This is a column I wish I were not writing. On back-to-back weekends recently, HCA Healthcare hospitals in San Jose, Calif., and El Paso, Texas, provided trauma care to victims of mass shootings.
Amid the mayhem, our Regional Medical Center of San Jose (which treated victims from the Gilroy Garlic Festival) and Del Sol Medical Center in El Paso worked hip to hip with their everyday competitors in a coordinated, collaborative race to save lives.
While the response was immediate, our mutual trust was long in the making, thanks to the 3Cs that guide sound community disaster preparedness—communicate, coordinate and collaborate.
Because of our geographic reach and scale, HCA benefits from comprehensive emergency planning shared across a 184-hospital system that includes a dedicated enterprise emergency response team and cutting-edge communications technology. Every HCA hospital also individually prepares for worst-case scenarios, and that preparation has saved lives after events including natural disasters, major traffic accidents and mass shootings.
Whether a stand-alone facility or part of a larger system, every hospital should take steps to be in the best possible position to respond to its community’s needs. This starts with the right mindset. Caring for the victims of a tragedy is an essential community responsibility that hospitals and their physicians and nurses bear alongside emergency responders, public health officials and political leaders. Hospitals must contemplate threats and prepare. These threats could be man-made intentional events (shootings), man-made unintentional events (car accidents), natural events (hurricanes), or even technological events (cyber events). A unified or “all-hazards” process brings the best response to the worst situations.
Leadership should make emergency operations a top priority and participate in planning and drills. To be most effective, duties for emergency operations must be worked out in advance so a leadership structure is in place.
Adequate preparedness is not an individual activity. When tragedy strikes, collaboration is key, even among fierce competitors. There is rarely time for introductions. This is why hospital leaders must be fully engaged in regional healthcare coalitions dedicated to emergencies before a disaster strikes.
Run under the aegis of HHS’ Office of the Assistant Secretary for Preparedness and Response, regional coalitions convene key actors to plan a community’s response. These include hospitals, EMS providers, emergency management organizations, public health agencies, and others in a defined geographic location. Hospitals share information about capabilities, including personnel, equipment and crucial supplies such as blood.
Many hospital leaders hesitate during emergencies because they might not know what is allowed or legal. But with mutual aid agreements and legal exemptions in place, you can focus on doing what is right for patients without hesitation. The collaboration lets public authorities know in advance who is best equipped to care for whom.
That is how EMS personnel in El Paso knew without asking to take children to our competitor, University Medical Center, also a trauma center, which has a children’s hospital on-site, and bring older victims to Del Sol Medical Center’s Level II trauma unit. Through standing agreements, military physicians from William Beaumont Army Medical Center were integral participants at the El Paso trauma centers, and surgeons from across our Las Palmas Del Sol Healthcare system treated patients in our Del Sol Medical Center.
Finally, planning for the next disaster should begin as soon as the most recent one ends. Immediately following the shooting in Las Vegas in October 2017, HCA’s Enterprise Emergency Operations and our colleagues at Sunrise Hospital and Medical Center, who cared for more than 200 victims from that tragedy, began compiling lessons learned. That is taking place already in California and Texas. Leadership will look at best practices and areas for improvement. HHS’ website also shares lessons dedicated to disaster preparedness.
America’s hospitals must be prepared for the worst emerging scenarios and pray they never happen. But when they do, community cooperation made possible by communication, collaboration and coordination saves lives.