Although much of the world will usher in the new millennium with celebration and champagne, hospitals will greet it with clear-eyed vigilance.
Thousands of extra eyes will be glued to hospitals' information systems, medical instruments and ancillary systems to ensure they're working properly at the stroke of midnight Dec. 31 and a few hours beyond, according to officials at some of the nation's hospitals and hospital associations.
The decision to bolster staff during the New Year's weekend seems to be an effort to pad an already thick safety margin. Hospitals and state hospital associations contacted by MODERN HEALTHCARE didn't anticipate any serious Y2K-related problems. Most have had their Y2K preparedness programs in place for two years or more and have spent millions of dollars to test and update or replace any suspect equipment.
"We expect it will be business as usual on New Year's Day," said Lance Ignon, spokesman for Santa Barbara, Calif.-based Tenet Healthcare Corp., the nation's second-largest hospital chain, with 113 hospitals in 17 states. Tenet has spent five years and $100 million to ensure Y2K compliance.
"For the most part, hospitals have not indicated any great fears and have a high level of comfort with having their patient-critical services ready," said Jeannie Cross, vice president of communications at the Healthcare Association of New York State (HANYS).
Maine hospitals are Y2K compliant, according to the Maine Hospital Association. "For decades Maine's hospitals have been dealing with bugs," said Steve Michaud, MHA president. "We've approached the Y2K bug as we would other viruses: We've examined our hospital system, located (the bug) and treated it."
Hospitals have prepared mostly by testing critical equipment such as generators and preparing checklists for testing other equipment after midnight Dec. 31. The most involved tasks will likely be resetting clocks on some imaging equipment that is Y2K compliant but cannot automatically detect the change in year, hospital officials said.
Most of this work will be directed from hospital "command centers" staffed for several shifts of eight to 12 hours.
Most hospitals plan to extend regular work shifts and have their executives on hand late on New Year's Eve and through the early morning Jan. 1.
"We'll have overlapping shifts on New Year's Eve," said Jim Shover, director of ancillary support services and co-chairman of the Y2K preparedness committee at 719-bed Rush-Presbyterian-St. Luke's Medical Center in Chicago. "A crew that (usually) goes home at 12 (midnight) will leave at 2 a.m. instead, and the one that comes in at 12 will come in at 10 p.m. instead." Executives will also be at the hospital but will likely leave by 2 a.m. Jan. 1 unless something goes awry, he added.
At 846-bed Cedars-Sinai Medical Center in Los Angeles, the command station will be set up at 8 p.m. Dec. 31. About 10 managers will be present, but line staffers will be the busiest, poring over checklists to make sure equipment functions properly, said Vicky Clevenger, Cedars' administrator of clinical-care services. "By 3 or 4 a.m., we will just disband," she said.
At 228-bed Newton-Wellesley Hospital in the Boston suburb of Newton Lower Falls, executive staff will work eight-hour shifts during the New Year's weekend, but hospital officials don't anticipate problems, said Melissa Rancourt, director of operations management services.
"We know we've done the best we can, and we have a high level of comfort," she said.
Members of the California Healthcare Association will be on call throughout the New Year's weekend, said Jim Lott, senior vice president of the Healthcare Association of Southern California, a CHA affiliate.
Hospital officials in charge of Y2K efforts said they had spoken with state and municipal officials to guarantee uninterrupted electrical and water service. But hospital representatives in New York are working closely with government agencies. The HANYS will have staff at the New York Emergency Management Services command center in Albany, and the Greater New York Hospital Association will have a desk at the New York City Office of Emergency Management command center.
In addition to all this preparation, hospitals have been testing, upgrading and replacing equipment for months or years.
Rush-Presbyterian-St. Luke's tested its four generators for a four-hour stretch earlier this year compared with the standard 10-minute test, Shover said. The hospital's ventilation system was changed to allow the generators to run for an extended time.
Newton-Wellesley replaced its phone switchboard and paging system, as well as several pieces of equipment in its gastroenterology department, Rancourt said.
Susan Waltman, a senior vice president at the GNYHA, said several of its members have bought pricey 800-megahertz radios to reinforce communication links with other area hospitals.
Given the extent to which potential Y2K problems have been addressed, officials say they are most concerned about the typical increase in auto accidents that causes an influx of emergency room patients on Dec. 31 and Jan. 1, and a push by expectant parents to give birth to their city's first baby of the millennium.