Lab “Day of Disaster” Provides Useful Lessons

Valuable insights about how to improve contingency and disaster response plans

CEO SUMMARY: On Friday, May 5, laboratory administrators and pathologists who guided their labs through some of the nation’s biggest natural disasters and emergencies will gather in Miami to share their experiences in contingency planning and disaster response. It is no understatement to say this knowledge can help your lab save lives and protect the well-being of lab staff during future emergencies and disasters.

WHETHER THEY KNOW IT OR NOT, laboratory directors and pathologists will be held to a higher standard of performance next time an emergency or natural disaster affects their laboratory.

Hurricane Katrina provided the most powerful example to date of the importance of effective disaster preparation and emergency response. This 400-mile-wide hurricane cut a wide swath of destruction, making landfall on the Gulf Coast and pushing deep into the United States with destructive winds and rain.

A large number of hospitals and laboratories were extensively damaged—and discovered there were often no functioning hospitals nearby to depend on for extra help (as planned) because they had been destroyed or severely damaged themselves. Some of these hospitals and laboratories based their disaster plans on the assumption that they could draw upon the resources of neighboring hospitals. With these neighboring hospitals destroyed or damaged, the ability to respond with maximum effectiveness was compromised. Media coverage of the most spectacular failures was swift, creating a public relations problem and longer-term business issues for some well-known hospitals in the afflicted regions.

To help all laboratories and pathology groups better prepare for these types of events, a special one-day program will take place in Miami on Friday, May 5. Titled “Readiness for Laboratories…with a Capital ‘R’!”, it is an optional program immediately following the May 3-4 dates for the Executive War College on Lab and Pathology Management.

This is an historic first for the laboratory industry. Coming together on the same day will be pathologists and lab administrators who have personally guided their laboratories through some of the biggest natural disasters of the past decade. They will tell their stories and share the lessons learned.

Get The Inside Story

These individuals have first-hand experience at guiding their laboratory through major disasters. For the first time, lab managers and pathologists responsible for contingency planning and disaster response at their laboratory will have direct access to this valuable experience and knowledge.

The list of laboratory and hospital “disaster case studies” is extensive: hurricanes, earthquakes, massive failure of the power grid, and SARS, to name a few. It is an unprecedented opportunity—one not likely to be repeated.

A rundown of the presentations reveals the scope and depth of what we refer to as the laboratory “day of disaster.” Opening the day will be Thomas Williams, M.D., who is Medical Director, Pathology at Methodist Hospital in Omaha, Nebraska.

Within the pathology profession, Williams has been at the forefront of contingency planning and disaster response preparation, both nationally and in his home town. He will discuss the specific requirements for disaster planning and how the laboratory’s plans must integrate into those of hospitals and the community at large.

In recent years, Williams has represented his hospital in planning and emergency exercises conducted by disaster response officials in Omaha. He understands how local, state, and federal efforts are designed to work collaboratively during disasters.

Concerns about bird flu, epidemics, and bioterror make the next presentation timely for all laboratories. It is a case study of the SARS outbreak in Toronto in the winter of 2003. Susan Poutanen, M.D., Microbiologist & Infectious Disease Consultant at Toronto Medical Laboratories (TML) and Mount Sinai Hospital in Toronto, Ontario, Canada, was directly involved, from start to finish, in the effort to diagnose what was then an unknown disease, treat affected patients, and control the spread of the disease.

Be prepared for some shocking lessons in laboratory management. TML is a consolidated laboratory organization, serving multiple hospitals and other sites. The emergence of SARS, transmitted by airborne infection, forced the laboratory to reconsider such basic issues as open space labs, the daily or weekly rotation of med techs between different hospitals and lab sites, and how the hospital infection control team should interact with the microbiology department during outbreaks of diseases spread by airborne transmission.

When The Power Failed

Remember the great power grid failure of August 2003? From Toledo, Ohio in the West to most of New York State in the East, electrical power failed and stayed off for more than 48 hours in many cities.

The laboratory department of Detroit Medical Center (DMC) in Detroit, Michigan, serves 10 hospitals and 1,900 beds. The extended blackout revealed many deficiencies in contingency planning. In Detroit, the power failure caused a shutdown in the municipal water system. This meant DMC’s labs could not produce de-ionized water. Another unanticipated consequence: with no running water in the hospital, toilets couldn’t be flushed. Other issues involved the ability to air condition the lab instruments, as well as the computer hardware running the laboratory information system (LIS). William Neeley, M.D., Medical Director of Labs at DMC, will discuss the lessons learned.

