Biomedical Engineering Reference
In-Depth Information
hospital could have handled many more patients.
As a result, the staff viewed the facility as sound
but underutilized.
Overall, the strongest factor was the spirit of
volunteerism among the workers. When asked to
perform, volunteers and local suppliers could not
do enough, according to Winkler and Nijoka. Only
two suppliers refused to send needed provisions,
because the hospital could not issue purchase order
numbers, and had no means to ensure payment.
Steven Winkler, MHA, and Monica Nijoka,
MHA, BSN, R.N., served as the primary sources
of information for this case study.
Force, worked with HSC staff as well as repre-
sentatives of the CDC, Public Health Service, and
FEMA to establish the facility. The volunteers set
up the first 600 bed component before the arrival of
any outside help, and an additional 500 beds from
the CDC were added before the storm hit. Thus, the
1,100 bed surge facility was prepared to provide
care prior to Hurricane Rita's assault. The staff
included physicians, nurses, medical and veterinary
students, and many volunteers. Only one medical
procedure had to be done, which was to treat an
abscess. At one point, Evelyn Castiglioni, Ph.D.,
head of the university's Department of Veteri-
nary Anatomy and Public Health and an accom-
plished harpist, calmed patients with an impromptu
concert. The hospital remained open for six days.
Case Study 5: A veterinary hospital in
College Station, Texas
Hurricane Rita also produced an unlikely site for
a surge facility: the Large-Animal Hospital at the
College of Veterinary Medicine and Biomedical
Sciences at Texas A&M University. The univer-
sity transformed the veterinary hospital into a
special needs shelter that cared for 320 patients—
primarily geriatric nursing home patients, pediatric
burn victims, physically handicapped children, and
home health care patients—from Houston and
Galveston. University staff emptied the hospital
of all of its animals (including 20 horses), then
cleaned and sterilized the building and made it
ready for use in less than a day under the direc-
tion of William Moyer, D.V.M., head of the
Department of Large Animal Clinical Sciences.
At its peak on the night before the hurricane hit,
the facility housed about 650 people, including
patients, families, and caregivers. The transfers of
high acuity patients from less sophisticated shel-
ters into this facility and free transfers back and
forth between the surge hospital and St. Joseph
Hospital, the largest hospital in the area, allowed
St. Joseph Hospital to never exceed 80% occu-
pancy. This enabled the standard of care to be met
despite transfers of large numbers of patients with
critical medical needs.
Paul Carlton, M.D., of the Texas A&M Univer-
sity System Health Science Center (HSC), served
as the medical director of this surge hospital.
Carlton, a former surgeon general of the U.S. Air
Lessons learned
The main advantage of converting veterinary
hospitals into surge hospitals is their state of
readiness. The state-of-the-art facility was a fully
equipped hospital, so no building issues had to be
dealt with. The power system had an emergency
generator for continuous power if commercial
power was lost and the building was plumbed with
medical gases and suction so that portable equip-
ment did not have to be used. Use of this site shows
that a veterinary hospital can be an ideal model for
the surge hospital in a catastrophic situation.
Closing Comment
Advance planning, coordination of resources,
effective communication, and visible leadership
are critical to ensuring that surge hospitals can be
set up quickly and can provide care to patients
during emergencies. Health care organizations
must prepare for the possibility that their build-
ings could be too damaged to function during
as well as after a disaster, necessitating the use
of surge hospitals—some of which may need
to operate for months or years until permanent
health care organization facilities can be rebuilt.
As the Joint Commission considers the need for
standards to ensure the quality of care being
provided at surge hospitals, health care planners
