It would be no ordinary day for David Groth. He’d been advised that a disaster – natural, manmade or some assortment of both – was on his schedule. Groth could be confronted with a chemical spill, infectious disease outbreak, plane crash, tornado, terrorist attack, or any mixture of calamities, but he didn’t know which or when.
A web administrator for the University of New Mexico Health Sciences Center (HSC), Groth enrolled in disaster emergency training through the Center for Domestic Preparedness (CDP), an organ of the Federal Emergency Management Agency, or FEMA. He and more than 150 of his peers from the HSC and UNM Hospitals joined 100 other New Mexico health care professionals from state agencies and hospitals in Anniston, AL, last month to train for mass casualty incidents within the state.
“The number and professional diversity of our Health Sciences Center people who attended this year’s training speak volumes to everyone’s sense of duty and responsibility in caring for our community in the event of a disaster,” says Robert Perry, UNM Hospitals’ emergency preparedness manager who organized the trip. “We can always be better prepared.”
The CDP’s Health Care Leadership week-long training began with classroom refreshers on FEMA’s Incident Command System (ICS), which is designed to enable effective, efficient domestic incident management by integrating facilities, equipment, personnel, procedures and communications operating within a common organizational structure. It effectively creates order amid potential chaos by directing personnel and resources in major functional areas of command, operations, planning, logistics, intelligence and investigations, and finance and administration. FEMA provides the training at no cost to UNM.
“This exercise reinforced how profoundly interested I am in emergency management,” Groth says. “The more I become involved, the more I like it. I also think it’s important to my job in developing communication methods that share vital information in a high-pressure, high-intensity environment.”
Enrollees in the Health Care Leadership for Mass Casualty Incidents course, of which Groth was one, already had ICS training under their belts as a prerequisite to this advanced program. Their day-to-day UNM jobs included everything from office supervisors to trauma physicians. Some were administrators, some managers, some directors and some vice presidents.
After two days of classroom training, attendees were asked to provide preferences for specific roles in several unique systems – a hospital command center, an emergency department, general patient care, public health and public safety. Some assumed roles with which they are familiar and experienced to hone their skills, like an emergency room doc or a hospital public information officer. Others branched out to gain a greater understanding – and appreciation – of the overall system.
The CDP Anniston Campus is ideal for assembling a fictitious community with the usual amenities, like public transportation, neighborhoods, schools, a business district and industrial center, an event venue, parks and museums.
The mock community also includes a hospital central to the week’s activities. The Noble Training Facility, a former U.S. Army hospital, is a 100-bed complex with emergency room capabilities. The faux facility, now used as a training site for health and medical education in disasters, is the only one of its kind in the nation dedicated to preparedness and response. In addition to a simulated ER, the site includes classrooms and breakout rooms, exercise simulation areas, a television and radio broadcast studio, observation areas and more.
To complement Noble, there’s the Chemical, Ordnance, Biological, and Radiological Training Facility (COBRATF), and the Advanced Responder Training Complex (ARTC). All of these elements make the CDP campus a wholly unique place for disaster preparedness training.
Let the Games Begin
As the week progressed, classroom instruction yielded to small exercises enabling teams to become familiar with one another and their roles within specific scenarios. Teams were instructed to develop on-the-fly, objectives-based incident action plans – cornerstones to an effective response under the Incident Command System. Essentially the first four days ramped-up students for the Integrated Capstone Event finale.
Groth was anticipating a full-blown exercise for some sort of mass casualty incident that would integrate the health care leadership team at Noble with emergency medical operations from COBRATF, Hospital Emergency Response Teams and Disaster Medical Assistance Teams – all players in a single, large-scale event. His role would be hospital emergency department public information officer, or PIO.
After a sturdy breakfast, participants assembled for the bus ride to the Noble and ARTC facilities. The exercise began before anyone stepped off the bus and ended hours later with a whirlwind of realistic injects, or curveballs, in a carefully designed and staged community disaster scenario. “What a day – clearly I didn’t know what I was signing up for,” Groth admits. “But I knew I needed and wanted to be there. The PIO position seemed the most appropriate to my current role.
“I found myself continually developing vital communications for numerous groups of people involved – from my internal hospital staff to public health and safety leadership to EMS personnel to the public,” he adds. “Those communications had to be quick, accurate, consistent and helpful and appropriately delivered. I needed to develop contacts, relationships, sources, verbiage – so many things I hadn’t considered in this role.”
Groth was consumed by hospital patient counts, saturation levels and supplies, decontamination activities and EMS field reports, news broadcast and health department bulletins – all important information to direct personnel and the public toward treatment.
Through his fevered response, Groth took the opportunity to observe others. “I was completely impressed with how quickly the teamwork kicked in,” he says. “The amount of knowledge in my team that percolated to the surface was astounding, and the amount of support was equally amazing. This is training for people who have to run toward an incident and rely on one another for their own safety and effectiveness, underscoring the value of relationships I formed here among participants. I came away with a much broader and deeper understanding of the myriad resources and challenges associated with a natural disaster or terrorist attack.”
“We can never prepare or train enough for all the possibilities that exist,” Perry acknowledges. “But it’s training like this that advances our knowledge and builds our capabilities to respond when that event occurs. Ultimately we’re here to help our community and our families. We’re all leaving Anniston with more tools and confidence to do just that.”