One of these is the St. Louis Medical Operations Center (SMOC), which during an emergency serves as a center for collecting and disseminating current information about health care resources and needs (including equipment, bed capacity, personnel, supplies, etc.), developing priority allocations, tracking disbursement of resources and other relevant health care response matters.

The SMOC serves as a central point of contact between healthcare facilities and other governmental and non-governmental response agencies as necessary. A SMOC duty officer is assigned each month to act as the initial contact. This position is rotated among key hospital personnel who volunteer to serve in this capacity. The SMOC may be activated either virtually or may be physically activated to the local emergency operations center as part of ESF-8. SMOC has proven to be a significant resource to healthcare and other first responders in coordinating resources and providing information related to healthcare status in the region.

Hospitals Plan for Alternate Care Sites

Another key plan to assist with regional surge is the St. Louis regional hospital alternate care site (ACS) plan. The purpose of it is to enhance existing agency plans for m
anaging a disaster that creates a surge of patients — beyond regional hospital capabilities — by providing additional facility care to patients who would otherwise seek care at hospitals and community health centers. The purpose of this plan is to provide operational concepts unique to ACS response, document coordination and enhance response efforts when responding to regional healthcare demands.

Related Article: 21 Lessons Learned by Hospitals After the Boston Marathon Bombing

An adjunct plan to support surge is a St. Louis regional shelter medical support plan, which integrates a medical component into a shelter that may be opened by the American Red Cross or other recognized shelter management organization. The intent is to assist the sheltering model with a medical clinic to minimize overloading the regional emergency departments with non-acute patients who will be treated within the shelter environment. This is a regional healthcare volunteer program and is coordinated through regional EOCs, public health and the American Red Cross shelter manager.

By establishing partnerships within the medical center and throughout the St. Louis region, Washington University, BJC HealthCare and BJH have built a foundation that can support the needs of patients and staff in emergency surge situations.

Mark P. Bagby is the director of emergency management at Washington University in St. Louis, and Debbie Mays is the director of emergency preparedness and safety at BJC HealthCare.

---

Broken Water Main Puts Partnerships to the Test

Coordination efforts among the St. Louis Region, Washington University School of Medicine (WUSM), BJC HealthCare and Barnes-Jewish Hospital (BJH) were required during a 2012 event that caused the evacuation of patients from a one of the medical center’s largest buildings, the 17-story Queeny Tower.

It was a typical Fourth of July in St. Louis, with heat and humidity on the rise and red flag warnings issued due to drought conditions. The city needed moisture, but it came suddenly and from an unexpected source. Just after 10:30 a.m., a 20-inch water main burst, spilling millions of gallons of water on Kingshighway Blvd. at the doorstep of BJH, the city’s major Level 1 Trauma medical center. Within minutes, water began to penetrate the nearest building, Queeny Tower, which houses hundreds of patients, clinical labs and physicians’ offices. The flood waters soon reached electrical switchgear and the building went dark. A few seconds later, emergency generators began working. Although it sounds like the plot of a scripted TV series, this event was real for hundreds of patients, visitors and staff. More than 2 million gallons of water flooded the basement, overwhelming switchgear, HVAC systems and back-up generators. The flood and its aftermath trapped people in elevators and forced the evacuation and movement of 106 patients. 

The hospital’s emergency response team immediately set up an incident command center and notified the St. Louis City Emergency Management Agency (EMA) and the BJC HealthCare director of emergency preparedness and safety. Notification of this event was initiated both internally and to key responders and receivers throughout the region. The hospital then initiated internal processes to swiftly relocate patients and services. The St. Louis Medical Operations (SMOC) duty officer initiated a bed and staff request for all hospitals in the region and followed that with a regional conference call to understand the magnitude of the incident as well as what resources were needed. This was the first in a series of conference calls in which inpatient bed availability in the region was established, assessment of the region’s emergency departments was provided, and portable spot coolers were identified and dispatched to the hospital as a temporary cooling measure. Through coordination with St. Louis City EMA, assistance with movement of patients from the St. Louis Fire Department was initiated and direct contact with leadership of the city water division assisted in determining a clear understanding of the damage.

If you appreciated this article and want to receive more valuable industry content like this, click here to sign up for our FREE digital newsletters!

Related Content