Emergency Management

How I Heard

When the incident occurred, I was at home sleeping. I received a text message from my boss at the time asking if I was going into work. I then quickly looked at my emails and saw numerous alerts for a mass casualty incident, active shooter, etc. I didn’t even read them, just quickly got ready and responded into work. I arrived at ORMC around 4 something that morning.  My reaction was, I need to get there as quickly and safely as possible to help. I just kept thinking, What is next? What else is going to happen?

Synopsis

At the time, I was the manager of emergency preparedness for Orlando Health. My job was to assist the organization by leading the Emergency Management program, which includes the strategic direction and oversight of preparing, responding, recovering and mitigating emergency situations that may or have occurred in our community or at our facilities. You cannot stop or mitigate all disasters or emergencies from occurring, but you can try to plan, educate and exercise for the impact of them. This is a very challenging role for anyone who fulfills it within any organization, but especially for a healthcare system. We try to plan and train for all hazards, which could include man-made, natural, intentional and health-related. If you have watched the news recently, you know there is a rapidly increasingly amount of threats and hazards we may be faced with. It takes repeated, persistent and dedicated efforts to build a better-prepared organization. This is not a one-time occurrence nor can it be achieved within just one day, month or year. It must be accomplished over time -- one step by one step, just like building blocks. The continual efforts we undertake at Orlando Health were proven valuable during the June 12, 2016, Pulse tragedy.  Numerous people told me in person, in text messages and emails that our efforts helped save lives in the incident. I am an administrator not a clinician, so this was quite humbling to hear. It also makes me want to continue enhancing our efforts to ensure we are better prepared for the next disaster.

Although the Corporate Command Center, Orlando Health’s overall system Emergency Operations Center, was not activated during our Pulse response, I still fulfilled the Liaison Officer (A shift) role. In this capacity, I ensured the hospitals were responding appropriately to the incident at hand. This is where my certifications, training and experience come into play and practice during an incident.

Preparation

To learn more about Orlando Health’s 20-year journey of emergency preparedness, click here.

Need help making a case for emergency preparedness at your organization? Click here for an overview of why and how you should prepare. 

Response

The Orlando Health team was able to go into fight mode and remain in place to care for the patients due to their training and education. Without that, they could have gone into flight mode. It is very eerie for me to look at pictures from our full-scale community exercises because a lot of the same people were in the same location doing the same thing during Pulse. That just proves the worth of training and preparing for major emergencies.

The Orlando Health Emergency Preparedness team is even more dedicated today than ever because of what we experienced during Pulse and what the community expects of us during the next disaster. We now have an incident response and management playbook that is updated with our major lessons learned from previous emergencies. We can and have used it a subsequent emergency to ensure we don’t fall into the same traps or experience the shortfalls of previous incidents. This proved successful in our Hurricane Irma response in 2017. No organization is truly prepared for a major disaster; there are always areas that can be improved or streamlined.

Lessons Learned

Our After Action Report (AAR)/Improvement Plan (IP) for the Pulse Tragedy is 51 pages long and includes 66 areas of improvement. To this day, we continue to work on the corrective actions for those areas to ensure we are the best hospital possible not only during normal, everyday life but during times of major emergencies.

What worked well:

• We, the Orlando Health team, were able to respond, treat patients and save lives when it mattered most.
• Team members showed exceptional care and compassion to the victims and their families/friends.
• Prior experience and knowledge of the ORMC Hospital Command Center (HCC) helped to manage the incident effectively, including quick activation of emergency plans and HICS.
• Continual work and coordination with our community partners.

Areas for improvement:

• Need for a mass notification system for Orlando Health that can alert specific hospital departments/individuals to respond and provide updates to all team members on the incident situation. This system needs to have a hunt feature that will not stop until the recipient responds.
• Additional planning around support and care for victims’ families and friends following a tragedy such as this.
• Expanded collaboration and coordination with our community partners.

What We Changed

We continue to leverage learnings from Pulse to ensure that our Emergency Operations Plans (our policy and procedures), equipment, training, etc. are enhanced from and by the incident.

• Security at ORMC will never be the same, and the post-incident impacts will remain or be bolstered in the future.
• We now have a process for working with foreign national patients, which is rare for American hospitals and healthcare systems.
• There is recognition that our team will need post-trauma support when something else major occurs in our community.

Key Takeaways

• Plan, prepare, educate, train and exercise for what emergency could affect your organization. These efforts do save lives as this incident illustrates.
• Collaboration and coordination with both internal and external stakeholders are extremely important, especially for a manger in the emergency preparedness role.
• Communication will always be an issue, no matter what. History shows that no matter how much effort you put into a crisis communications plan, there will be communication gaps and issues whether you are conducting an exercise or responding to a real incident. So take additional steps now to ensure there are redundant systems, people or equipment in place.