Emergency room workers at Robert Wood Johnson University Hospital in New Brunswick, N.J. used laptops last week to examine the records of "patients" ill from the effects of a simulated terrorist attack.
They soon realized that taking turns looking at the screens wasn't the most efficient way to examine the data and started projecting the information on walls so circulating staff members could glance up and check on the latest logged patient status.
It was one of several lessons learned as part of a two-state bioterror drill held last week in New Jersey and Connecticut. In the future, projectors will likely be incorporated into the hospital's emergency-preparedness plan. Although the change may not seem that significant, it underscores how such drills can lead to streamlining the care delivery process during an emergency, said Clifton Lacy, the hospital's president and chief executive officer.
Last week, hospitals in New Jersey and Connecticut scrambled to make room for volunteers who were acting as if they had become ill after a terrorist attack. TOPOFF 3-the third biennial $16 million event coordinated by the U.S. Department of Homeland Security-simulated a chemical attack of mustard gas in New London, Conn., and a biochemical attack centered in Middlesex and Union counties, N.J., that infected thousands with bubonic plague.
While the drill was getting under way, back in the nation's capital Senate Finance Committee Chairman Chuck Grassley (R-Iowa) sent a letter to HHS Secretary Mike Leavitt requesting information about how much of the anthrax vaccine the nation has stored. In the letter, Grassley said his staff was concerned that the amount may be inadequate if an attack occurs.
Access to vaccines and supplies will be addressed in Robert Wood Johnson's formal report, which is expected to highlight what steps can be taken to improve response in the event of an actual attack. One topic that will be mentioned is how to acquire supplies from vendors when a hospital is running low.
Two days into the weeklong drill, Robert Wood Johnson hospital officials learned they were out of gloves. Access to beds was another problem cited by hospitals throughout the densely populated state. Participants had to quickly form plans to transfer more stable patients to neighboring states, said a spokeswoman for the New Jersey Hospital Association, which coordinated communications among the state's healthcare workers.
Communications will be among the topics covered in Lawrence & Memorial Hospital's report, said Ron Kersey, the New London, Conn. hospital's emergency management director. He said early on in the drill it was difficult for workers to access updated information on bed counts. The drill showed just how difficult it is for local, state and federal officials to coordinate and disseminate accurate information to the media, he said.
He added that the drill provided a good opportunity to work out the kinks in emergency plans. "Any drill that practices what you do well is not a good drill," he said.
However, some participants noted the drill's limitations. "You can't simulate hysteria," Susan Boruchoff, an epidemiologist at Robert Wood Johnson, said as she looked out over the calm hospital workers dealing with even calmer patients. In the drill, medical staff knew ahead of time that they would be dealing with the plague, but in a real attack, it could take up to two days to diagnose the disease, she said.
Officials from both states said hospitals were spending significant resources on the drill, and part of the final reports will determine how much was spent. The New Jersey Hospital Association gave grants of up to $4,000 to hospitals, depending on how involved they were in the drill, but "it's truly not enough to cover their expense," an association spokeswoman said.