality. At least once a month the facilities conduct fire drills or disaster drills. Some of them are unannounced drills conducted by the Montana Department of Health and Human Services to insure hospital compliance, Kulzer said.
The hospital and care center document what occurs during each drill and the Safety Committee then meets to make corrections and suggest training for the staff.
Each new employee takes training for a possible fire or external disaster shortly after being hired. VanderMars spends about 3.5 hours explaining fire drills and hospital codes. Newcomers also receive training in Crisis Prevention Institute procedures for dealing with patients or visitors who may be upset or even hostile.
Trainees also learn the location of fire alarms, fire extinguishers and fire doors, VandeMars said.
"Then we actually observe a fire drill so that new employees can get an idea how our staff responds," he said.
According to VandeMars, the staff is trained to remove any potential victims of a fire, close the door to the room, and call the switchboard, dialing a code and giving the room number where the fire is located. They will also dial another code to establish an open line between the scene and the command team that will gather at the switchboard.
The switchboard will then broadcast a third code over the PA system. The switchboard will call the fire department and pages the building and grounds crew, which rushes to the scene of the fire. The first building and grounds crew member on the scene will serve as the fire marshal.
The fire marshal makes sure all the preceding steps have been followed and determines whether containment has occurred or if evacuation is necessary.
A backup system, activated by a smoke detector, sprinkler system or manually operated fire alarm, is also in place. The backup automatically notifies a service that alerts the Havre Fire Department.
Kulzer said any time an alarm is sounded, the fire department responds. The department has keys to the hospital and care center, plus floor plans. If they have not been notified that the alarm is part of a drill, he said, they will respond in full force.
Each department participates in the drills regardless of whether the "fire" is located near that department or not, VanderMars said. Everybody in the facility has a role to play.
Kulzer said the likelihood of a fire is slim because everything in the building, from drapes to furniture and ceiling tiles to waste baskets, is fire rated. In addition, every corner of the facility is equipped with sprinklers and smoke detectors.
Not all drills are fire-related. Drills that are meant to train personnel for external emergencies are equally critical.
An external emergency is any disaster that causes an sudden increase in the number of patients in the emergency room. This could include tornados, a train derailment, a bombing, or a large fire.
The disaster drills can be larger in scope, encompassing city and county planners as well as hospital staff. Planning has included the Havre police and fire departments, the American Red Cross, Hill County Sheriff's Department, and other agencies.
John Rosenbaum, vice president of professional services at the hospital, said drills using various scenarios that include city and county officials have been conducted.
"It's important to know that it isn't going to just be us," Rosenbaum said.
A manual governing the responsibilities of each department of the hospital and care center during a disaster has been compiled and is available in each department. All employees are expected to be familiar with the procedures, Rosenbaum said.
Elena Guevara, nurse manager for the emergency room, intensive care and behavior health units of the hospital, is primarily concerned with the delivery of patient and trauma care during a disaster.
She said all staffers have an assigned area they are to report to. Nurses who work in the emergency room or intensive care report to the emergency room where they will do triage, she said.
Patients will be reviewed when they arrive and will be assigned to the appropriate area for treatment.
Nurses who do not work in one of the specified areas report to a nursing pool in the cafeteria. Nurses can be assigned where they are needed from the pool, she said.
Hospital supervisers use a phone tree system to call in off-duty workers as needed.
Buildings and Grounds can be used in an emergency to do everything from direct traffic or provide security in the hospital.
Cafeteria staffers may be called in to provide snacks for waiting staff, relatives of victims or even the children of staff members who have been called in unexpectedly. Other staffers may provide day care for the children.
Medical records staffers could be used as runners, Guevara said.
Kathie Newell, public relations director for Northern Montana Health Care, has the responsibility of answering questions from the media, issuing press releases, and taking care of the clergy and family members.
"Everybody that works for the organization has a role," Guevara said.
Drills conducted in the past have used local Boy Scout troops or students from Robins School as victims in mock disasters. The victims are instructed to play the part as realistically as they can.
As in fire drills, administrators use codes to tell the staff what kind of disaster they are dealing with, said Rosenbaum.
The disaster code is DSR, he said. DSR Red is an indicator the staff will be dealing with chemical contamination, or radioactive material, and will require a slightly different approach that includes a decontamination unit.
All disaster drills, like fire drills, will be critiqued to ensure effectiveness, Rosenbaum said. Changes to the manual are common as things within the hospital change.
Continued drills for fire and disasters are necessary to insure adequate care is provided during the times it would be the most difficult to provide.