Amidst chaos from tornado, 'everybody worked together'
Registration staff moved smoothly into 'downtime procedure'
When admitting and registration supervisor Tammy Wellons entered Sumter Regional Medical Center in Americus, GA, just minutes after a tornado ripped through the 143-bed facility, her first impression was that it looked like a scene from a horror film.
"It was dark, water was pouring in, the halls were empty, and then there would be 10 people coming down the stairwell, wet to their knees from the water, holding onto a mattress with a patient on it," says Wellons, who estimates she reached the hospital at about 9:45 p.m. The tornado hit between 9 and 9:30 p.m. March 1, according to news reports.
"When I got there, we had to walk [from a distance] to get to the hospital," she says. "There was a group of us who walked together. We had brought flashlights from home. They had to cut up and clear away trees to get the ambulances lined up to get to our emergency department."
People were "scared and screaming and all that, but everybody worked together, no matter what it was that needed to be done," Wellons recalls. "My staff [who were on duty when the tornado hit] were shaken up [and] said you could never imagine the noise and sound."
Moments after disaster struck, however, those employees segued seamlessly into the registration procedure designed for when computers are not operational, Wellons says. "As soon as the tornado went through, all systems shut down, our servers went down. That's when we started with the downtime procedure manual. I was able to get the downtime books out when I went in."
Copies of forms — for patient identification, HIPAA privacy acknowledgement, and consent for treatment — were ready to go, she adds, along with patient armbands and "plenty of clipboards."
Registrars filled out the patient identification sheets, had patients sign the HIPAA and consent forms, and placed an armband on each patient, Wellons notes. In addition to the registration forms, each clipboard contained all of the pages of nursing notes. "Everything stays together and follows the patient all the way through. To make sure nothing gets misplaced, there is an account number on every sheet."
The process is set up so that every area that does registration has so many pages of "downtime numbers" to be used to identify patient accounts, she explains. "When we come back live, [clinicians] wait on us to get the patient information keyed in, but they don't have to look for an account. All they have to do is key in an account number and pull up the patient [information] and not worry about spelling the name right."
Having that procedure so firmly in place that it was second nature to employees enabled her department "to keep business going" in the midst of chaos, Wellons says.
"Every hospital should have a downtime procedure and manual that staff are very aware of, in case they have nothing else to work with," she advises. "What if you're in that situation for days or weeks? We all depend on computers a lot, but always remember, there could be a day when you don't have that computer."
By about 11 p.m. on the evening the tornado hit, ambulances "were lined up to help take our patients out," Wellons says. Also on the scene were physicians and other medical personnel from nearby towns, as well as Sumter physicians. "I can't even tell you where they all came from," she says.
"When it was all over, about 2 in the morning, the president of the hospital called a meeting and we all stood there and cried," she says. "We were thankful that none of our employees were hurt."
Temporary hospital erected
The Tuesday morning after the tornado hit on Thursday night, Sumter Regional put up a makeshift, "M*A*S*H"-style hospital, with a "hard-shell" ED and tented areas for lab and X-rays, and even a nursery — in case a pregnant woman came in who was too far dilated to be transferred, Wellons says.
"It's a pop-up hospital," she adds. "It has air and heat, water supply, bathroom area with shower, and a washer and dryer. It's like a funnel all hooked together."
Outside the entrance, Wellons says, was a smaller tent for registration and triage.
"Those we can treat and send home, we're doing that," she says. "We can suture people, but can't do surgery or anything like that."
Patients with more serious conditions were being transferred to several different facilities, all within an hour's drive or less from Americus, Wellons notes. In addition to Phoebe Putney Memorial Hospital in Albany, which took most of Sumter's evacuated patients immediately following the tornado (see related story below), those included Columbus (GA) Medical Center, Flint River Community Hospital in Montezuma, GA, and Crisp Regional Hospital in Cordele, GA, she says.
'We implemented our disaster plan' When the call for help came through to the command center at Phoebe Putney Memorial Hospital in Albany, GA, staff began looking at the facility's census, says Todd Braswell, RN, BSN, MS, CEN, director of the emergency center. The immediate response was to ask, "What beds are available? Who can be transferred?" Braswell adds. "We implemented our disaster plan." The facility in need was Sumter Regional Medical Center in nearby Americus, GA. A tornado had ripped through Americus on the evening of March 1, killing two people, destroying parts of the hospital, and severely damaging more than 200 homes in the town of 17,000. There were no immediate inpatient discharges from Phoebe Putney to make room for evacuees from Sumter Regional and other tornado-related admissions, Braswell says, although a few patients were discharged from the emergency department. From the entire tornado incident, Phoebe Putney accepted 45 patients, which included emergency patients as well as the transfer of inpatients from Sumter Regional. "We had a ready bed waiting for every inpatient transfer," he says. "They told us what they were sending, in terms of obstetrics, psychiatric, etc. We received a mix." The evacuated patients came through the ED but didn't stop there, Braswell explains. They were routed immediately to inpatient beds and were assigned to inpatient physicians, he adds. "It made tending to emergencies easier." Emergency Medical Service (EMS) technicians carried the patients to the nursing floor, he says. Those who were ambulatory arrived by bus, Braswell notes, and triage of those patients was performed in the EMS dock intake area. Patients he describes as the "walking wounded" were taken to the admit/discharge unit (ADU), a small clinical area that is open Monday through Friday and used as a holding unit, he says. "When we went into disaster mode, nurses came from the emergency center and inpatient areas to work the ADU," Braswell says. "We also had physicians who responded." |
Within a day or two of the opening of the modular hospital, eight patients had showed up for their regular outpatient lab tests, Wellons adds. "Who would have thought that before the week was up, we'd be doing some of our regular lab work?"
Five days after the tornado hit, she describes the schedule she had just followed: "I went in at 7, left at 6, and took work home with me. I want to make sure we don't lose anything. I meet the staff every time we change shifts, and they haven't been [to the temporary hospital] yet. I want them to know where everybody is, and not be scared."
About 10:30 p.m. or so, she was getting ready to leave to meet the night shift, Wellons says.
Registrars normally assigned to the obstetrics unit, under a different supervisor, were temporarily working with Wellons' staff, she says. "I introduce everybody to each other and make sure they know who I am."
At that point, five days later, "our only contact is by cell phone," Wellons says. Business office staff, including insurance and billing personnel, had been moved to an off-site building that had not been damaged.
Sumter HealthPlex, an 8,000-square-foot facility that had housed X-ray and outpatient laboratory services, as well as Wellons' office, was completely destroyed, she says. "My office is gone and any files I had are lost." If the tornado had hit during business hours, "there probably wouldn't be any of us alive."
When admitting and registration supervisor Tammy Wellons entered Sumter Regional Medical Center in Americus, GA, just minutes after a tornado ripped through the 143-bed facility, her first impression was that it looked like a scene from a horror film.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content