This same power grid failure is the backdrop on the session which deals with IT contingency planning and disaster recovery for hospitals and laboratories. Across town, at Hospital Consolidated Laboratories (HCL) in Southfield, Michigan, Gary Assarian, D.O., is Director of Laboratories. Something of a computer guru, Dr. Assarian created his own LIS that supports testing at HCL.

The 48 hour-long electrical black- out brought unanticipated problems to a well-prepared IT team. These ranged from adequate fuel for generators to complete failure of the telephone and cellular phone systems across Michigan. Assarian will share the “command center” approach to IT disaster response and how it performed superbly in dealing with problems unforeseen in years of emergency planning sessions and exercises.

Dealing With Katrina

Next up on this “Day of Disaster” is Hurricane Katrina. This unprecedented natural disaster is examined from three perspectives. First is the experience of the laboratory at the 580-bed Oschner Foundation Hospital in New Orleans, Louisiana. Oschner was the only hospital in the area which maintained services before, during, and after Hurricane Katrina and the flooding which followed.

One pathologist who was at Oschner during the entire crisis was Francis R. Rodwig, Jr., Chair, Department of Pathology and Laboratory Medicine. Emergency preparations at Oschner were extensive and the hospital is unique in having its own water wells.

But even detailed emergency plans could not prepare the laboratory staff for the natural disaster which unfolded hour after hour. With insufficient air conditioning in the lab to keep instruments cool, lab staff took hand-held point-of-care instruments into the hallways to run needed tests. Lab industry vendors played essential roles in enabling the Oschner laboratory to maintain services during and after Hurricane Katrina.

The second perspective on Hurricane Katrina comes from Houston, Texas, which saw 200,000 evacuees enter the city before, during, and after the storm. The three hospitals of the Harris County Hospital District sent laboratory staff and resources to the Reliance Center to create, on the fly, a full working laboratory to support lab testing needs of the 27,000 evacuees housed there and in the nearby Houston Astrodome.

How Labs Responded To Natural Disasters

Here’s the complete line-up for this special, one-day program on “Readiness for Laboratories…with a Capital ‘R’!” For full details, go to www.darkreport.com.

8:00 AM–9:00 PM Laboratory Contingency Planning and Omaha’s Disaster Preparedness Efforts–Thomas Williams, M.D., Medical Director, Pathology, Methodist Hospital, Omaha, NE

9:00 AM–9:50 AM Epidemics & Bioterror Preparedness: Lessons Learned from Toronto’s SARS Outbreak–Susan Poutanen, M.D., Microbiologist & Infectious Disease Consultant, Toronto Medical Laboratories & Mount Sinai Hospital, Toronto, Ontario10:10 AM–10:55 AM How the Laboratory at Detroit Medical Center Responded to 48 Hours without Municipal Power and Water–William Neeley, M.D., Medical Director of Laboratories, Detroit Medical Center, Detroit, MI

10:55 AM–11:45 AM Hurricane Katrina and its Aftermath: Contingency Plans at Oschner Foundation Hospital Keep the Laboratory in Operation–Francis R. Rodwig, Jr., Chair, Department of Pathology & Laboratory Medicine, New Orleans, LA

12:45 PM–1:35 PM Establishing the Emergency Laboratory During Disaster: Ben Taub General Hospital’s Laboratory “Moves” into the Astrodome–Sylvia Waller, Administrative Director of Pathology, Ben Taub General Hospital, Houston, TX

1:35 PM–2:20 PM Earthquakes: Lessons in Preparation, “Riding It Out,” and Staying Operational–Donald P. Sharar, Director of Laboratory Services, Northridge Hospital Medical Center, Northridge, CA

2:35 PM–3:20 PM How Laboratory Vendors Can Help During Disasters and Emergencies–John Kane, Director, Customer Service Operations, Abbott Laboratories, Inc., Abbott Park, IL

3:20 PM–4:05 PM IT Contingency Planning & Disaster Recovery for Hospitals and Laboratories–Gary Assarian, D.O., Director, Hospital Consolidated Laboratories, Southfield, MI

4:05 PM–4:15 PM Essential Lessons in Laboratory Readiness and Disaster Response–Thomas Williams, M.D.

