The computer screen is frozen, and the heat’s off
Drills test staff's knowledge of Y2K plans
You’ve tested your computer systems and medical devices for Y2K transition problems. You’ve developed a contingency plan. But in the event of a Y2K emergency, how would staff actually respond? Several hospital systems decided to answer those questions with a Y2K drill.
NCH Healthcare System in Naples, FL, ran a scenario-based drill on Sept. 9. "For the purposes of our drill, we tested staff knowledge and the ability to respond to the various failures," says Sallie Williams, vice president and CIO. "We didn’t change any dates on equipment; we didn’t turn any equipment off."
NCH’s four-hour drill involved 54 different events and failures, including internal device and system failures, external factors such as utility failures, and employee/human resource issues such as staffing shortages. The 9 a.m. to 11 a.m. part of the drill simulated midnight to 2 a.m., Jan. 1, 2000, and the 1 p.m. to 3 p.m. portion simulated 9 a.m. to 11 a.m., Jan. 4, 2000. All of the system’s units — two hospitals, one home health agency, and some offsite locations — participated in the exercise.
To prepare for the start of the drill, volunteers opened command centers at both hospitals and furnished them with computers, faxes, telephones, and printers. The command centers were manned by two vice presidents from the health system.
Volunteers, called "observers," dressed in orange "hazmat" vests and "Y2K drill team" name tags. They visited three to six departments in the two-hour time frame, armed with an "exercise/ failure" form that described a specific failure for each department. (See a copy of the exercise/failure form on p. 188.)
"The observers had individual forms that told which department they were going to, the type of failure, and the background of the scenario [such as air temperature in the department and the census numbers]," Williams explains. "We were telling them that the glucometers had failed or that all PCs based on a Windows 95 problem had failed." The form gave the participating staff a quick overview of the drill in case they hadn’t been alerted to it through messages distributed through NCH’s order-entry system.
The observer then talked with a manager or the person in charge plus two to three employees in each department, and recorded their names, titles, and reactions to their particular problems. If a failure involved other departments, such as biomedical or engineering, the staff in the department where the failure originated were encouraged to call the affected departments. Calls to outside agencies went to the "Y2K drill headquarters," where an internal auditor and risk manager conducted the drill.
Williams says she was sure that employees might scurry away when they saw the orange vest approaching, but they didn’t. She says she also expected most of the staff would be unsure of the contingency plan and what manual procedures to use in case of device failure. She was wrong on this, too. "We were pleasantly surprised that less than a handful of people said, I don’t know what to do’ or Talk to my supervisor.’"
In fact, many of the participants enthusiastically supported the drill. "Everyone really got into it," Williams says. The vice presidents manning the command centers found themselves with six or seven telephones ringing at once. The drill involved quite a few volunteers. "When we counted the number of people who participated in one form or fashion in the drill, it was more than 350."
The observers were chosen from support personnel with good observation skills. "These were non-management staff who we pulled from the quality management, risk management, internal audit, and education departments," she explains. "We didn’t want any of the people who were writing the drills and the scenarios or acting as observers to be on the management side of the drill. Managers needed to be in their departments."
California decided to test Y2K readiness on a grand scale with a statewide hospital and ambulance general emergency readiness exercise. All 473 acute care hospitals, 15 VA hospitals, as well as 273 private ambulance services, were invited to participate in the Sept. 16 drill, which was coordinated by the Emergency Medical Services Authority and the California Healthcare Association, both in Sacramento. Of the invited hospitals, about 350 accepted the invitation.
The statewide test was a mix of disaster emergencies involving an influx of "injured" volunteers to "paper tests," in which hospitals solved hypothetical problems. Some of the mandatory objectives of the tests for the hospitals included:
• implementation of the facility’s disaster plan;
• assessment of the backup generator system;
• use of communications other than the telephone to reach the County Emergency Operations Center, nearby hospitals, or sister hospitals;
• assessment of backup systems or techniques to handle potential problems associated with at least one computer system critical to the operation of the health care facility;
• assessment of the ability to respond to a large influx of patients and subsequent facility overcrowding.
Officials say they are pleased with the results of the drill, but are still compiling results. Hospitals are assessing their own readiness and filing them anonymously with the California Healthcare Association. The reports will then be forwarded to local and state emergency agencies.
To be effective, hospitals, health systems, or even statewide organizations must base their drill events on plausible scenarios, Williams says.
"For example, our drill mentioned specific manufacturers. It specified specific equipment that was germane to us. We had worked for about six or seven weeks prior to the drill in weekly meetings with groups of people including the educators, risk management, internal auditors, and safety officer. These people really know our operation and could create events or failures that they knew had challenged us before and we hadn’t responded well. The events were credible," she continues. "Otherwise, managers and staff will say, That will never happen.’"
(For more documentation about the NCH Health-care System drill, visit the Web site: http://www.rx 2000.org/data/selfhelp.html. More information about the California drill can be found on Emergency Medical Services Authority’s Web site: http://www. emsa.ca.gov.)
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