Hospitals plan
for outbreaks

Infectious illness drills call for
field facilities with 20 extra beds

Five 20-bed field facilities are planned to increase the capacity of Hawaii's hospitals to care for patients in a public health emergency.

The first unit will be deployed to North Hawaii Community Hospital on the Big Island for an exercise Aug. 1-3, said Toby Clairmont, Healthcare Association of Hawaii emergency program manager.

"The gap between available beds and the population is really on the neighbor islands," he said, pointing out a public health crisis would pose a severe burden on hospitals in those areas.

"We need to be able to expand hospital capacity in a major public health emergency," and it must be done quickly and safely, he added.

The exercise will simulate an infectious disease outbreak spreading through the population and overwhelming North Hawaii Community Hospital, Clairmont said.

According to the scenario, the hospital's 41 beds would be filled, some staff would be sick and "more people needing care than it is possible to help," he said.

The 20-bed unit being built to deploy there is a special type of tent with heating, electricity, bath and shower and an insulated floor, Clairmont said. It will function as part of the hospital, he said.

The Healthcare Association, which represents Hawaii's hospitals and nursing facilities, is conducting the exercise under an agreement with the state Department of Health.

North Hawaii Community Hospital was selected for the first exercise primarily because of its remote location away from airports, said Wayne Higaki, the hospital's assistant vice president. "If we can do this successfully here, we can do it anywhere.

"It's a terrific opportunity not only for the hospital, but for peace of mind for the outlying islands to have this capability," Higaki said.

Maui and Kauai will each get a field hospital, called an acute care center by federal officials, and Oahu will get two, Clairmont said.

If necessary, they could all be connected like a giant Lego to provide 100 beds, he said, "but we wanted one piece in every county so they would have a tool they could use tomorrow if they needed it."

In a situation where a hospital is faced with an excessive patient demand, inadequate resources and a worsening health emergency, resources would be drawn from other hospitals in the state to help, Clairmont said.

"One barrier is people; the other is space under roof."

The first exercise will test the ability to pull people and equipment together in one location to see patients, Clairmont said. Future exercises will be more complex scenarios, he said.

Equipment and supplies and about 50 people will be sent to the North Hawaii hospital with the new unit, including nurses, physicians, housekeepers, security personnel, respiratory and other technicians, Clairmont said.

This will be Hawaii's first disaster medical assistance team, he said, noting the planning, procurement, training and exercise are all federally funded as part of the state's disaster plan.

He said the acute care unit is being localized "into something that really works for us." Each tent will be identified with the name "Hawaii" and a Hawaiian flag.

Although the emergency system of people and equipment is designed to help Hawaii, theoretically it could be sent throughout the Pacific to help after a hurricane, tsunami or plane crash, Clairmont said.

The emergency medical plan has been in the works for two years, he said, noting some people were skeptical, saying no one would want to volunteer in an emergency.

Then the Dec. 26 tsunami occurred in the Indian Ocean, and the Health Department and the Healthcare Association "experienced an unbelievable number of calls" from local health providers wanting to help, he said.

"What we're building is a human resources system where we catalog all the people in health care interested in being in a disaster, and we can draw on them in an emergency," Clairmont said.

"This capability does not exist in the state today; it has never existed in the state, so August is our first step.

"We will pre-register people, make them members of an organization, and when we need them or they want to go somewhere, we've already got their credentials, we know what they're trained in, where they live and how to move them."

The exercise will include a review period to ask participants what they thought of it and to identify any gaps. Operations also will be suspended the evening of Aug. 2 to show community leaders what the exercise is about, Clairmont said.