November 15, 2002

The scenario played out like this: a "dirty bomb" – an explosive with radioactive material – destroyed part of a runway at Logan airport, damaging a plane that had just landed from Paris. More than 100 injured survivors were transported to Boston hospitals for contamination screening, decontamination and treatment.

This situation was the subject of a citywide disaster drill (See photos) that took place Nov. 7 and 8, involving most Boston-area hospitals – including the MGH – local and federal emergency response agencies and the Massachusetts Port Authority. An unthinkable possibility only a year ago, but now a plausible reality.

Since the tragedy of Sept. 11 last year, hospitals across the country have been modifying their disaster response plans to better prepare for incidents like this. Led by the MGH Emergency Management Committee, the MGH also has been building upon its existing disaster response plans. The committee was restructured from the original hospitalwide group after Sept. 11 to focus on revitalizing the hospital's overall response strategy and departmental plans.

During the last year, the committee has taken several steps to ensure the hospital is ready for any type of emergency or disaster. One important move was to hire a full-time staff person dedicated solely to ensuring the hospital's emergency response system is in place and ready to be enacted at any time. Julia Gabaldon – who comes to the MGH from the Pilgrim Nuclear Power Plant in Plymouth, Mass. – has been in this new position since June and has been meeting with senior management, department heads and committee members to assess the disaster response needs of the hospital.

"In meeting with managers and supervisors, I have found that many departments have a good emergency response plan in place – especially departments accustomed to crisis management, such as the Emergency Department, Admitting and Ambulatory Care Services," says Gabaldon. "Many departments have become more sensitized to emergency response since Sept. 11. They have put mechanisms into place to respond to a crisis, such as making arrangements with their vendors to get supplies or knowing how long supplies will last in the event that regular sources are cut off."

In assessing the hospital's state of preparedness, the Emergency Management Committee has enhanced the hospital's disaster response policies to incorporate the new emergency command structure that the MGH adopted this year, called the Hospital Emergency Incident Command System (HEICS). According to Gabaldon, the MGH is tailoring HEICS to fit the hospital's needs and also has revised the overall hospital plan to include more information about bioterrorism and hazardous material contamination responses. In revising the plan, the committee has taken into account the guidelines that the Joint Commission of Accreditation of Healthcare Organizations (JCAHO) recommended to hospitals after Sept. 11.

As part of the process, disaster response plans have been revised to incorporate a new format that will be more accessible and easier to use in the event of an emergency or disaster. The new format uses elements of the HEICS system and includes a two-page summary description of what the department is responsible for when a disaster is declared in addition to the full departmental plan.

This fall, employees and staff also have been participating in training sessions, table-top exercises and the most recent citywide drill to help evaluate the HEICS plan and assess the MGH's level of preparedness both departmentally and hospitalwide.

"These exercises and drills are useful to test our internal systems, assess the new management structure and gauge our ability to coordinate patient care with other hospitals, public agencies and emergency response systems," says Ann Prestipino, senior vice president for MGH Surgery, Anesthesia and Cardiac Program and chair of the MGH Emergency Management Committee.

For more information about the hospital's emergency response plans, call Gabaldon at (617) 726-0312.