System connects ERs, emergency dispatchers

DAWN MARIE LEWIS, emergency preparedness coordinator at the Hospital Association of Rhode Island, explains how the Hospital Capacity System works /
DAWN MARIE LEWIS, emergency preparedness coordinator at the Hospital Association of Rhode Island, explains how the Hospital Capacity System works /

When The Station nightclub burned down in 2003, leaving hundreds of people injured – many grievously – a handful of hospitals took the majority of the victims, overwhelming their emergency departments while other facilities stood by, eager to help.
The good news is, the injured got the care they needed, and almost all survived. But after the fire, Rhode Island’s hospitals and emergency management officials vowed to do better in the future. And last Feb. 28, they launched a system they say will make all the difference.
The new Hospital Capacity System, developed by the Hospital Association of Rhode Island with state and local officials, connects all the emergency rooms in the state with the regional dispatch centers – and potentially, with the commander at a disaster scene – to provide up-to-the-minute information on how many beds are available at each facility.
The beds are further classified as red, yellow or green, denoting the number of critical and non-critical cases a hospital can handle. When an ER is full, it can use the system to go on diversion – meaning ambulances are diverted to other facilities.
Dr. L. Anthony Cirillo, chief of the R.I. Department of Health’s Center for Emergency Preparedness and Response, said the system was tested for about two months before going live, and it’s now used daily to track ER capacity.
“The system is designed to be functional not just for disasters,” he said, “because there are plenty of lessons learned that if you design it for disasters only, it will be a disaster.” In the future, he added, the system will also be able to track individual patients’ progress. The HCS cost $200,000 and was financed with homeland security grants. It’s a Web-based system, so anyone with Internet access and a passcode can connect to it.
Each ER has a computer dedicated to HCS, and there are terminals at the state’s two major emergency dispatch centers in Cranston and in Exeter. In addition, local fire departments, community health centers, the R.I. Disaster Medical Assistance Team, the police at T.F. Green Airport and emergency officials in Massachusetts and Connecticut are hooked up.
When officials need to know ERs’ situations, they send out an alert, and because the computers have loudspeakers, along with a pop-up window, a voice comes on, “HCS alert message, please respond!” When Dawn Marie B. Lewis, hospital emergency preparedness coordinator at HARI, did a demonstration recently from Memorial Hospital of Rhode Island, most of the ERs replied within a minute or two.
The system updates itself every 15 seconds, so changes are quickly logged. And HCS also can alert hospitals to needs at other facilities; all have signed an agreement, Cirillo said, that allows them to send staff, equipment and supplies to whomever needs them – so if, for example, there’s an emergency in Warwick, patients might not be diverted to Memorial in Pawtucket, but Memorial could send help to Kent Hospital.
The state is still keeping its Nextel phone-based emergency system and three other communications systems in place as backups. But as long as the Internet is accessible, the HCS is infinitely superior, Cirillo and Lewis said.

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