Code Orange at North Bay Regional Health Centre, Re-evaluating emergency preparedness

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When the staff from the former Northeast Mental Health Centre and North Bay General Hospital moved into their brand new, state-of-the-art facility in January of 2011 there was a lot of changes—and emergency preparedness was one of them.

“The move to the new hospital forced us to re-evaluate and change our plans for everything,” explains Eric Bouchard, Emergency Department Manager. “The emergency department alone is three times the size it was at our old site. It became clear very quickly that our plan did not suit our new physical space.”

The new North Bay Regional Health Centre is located on a 32 hectare site adjacent to Highway 17. The District Hospital has 275 acute care beds and the Regional Mental Health Centre has 113. Combined, the hospital has a gross area of 70, 171 m2.

The first year after moving into the new building was full of changes, including the amalgamation of the former hospitals into the North Bay Regional Health Centre.  Ellie Naismith, Coordinator Parking Security and Emergency Response says there were so many changes and adjustments for staff, that the emergency response plan wasn’t front and centre. “It took time to get in and get used to our new surroundings. Then we were ready to tackle the new plan.”

Naismith says there were also a few events in and around the North Bay area that really pushed the need for an updated plan. “There was an overturned tanker truck that leaked formaldehyde into Trout Lake, a lightning strike directly across the highway from the hospital caused a gas pump fire, and some other emergencies in the region that threatened to have an impact on our hospital.”

“We knew more players had to get involved because of the physical layout and sheer size of our new hospital. We had to figure out how we were going to set up for an emergency, how things would flow,” Bouchard says.

A multidisciplinary group comprising of representatives from the Emergency Department, Health and Safety, Environmental Services, and the Laboratory began to meet bi-weekly to create a new plan that would meet the needs of the new facility. “One of the successes is having this great cross section of staff from the hospital, each bringing different perspectives,” Naismith says. “At this point we have mainly been working on Code Orange & CBRNE.”

Naismith says the size of the new building has enabled the committee to plan for scenarios that they never could before. “In a small or large surge respiratory scenario, we have the capability of changing one of our 32 bed inpatient units into a negative pressure unit. Also other areas such as our ambulatory care unit and our gymnasium can be utilized if needed,” Naismith says. “We also have the ability to instantly lockdown the building with the security software.”

Training staff and getting their buy-in was the next step. “All of our emergency department and environmental services staff have to be trained,” Naismith says. “The environmental services staff are key to setting up everything and helping to make sure patients are transported properly to prevent contamination of the rest of the building.”

Bouchard says to date about 60 per cent of the emergency and environmental services staff have been trained. “We have had two training sessions, with a third planned in the fall. They are full day sessions from eight am to four pm with a debrief at the end of the day. The feedback from our frontline staff about what went well and what could be improved upon has been helpful in framing our next sessions.”

Bouchard says after some initial hesitation, the staff have embraced the training and are asking to sign up for upcoming sessions. “Our staff have bought into the idea that is all about safety—we want to keep you safe, and to be safe you need to have this training.”