Ambulatory visits had to be cancelled or rescheduled. Delivery trucks stopped delivering necessary supplies, such as fresh linens. Taxis and shuttles stopped running. The entire public transportation system of Boston was also shut down, which prevented hospital employees from getting to their jobs. At MGH, for example, around 8,000 of their staff members take the train to work. This forced MGH to ask the employees who were already on site to work overtime and work in other positions.
“We had building and grounds guys washing pans in the kitchen because we couldn’t get all the dietary people in,” says Michelman. “We had people doing everyone else’s jobs. Never has the public transportation system not run in Boston, except for just a few times for severe snowstorms. This had a major impact on us, and people were very antsy.”
The media was also reporting that one of the suspects was being treated at MGH, which angered some of the victims’ families. Although the reports were false, MGH staff spent a lot of time communicating with family members, calming them down.
Fortunately, the other suspect was apprehended that evening, so BMC and MGH, as well as the entire city of Boston, could get back to some semblance of normal.
Planning, Drills Pay Dividends
Despite all of the chaos that happened in those five days, both Packard and Michelman say their disaster plans and vulnerability assessments helped them manage.
“We have a hazards vulnerability analysis where you look at probabilities, and terrorism is one of ours as I’m sure it is others’, Packard says. “We look at the increase in volume. We [plan] critical care and how we do the patient surge: what patients can be moved out and what beds can be changed. It includes staffing pools, declaration phases A, B, C. As you go up higher, different things change. This whole incident had us in phase C. That also allows you to hold staff over, change normal business, and we have our own de-con team. In terrorism, you start to think about whether you have de-con issues.”
BMC also drills for mass casualty scenarios, such as plane crashes and train derailments. They have tabletop training and active shooter exercises, along with annual training involving local law enforcement and EMS. Additionally, BMC and MGH both prepare for big events, be they sporting, like the Boston Marathon, or political, like the 2004 Democratic National Convention, in which MGH played an active role with its law enforcement and emergency management partners from other jurisdictions.
Hospitals Appreciate Support from Peers, Public, 1st Responders
Throughout the five-day marathon bombing ordeal, both Michelman and Packard were impressed with the support they received from the general public, their on-campus stakeholders, local first responders and their peers at other institutions across the nation.
Hospitals from all over North America, including California, Michigan and Illinois sent pizzas to MGH. The hospital in Waco, Texas, which that same week experienced its own massive patient surge as a result of a fertilizer plant explosion in West, Texas, sent a big barbeque feast.
“We got so many calls and E-mails from friends from all over the place — California, Canada — that they were thinking of us. It really meant a lot to me,” says Packard. “As I reflected on the whole week, I thought about the people I knew who went through other disasters like Hurricane Katrina. I remember talking to them and some of my police colleagues at Sandy Hook. I always tried to offer support and learn from what they have, and here we are, doing it ourselves, which I never thought would happen. You can never say never.”
Hospital staff also stepped up to the plate. For example, one MGH doctor who ran the marathon crossed the finish line just before the bombs went off. Knowing that he would be needed at the hospital, he continued running the one and a half miles to MGH where he operated on 15 victims that day.
Packard was impressed with the help that the Boston University Police Department provided.
“It was very helpful to get them down here to help with perimeter control, which gave me the ability to pull [BMC] public safety officers back [inside our buildings],” she says.
Other first responders, such as the State Police, SWAT and Boston PD also worked well with BMC.
“Some may think that they have this one-ups-man-ship on each other; there was none of that,” Packard claims. “Everyone worked together with one mission in place, and that goes for the physicians too. We were pulling people from other clinics and putting them in the ED setting that they’re not comfortable with. It worked really well.”
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