Even before the storm named Nemo began to batter Connecticut, Yale-New Haven was taking steps to prepare for the worst. At 9 a.m. on Thursday, February 7, the hospital's Incident Command System held its first meeting in the command center in Smilow Cancer Hospital.
"We met and immediately started to plan how to hotel employees and transport essential personnel to the hospital. On Saturday, we implemented Plan D, which ensures that essential staff stay in the hospital until their shift is covered," said Abe Lopman, senior vice president, Operations, and executive director, Smilow. "We had to find beds on two campuses for 800 employees who needed to sleep for multiple shifts and days."
The command center for Nemo was operational for three days and in his 17 years at Yale-New Haven Hospital, Donnie MacMillan, physician assistant, and coordinator, Emergency Management, said that this was the longest that a command center was open.
It was already snowing heavily on Friday when Amy Jo Cochran, a business associate on Labor and Birth, came into work fully armed with two pillows and a large cup of coffee. Based on weather reports, she was pretty sure she would be working more than one shift.
"Usually, the command center is up and running for 12 hours until we get things under control," said MacMillan. "Clearly, with this storm, we were in it for the long haul." Lopman noted that because the storm hit on Friday, the hospital had received most of the supplies it needed for the weekend: medications, linen and food. The supplies proved critical because the York Street Campus had more than 900 patients and the Saint Raphael Campus had more than 350.
"Starting on Friday afternoon, we could no longer discharge patients because the roads were becoming dangerous and it was risky to send patients home or to nursing homes," said Lopman. "We had to keep patients here and safe until the roads were cleared."
Despite being unable to discharge patients, staff in the command center had to ensure that patients and ambulances were able to get into the hospital. Facilities on both campuses worked hard to keep the entrances clear and accessible for patients and ambulances. Above the Children's Hospital, Facilities crew cleaned the helipad on Friday night and again on Saturday morning in case a Life Star helicopter had to transport a trauma to YNHH.
"I think this was our best effort to date working with city, regional and state staff to make sure that they would give priority to keeping the streets around both campuses as accessible as possible," pointed out MacMillan. "We were in touch with them to assess the safety of getting staff and patients here and the communication really helped."
The command center also worked closely with Yale Medical Group and hospital clinics to send a unified message to patients. "We spoke with one voice telling patients that clinics and practices would be closed on Monday and this minimized confusion for them," said Lopman.
Employees throughout the hospital were heroic in their efforts to get to work and stay at work until the storm passed and travel was safe. In addition to employees who walked great distances to get in, many were creative and used skis, ski shoes and even a snowmobile to conquer the snow.
On the Saint Raphael Campus, staff came together to care for a particularly vulnerable group of young patients on the Children's Psychiatric Emergency Services Unit (CPES).
"Our milieu counselors and nurses worked long hours and multiple shifts to ensure that our patients had a calm, safe environment during the storm," said Katie Goldsmith, RN, CPES. "One of our milieu counselors abandoned his car and walked a mile on Saturday morning to get to the hospital. Staff and managers who couldn't get in supported us by phone and helped us keep things running smoothly."
On the York Street Campus, teamwork was crucial to the General Medicine Unit on 10-7 — a high-acuity, 27-bed unit, where six beds are for pulmonary patients who are on ventilators or tracheostomy masks.
"Everyone pitched in — we set up cots in our family lounge, rotated sleeping and used a visitor shower to clean up," said Stacy Farago, RN, who was the weekend charge nurse for the unit.
"One of our PCAs walked two miles to get here and one of our nurses who lives close by offered his apartment so three staff members could crash there between shifts," said Farago. "We all did what we could for our patients and each other and we did not have one patient complaint. What can I say — our staff rocks!"
"Throughout the weekend, we continued with our safety huddles by teleconference to both campuses," said Lopman. "We were on the alert for safety incidents and none was reported — not one — during the storm. "Our staff delivered the highest quality care to our patients over the course of 48 very, very difficult hours," concluded Lopman.