Project Details
About the Project
As an Emergency Room Physician, you never know what your day is going to look like and you have to be prepared for any situation. Dr. Mike Thomson, Emergency Chief at Victoria General Hospital has been working with an outstanding, cross-organizational team of people to prepare the ER for disasters, a.k.a. Code Oranges: Major incidents or emergency situations that result in the simultaneous arrival of several injured people at the hospital. Code Oranges could be triggered by natural disasters, multi-vehicle accidents, mass injury events, or dangerous substance or pathogen exposures.
This monumental preparation task requires ongoing collaboration between physicians, Island Health employees, as well as with partner agencies. Within the department, much of this work falls to the nursing management team (Danica Kay, Stephanie Richter, Laura MacKinnon) along with Auden Neuman RN and Barry Sohal HCA, who lead the work on preparing the disaster carts, equipment, and PPE. Regionally, Dustin Griffiths from Health Emergency Management BC (HEMBC) coordinates South Island emergency preparedness.
Through Facility Engagement funding, Dr. Max Moor-Smith, Dr. Jessica Timmings, and Dr. Hilary Drake, have been able to contribute the physician voice and expertise to simulation, organizing a massive mock Code Orange with HEMBC expert Dustin Griffiths. A day-long disaster event was held at Camosun College’s School of Nursing, bringing together nursing and health care students, residents, paramedic students, Island Health leadership, and critical care RNs. It’s through simulations like these that all members of the emergency response team are able to network and become ready for real-life situations.
The annual mock disaster at the Legislature brings together police officers, fire fighters, Legislative security officers, BC Emergency Health Services, HEMBC, and Island Health. As shared by Dr. Thomson, “we speak a similar language, but each group has a different and important role in a disaster scenario.” This funding ensured there was a physician voice at the multi-disciplinary table.
Adding to the benefits of simulations, numerous Victoria-based emergency physicians who have additional education and expertise in Disaster Management have jumped in to tackle snippets of the important planning work. Overall, this Code Orange project has been a robust, team-based effort.
Within the hospital, there are so many aspects to emergency preparedness planning, often done in silos when there isn’t a central role to bring everyone together. As shared by Dr. Thomson, “Leadership from HEMBC, physicians, and nursing is essential: the work needs all three groups, as everyone brings something different.”
This connection has led to related and equally important planning discussions: How does the EMR support a disaster situation and what changes need to be made? If Security is required to lock down the hospital, how do health care teams continue to provide both emergency and regular care to patients? What contingency plans exist if a hospital becomes overwhelmed? As offered by Dr. Thomson, “there is still much work to be done for optimal disaster preparedness, and this work has highlighted the ongoing need for continued quality improvement initiatives in this area.”
It has become clear that the next steps in disaster preparedness must include enhanced collaboration among all departments in the hospital, including Surgery, Trauma, Critical Care, Anaesthesiology, Pediatrics, and the Hospitalist team. If and when a significant event occurs, it will require ‘all hands on deck’ approach to treat our community effectively. Having a robust, tested, and regularly updated Code Orange plan is an essential success factor. Further, the amount of ongoing effort required to complete this interactive and essential Code Orange work clearly demonstrates the need for a fully funded dedicated multi-disciplinary team involving HEMBC, nursing, and physician leadership.
Island-bound communities like Victoria need to be especially prepared and self-sufficient for when disasters strike: We are truly grateful to Dr. Thomson and his Emergency Medicine colleagues, as well as to Dustin Griffiths at HEMBC, and Danica Kay, Stephanie Richter VGH ER Managers for their support, dedication, expertise, and forethought to keep us all safe.