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Evacuating our local hospital, skilled nursing facility

Fallbrook Hospital and its skilled nursing facility (SNF) are arguably two of the community’s most vital assets. When winds pushed the ferocity of the Fallbrook (Rice Canyon) Fire onto the west side of I-15, hospital administrators made the unprecedented decision to evacuate its patients and temporarily close the hospital and the SNF.

Hospital physicians, nurses, medical technicians, maintenance and administrative staff practice annually for just such a situation. Each person has a role to play in securing the safety of hospital patients and the facilities. The Village News asked Fallbrook Hospital to explain the procedure and what happened.

Here are our questions, along with answers from Monique Murphy-Mijares, marketing/public relations director for Fallbrook Hospital.

Village News: When did the hospital make the decision to evacuate?

Monique Murphy-Mijares: As the fires approached, our emergency response plan was implemented. We geared up when it became clear that the fires were headed toward the Fallbrook area; we implemented our emergency response plan at about 10 a.m. [Monday, October 22] and made the decision to evacuate around 1 p.m. before officials issued the mandatory evacuation orders for Fallbrook.

Our first concern was for the safety and security of patients and residents at Fallbrook Hospital and Fallbrook Skilled Nursing Facility. We immediately began arrangements for our top priority – the safe transport of patients to healthcare facilities outside the outlined wildfire area.

We made every effort to ensure that no employees or volunteers were put at risk and that they could leave as quickly as possible to a safe location.

We also began securing the buildings. This included retesting the sprinkler system, running a backup of information systems, cutting off all gases, shutting down the mechanical systems and running negative air machines.

From the onset, we immediately initiated contact with authorities and emergency agencies and have stayed in touch with them throughout the evacuation process and the past few days, and now as we assess, clean and plan to reopen.

VN: How many patients were in the hospital at the time, including the emergency room?

MM: As we were making plans to evacuate, there were 16 patients in the hospital and 60 patients and residents in the skilled nursing facility. With the cooperation and approval from facilities in Oceanside, Vista and Corona, hospital patients and skilled nursing facility patients/residents were transferred outside the immediate threat of fires.

VN: What was the age range of patients involved?

MM: The patients and residents were all over the age of 18.

VN: How were they transported?

MM: The patients were transported in ambulances and transportation provided by the Fallbrook Union Elementary School District. They were accompanied by clinical personnel and were transported with their medical records and a supply of medications.

VN: How much staff – and what type – accompanied the hospitalized evacuees?

MM: Nursing teams and other hospital support personnel <accompanied evacuees>.

VN: Did any staff stay where the patients were taken?

MM: Staff accompanied the transferred patients during the transport and through the transition process to the new facilities.

Employees contacted the families – emergency contacts – for each of the patients, giving an update of the evacuation process and the hospital or skilled nursing facility their loved one was being transported to.

Home Health staff made calls to check on their clients.

VN: Which healthcare facility did the hospital take the patients to?

MM: <All> 16 patients were transferred to Tri-City Medical Center and the skilled nursing facility patients and residents were transported to various skilled nursing facilities.

VN: How did doctors follow their patients?

MM: The patients were transferred with their medical records, including physician orders, and a supply of their medications.

VN: Do you know if any other hospitals in the region had to evacuate? If so, which ones?

MM: It is our understanding that the hospital and neighboring nursing home in Poway evacuated.

VN: When the hospital reopens, do you anticipate any limitations at first?

MM: When we reinitiate services, we expect Fallbrook Hospital to be fully operational with all previously provided services being offered.

Our recovery phase involves the restoration of the hospital’s and skilled nursing facility’s functions and activities to help us open our doors again as safe and secure healthcare facilities as quickly as possible.

This will happen as soon as the hospital and skilled nursing facility are given the go-ahead to reopen after each has a combined survey by the Department of Health Services [DHS] and the Office of Statewide Health Planning and Development [OSHPD].

VN: How will the hospital bring patients back/welcome them back to their community hospital?

MM: We anticipate that Fallbrook Hospital patients will remain at their transfer facility and be discharged from there once they are ready to go home.

Once the Fallbrook Skilled Nursing Facility is given the green light to reopen after inspection by authorities, we will work with the County Emergency Operations Center and the other facilities to arrange transport for patients and residents.

VN: After this experience, which we hope will only be a once-in-their-lifetime experience, what will the hospital do differently? What will the hospital do exactly the same that worked well?

MM: In an unexpected situation like this, you have no time to develop plans from scratch. Fortunately, we didn’t have to. We have an emergency preparedness and response plan that addresses prevention, preparation, response and recovery.

We train, exercise and drill to help us maintain our preparedness and response capabilities, because we want to be as effective and safe as possible in responding to an emergency that suddenly and significantly affects the need for our services or our ability to provide those services.

It’s this plan that provided the processes, framework and contacts to help us handle the very real events we’ve dealt with the past few days.

Through our plan, and regular communication with other healthcare facilities, we had a list of alternative care site(s) that had the capabilities to meet the needs of our patients and residents who would need to be transferred to facilities beyond the fire danger.

Our emergency plan included redundant communication vehicles, including an employee calling tree, and the hospital’s phone system, where we included a message about the evacuation and directed callers to our Web site.

We had cell phones, a satellite phone, a dedicated conference call line with our corporate office and pagers. An offsite command center was established and the management team stayed in touch regularly and via phone.

Regular conference calls were held – two to three a day. We took advantage of Internet connectivity and our hospital Web site to keep family members, employees and the community informed.

We appreciate the coordinated efforts of the San Diego County Emergency Operations Center, North County Fire, the Village News and other media to ensure consistency of messages delivered about the status of the hospital’s evacuation and plans for reopening.

From the time when we first began notifying next-of-kin and family members listed for each of the patients and residents who had to be transferred, it was our goal to provide clear, accurate, sensitive and constructive information.

The time and resource requirements associated with emergency management planning, response and recovery are considerable. No community is exactly like another.

One of our key assets in Fallbrook is the relationships among partners in the community. From the utility company, telecommunications company, water district, public health department, hospital, fire department and emergency medical services, county, law enforcement, Camp Pendleton – together we’ve got a stronger platform for building response capability.

Much like the rest of the community – the schools, government agencies, businesses – we’re focused now on recovery and reopening of services. It’s important that our community has its hospital open and fully functional as quickly as possible so we can take care of patients right here in our own community.

When the time is right, we will begin working with local and state authorities to assess our combined preparation and response effectiveness, how we can strengthen the recovery and how we can support families needing to rebuild their lives.

We will have to give consideration to not only the structural and physical recovery of our communities but the emotional and mental as well.

VN: What positive things does the hospital want to highlight?

MM: Employees, volunteers and physicians have been fantastic. From the beginning, they have been responsive, dedicated and focused on protecting patients.

It’s inspiring to be a part of a team that remains focused in the face of crisis and pulls together to take care of patients and each other.

I am also proud of the thorough planning and the quick thinking of staff, whose responses minimized physical damage to our facilities.

The Village News has been important in the dissemination of information during this crisis and we look forward to continued partnering with you in the follow-up recovery and outreach, health information and healing efforts to rebuild our communities and lives.

VN: What challenges did the whole process encounter?

MM: This will be explored as we debrief with staff and review our disaster plan implementation.

 

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