Kim Phelan, Editor
Disaster preparedness is one of the cruel realities with which healthcare professionals must contend today, more so than probably any other generation of caregivers — because while there have always been wars, disease, natural disasters and fanatics to create mass impact on the general population, the convergence of all these factors plus the threat of terrorist devastations has shaped our 'be-ready-for-anything' culture.
In this issue, Managing Editor Maureen Leahy presents a discussion and offers resources related to both the IT side of preparedness as well as the critical care aspect of triaging hundreds or thousands of seriously sick or injured people. In addition to the vendor solutions she shares, I find efforts from groups such as the Society of Critical Care Medicine to be especially noteworthy. For example, an SCCM collaborative Work Group on Emergency Mass Critical Care published its recommendations in the October issue of “Critical Care Medicine.”
The recommendations propose which critical care interventions should be given highest priority in scenarios of bioterrorist attacks or epidemics. They also provide guidance about how patient triage decisions should be considered, how to make the best possible use of highly skilled medical staff, how to make the best use of a hospital's physician assets to deliver critical care, which infection control procedures should be given top priority and which medical equipment and classes of medications should be held in reserve for these crises.
I came across another important emergency readiness resource several months ago when I interviewed facility- and workflow-simulation modeling expert Rainer Dronzek from Automation Associates in Chicago. Although most of that published Q&A from our June issue covered practical decision-making facilitated with simulation modeling that Dronzek's company customizes with a hospital's specific data, he also described the great, untapped power of simulation modeling to aid in disaster planning.
“One of the nice things about simulation is, in many cases, it's the only quantifiable method to understand how a system reacts or responds to an emergency,” Dronzek said. “I know hospitals do live simulations, but it is a huge undertaking, and they can't always simulate exactly what is going to happen. But with the computer-based model, we can create a model of a hospital — or a community — flooded with 20,000 patients. The most intriguing part would be to assess not only how a single hospital responds to an emergency situation, but how does a metropolitan area respond. Simulation modeling allows you to look at the five or 10 hospitals in the system and create an approach for dealing with a large-scale disaster, including the transportation that has to occur between those hospitals in a disaster site.
“We can model things that are very difficult, such as large influxes of patients and different kinds of patients with different specific needs based on their acuity or types of injuries,” Dronzek continued. “We can also look at equipment failure, the ambulance system response and then the overall metropolitan response.”
The burden of saving lives is not new to you medical professionals, and neither is the dexterity with which you maximize all the technology resources at your disposal. I believe Dronzek's technology is a perfect example of how smart IT tools, in the collective hands of healthcare, can be channeled toward powerful life-saving feats — ones that we sincerely hope will never be needed.
Thanks for reading.
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