Creating A Lab Overnight

Sylvia Waller, the Administrative Director of Pathology at Ben Taub General Hospital, was a key figure in organizing this ad-hoc laboratory. She will share the lessons learned. The lab team used roving phlebotomists to collect specimens, instituted a patient identification system, and provided a broad lab testing menu. Throughout the operation of this temporary laboratory, quality control standards were maintained at the same level as fully-accredited laboratories.

The third perspective on Hurricane Katrina comes from a major IVD manufacturer. John Kane, Director, Customer Service Operations at Abbott Laboratories, Inc., in Abbott Park, Illinois, will provide the remarkable stories of how lab industry vendors responded to the needs of laboratories operating in the areas destroyed or damaged by Hurricane Katrina. In the case of Abbott Laboratories, it moved its Architour trucks into the disaster zone. One operated as a mobile laboratory at Houston’s Reliance Center, in support of Sylvia Waller’s laboratory operation there. Another Architour truck was sent to Oschner Foundation Hospital in New Orleans to support laboratory testing needs at that location.

Lab Vendors Can Help

One positive development from Hurricane Katrina is that lab industry vendors are now revamping their own contingency plans and disaster response capabilities. THE DARK REPORT predicts that, as a consequence of Hurricane Katrina, the resources and capabilities of lab industry vendors will be included in the contingency planning of their laboratory clients.

Earthquakes are next on this unusual “Day of Disaster.” Along the West Coast and into the Rocky Mountains, the American earthquake zone affects several thousand hospitals. At 4:30 a.m. on the morning of January 17, 1994, a magnitude 6.7 quake shook the San Fernando Valley in Southern California. At ground zero of what is now called the Northridge Earthquake was the laboratory of Northridge Hospital Medical Center (NHMC).

The Northridge Earthquake

Donald P. Sharar, Director of Laboratory Services, made it into his lab that morning. He will be in Miami to tell his laboratory’s story and make recommendations on how to better prepare for earthquakes.

This destructive quake killed nine people and injured 9,000. It left 22,000 people homeless. Nine hospitals, representing 2,500 beds, were closed. Yet the laboratory at Northridge Hospital Medical Center was back in full operation in 30 minutes after the quake hit.

Here’s an opportunity to learn the practical lessons of how laboratories can best respond to an earthquake and its aftermath.

Post-Disaster Planning

In discussions with each of these speakers, THE DARK REPORT learned about a dimension of contingency planning that is often overlooked. That is the post-disaster period. Once the actual hurricane or earthquake is over, a region may be so damaged that normal life is impossible for weeks or months.

During this recovery period, extraordinary measures are often required for a hospital laboratory to restore and maintain operations. For example, in August 2004, Hurricane Charley hit Punta Gorda and Port Charlotte in Florida with winds of 145 miles per hour and a storm surge of 15 feet.

Lab staff living in areas which still had full power did laundry for lab employees living in communities without power. They would also bring in bottled water, and help with clean-up efforts at other lab employee’s damaged homes.

There will be plenty of insights like this on May 5. It will be the first time that these individuals—who personally led their laboratories through major disasters—are gathered in one place to share their experiences and compare the lessons learned. It’s a unique opportunity to acquire lifesaving knowledge.

American Board of Disaster Medicine Announced on February 1, 2006

HERE’S MORE EVIDENCE that contingency and disaster response planning is gaining in importance and emphasis.

Earlier this month, the American Board of Physician Specialties (ABPS) announced the creation of the American Board of Disaster Medicine. The announcement was made on February 1. Goal of the new board specialty is “to address the ever-increasing need for physicians trained in disaster planning.”

Physicians of all specialties can apply. The board will begin accepting applications from interested physicians on May 1, 2006. It will administer the first examination before year’s end.

THE DARK REPORT believes the new board specialty of disaster medicine is consistent with the trend of improving healthcare’s ability to respond to natural disasters, emergencies, terrorist events, and epidemics. The ability of hospitals, laboratories, and physicians to deliver needed care during a time of crisis is getting more attention.

That is why it is important to bring together those pathologists and laboratory administrators who have guided their laboratories through some of the biggest natural disasters and emergencies seen during the last decade. The knowledge and experience they will share can help other laboratories save lives during similar emergencies.

It also provides the knowledge necessary to better protect laboratory staff—and their families—during these emergencies. Every laboratory and pathology group should have someone attend “Readiness for Laboratories…with a Capital ‘R’!” in Miami on May 5. It’s knowledge that can mean lives saved in the next disaster.

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