Stanford Medicine Newsletter Updates For the Local Community


In case of emergency

Hospitals prepare and train for disaster



Imagine that Homeland Security officials issue a warning about possible attempts to sabotage water supplies across California.

That scenario was the focus of an emergency exercise in November by hundreds of employees at Stanford Hospital & Clinics and Lucile Packard Children’s Hospital, led by the hospitals’ Office of Emergency Management.
Just three weeks later, Packard Children’s faced an actual crisis when the ground floor flooded after a water line failed. But largely as a result of preparation and training, the emergency was quickly contained and never affected patient care or safety.

Preparing for the worst is what occupies practically every hour of the day for the four full-time staff members in emergency management, according to Bernadette Burnes-Line, the group’s administrative director. The team develops plans for every imaginable hospital emergency, including earthquakes, fire, explosions, floods, acts of violence, viral pandemics, radioactive fallout and bioterrorism.

Training session

Team members train hospital employees in emergency response and preparedness; forge emergency-response partnerships with local cities, counties, institutions and businesses; and work closely with staff from the School of Medicine and university on campus-wide crisis-response strategies. The office also stocks emergency supplies and equipment, including decontamination tents, burn-trauma caches and portable generators. “We live our motto of ‘together prepared, together ready’ in all our planning,” Burnes-Line said.

By 9 am the day of the Nov. 17 exercise, the emergency team had convened top-level administrators, clinicians and other staff in the Hospital Command Center on the third floor of Stanford Hospital. The group faced two key challenges: Keep the hospitals functioning without tap water, which is used for everything from hand washing and cleaning rooms to heating and cooling the buildings, and accommodate the inevitable surge of new patients sickened by the tainted water.

More than 50 volunteers acted as patients, inundating the emergency department (which that day was already full). Almost all hospital staff had a part to play, from the CEOs in the Command Center to the housekeeping staff who practiced cleaning patient rooms without water, said Emergency Management Director Brandon Bond.

“Everyone rose to the occasion and came together as a cohesive team,” Bond said. “Of course, there was some learning that took place and opportunities for improvement that we identified, but that’s why we drill: to see what works and what doesn’t—so we can be prepared when it really happens.”

Real-life situation

And then something really happened: On Dec. 10, a chilled-water line serving both hospitals failed, flooding the ground floor of Packard Children’s with 2 feet of water and temporarily forcing the relocation of nine Stanford Hospital patients.

In this real-life emergency, the payoff of the November exercise became apparent, Bond said. The Hospital Command Center was activated and the emergency response was rapid, turning off tap water for about four hours to determine whether it had been contaminated. (It hadn’t.) Bottled water was distributed to all inpatient units, as had been practiced during the exercise.

In 2010, the Joint Commission, the major accrediting body of U.S. health care organizations, recognized the emergency management team for best practices and quality of care in two separate surveys. “The hospitals are a recognized leader in emergency preparedness, and our goal is to continue advancing the field,” Burnes-Line said.

Creative solutions

The emergency team also develops new tactics to prepare for, minimize and recover from disasters. In 2009, they tested the idea of using a drive-through emergency clinic. Mock patients were examined and treated in their vehicles, a model that could be especially useful after a bioterrorism event or during a viral pandemic, said Eric Weiss, MD, an associate professor of emergency medicine at Stanford.

“We can use the patient’s vehicle as a self-contained isolation compartment to limit the person-to-person spread of germs,” he said. “Not only is it an effective social distancing mechanism, it also allows us to see patients faster than we are able to in a regular examination-room setting.”

The results of the study were so successful that the Santa Clara County Department of Public Health gave the group a grant to develop a plan for operating drive-through clinics that can be distributed to hospitals and shared around the nation.

Burnes-Line and Weiss said the emergency group also plays an important role in developing and strengthening emergency-response partnerships with local agencies, organizations and businesses as diverse as the SLAC National Accelerator Laboratory, Palo Alto Medical Foundation, Stanford Shopping Center, and Palo Alto fire and police departments. “You don’t want to be getting to know your partners in the middle of an emergency,” Burnes-Line said. “We want these relationships well established.”

Always prepared

In the event of a surge of patients from local communities, the emergency management group has established plans for doubling up patients in rooms, converting the cafeteria and other non-clinical areas into space for patient care and ensuring quick access to emergency supplies. And while three emergency generators would be used to supply power to vital patient-care functions during a blackout, the group keeps flashlights and headlamps on hand to ensure that staff can continue to work effectively. It even has a plan for sheltering animals and pets in a catastrophe.

If it can happen, the emergency management team is planning to deal with it. But Bond emphasized that the most important factor in disaster preparedness is overall community readiness.

“I cannot stress enough how vital it is for community members to be prepared themselves, to get involved with their community emergency response teams and to be sure they have basic first aid training and supplies, CPR training and emergency food and clothing,” he said. Being prepared will help relieve stress on emergency responders and the hospital in a disaster situation.

A 54-page emergency preparedness guide, “Ready!” is available at

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