planned that for several months. It was managed by the local manage- ment coordinator, which, in our case was the county.” Mohawk Valley Endoscopy per-

forms two emergency preparedness drills each year and reviews its emer- gency preparedness plan annually. It also conducts quarterly code blue and fire drills. “In health care, we have long known the value of doing drills,” Dixon says. “We practice code blue, so if we have a patient code, we have the comfort level of knowing what to do. “It is critical to know how to respond. The more you do drills, the more you involve your community resources and the more comfortable the staff is with how to respond,” she adds. The ASC invited its local police

department to go in and help evaluate what it needed to develop an active shooter policy and drill, Dixon says. “The police came and made recommendations for locks on certain doors so, in case of a shooter, staff can barricade themselves and patients in until help arrives,” she says. “They also did a presentation to show their equipment and what they would look like in gear if they had to come in. They instructed us on how to describe a shooter’s weapon to 911—long gun, short gun, etc.—something that we would never think to note.” The police also recommended a silent alarm for the facility that would immediately summon the police. Marla Noseworthy, RN, CASC, clinical director of Advanced Surgical Institute in Sewell, New Jersey, also reached out to her local police depart- ment for help with the ASC’s emer- gency preparedness plan “because it was important to me given the state of the union, if you will, today,” she says. “Our local police department has a community resources officer who came out and provided an in-service for us,” she says. “We offered him lunch.” The officer provided information about man-

straight to the police department and the ASC has incorporated those but- tons in its disaster preparedness drills. “The police

department wanted to

judge how quickly they could get to us if we pulled the panic button,” she says. “They got here within a minute and blocked off the parking lot. That gave my staff the confidence that the police were here for us.”

The more you do drills, the more you involve your community resources and the more comfortable the staff is with how to respond.”

— Wende Dixon, RN Mohawk Valley Endoscopy Center

aging an active shooter situation and did a walk-through of the facility with her, the ASC’s business services director and the charge nurses. “He told us where we could hide or

have potential primary shelters inside the facility,” she says. “The hiding rooms have to have a cell-phone signal. One of ours also has a window, so if needed, we could take a piece of equip- ment, bust it open and get outside.” The officer also told Noseworthy

what to do if she heard a gunshot. “He said if you can and if there is an escap- able path, run, do not hide. He also said that more often than not, patients will follow our direction, so we would have to lead them out to safety. “The officer was brutally honest

with us,” Noseworthy continues. “He let us know that our front desk would be in the line of fire. He told us about installing panic buttons, and we now have two at the front desk and two in each department.” The buttons go

How to Reach Out to Local Authorities For smaller facilities, devoting resources to emergency preparedness


might be challenging, Bland says. “Many do not know that their county or city has a plan that they could partake in because they don’t know the right people,” he says. “They might feel like they are on their own, but they are not. Call your local fire chief or check your county’s web site—because every county has an emergency management coordinator— and reach out to them.” Most communities have some kind of a central emergency plan, Dixon says. “Ours is at the county level. I looked them up on the web and sent them an email,” she says. “They were very eager to include our facility in the community planning, and now, they know what resources we have to con- tribute to what the county has in the event of a community-wide disaster. All our staff is ACLS-trained, we have anesthesia providers, stretchers and EKG monitors—supplies that you’d need in an emergency situation—and that is valuable for the county to know. So reach out to your area emergency center. Google them if needed.” Smaller ASCs could also enroll in

National Incident Management Sys- tem (NIMS) classes, learn how their county and city function during disas- ters and mimic that in their facilities, Bland suggests. “NIMS was created after 9/11, so all first-responders and health care facilities could be on the same page,” he adds.


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