HJNO Mar/Apr 2025

12 MAR / APR 2025 I  HEALTHCARE JOURNAL OF NEW ORLEANS ROUNDTABLE Maslanka That was an EMS decision, on scene, for what they thought was the most appropriate facility based on those patients’ injuries, and they are great at making that determination on a daily basis. Editor It sounds like I'm hearing that the existing protocol worked pretty well. Baudouin Yeah, I think it did. We have been ramping up, in particular, with this mass casualty plan. As Dr. Elder mentioned, Dr. Maslanka has been the architect of this for many years. But with all of the attention of the Super Bowl and our larger events, we really wanted to ramp up our MCI plan and our protocol. This is something that we've really been at the forefront of — our emergency preparedness efforts throughout the year. I, personally, was very pleased to see throughout even the course of the last year how we've improved on some of those ini- tial efforts or things that we've identified that needed it. And I think that, to Dr. Grei- ffenstein's point, you cannot undersell the amount of institutional knowledge that we have at this hospital and the amount of tal- ent that we have here. It is a great protocol and plan in place, but the people we have here are the best in the business for a rea- son, and that is why it goes so seamlessly when something dire really does occur. Maslanka If I may, about the plan: I started 10 years ago, along with several of our charge nurses from the emergency department, to create a protocol for the emergency department. We quickly realized you have to build one for the entire hospital, because every department is affected or impacts the ability of the emergency department to respond. Since then, it has grown. This plan is the fruits of the labor, blood, sweat, and tears of many people. Misty here has been absolutely critical and has written the plan for our nurses in the emergency department, and she has done a phenomenal job. And Jeanne Marie and I have spent hundreds of hours over the past year revamping this plan in anticipation of the Super Bowl. Since this incident, we have worked tirelessly to put in corrective actions of things that we thought we could fix from this plan because, while we're always proud of it and we always think it's the best it can be, every time you do a drill, every time you have an incident, you learn that there are these things you could do even better, so let's change it to be able to do that. Editor And what did you learn? Maslanka Typically, the thing you learn most about is communications. Any disaster that you look at, communication is absolutely critical. We tweak some things with our communications plan — who we want on the lists and the messaging that goes out to provide everybody with more clarity. We've reached out to each department so they can tweak their notification lists, and we've worked in our automated system to change the wording so people know exactly what's going on. Baudouin One thing that I would like to say that we learned a lot this time is how our nurses were able to respond when they got that volume, and really, what was a more practical approach as opposed to one that was originally listed on paper. Since then, Misty has continuously evolved that education for those nurses, and we have made a lot of advances there if you want to touch on that. I think seeing it being done is where you see it the most, as opposed to just drills and exercises. Dufrene Maybe starting September or October last year, we really started drilling our plan very hard because we knew all the big events that were coming up. Unfortunately, the actual event did make us see where our errors were — what can be improved. Even our check-in process is now different. It was easier for them to just put the patient in the system once they got to where they were versus trying to stop everybody at the door, so it doesn't delay care. Not that it necessarily delayed it, but it's one less step you have to do so they can get to their final care point. Now what we've done is every nurse assignment in the entire ED, if you go and look at your assignment, there's a sheet that tells you exactly what you have to do — very simple, just start to finish — and then return to your assignment whenever everything's over. There's a map of the ED, because they were saying, "We don't know where these areas are." Now, there's every graphic you can think of to help show. If you have a question, everything's pretty much answered, laid out right there for you. You don't have to find the charge nurse and ask, "What am I supposed to do?" It's all there and simple for whoever needs it. Lacy Just to expand on that, not only are we doing internal drills, we are just getting off of doing regional drills. Drilling with our external partners and having those relationships with the EMS and the government — the city government, the state government — that is really crucial for this response. Having that line of communication with EMS ahead of time has been very beneficial just to get the heads-up, "Hey, this is what's going on." People are starting to be a little bit more aware and be able to get in that mindset of, hey, something's going on. And having those relationships with the city government and being able to communicate that this is where we're at as the trauma center and these are the resources that we need … all of that was only possible because of the work of emergency management and participating in those drills ahead of time. Editor You guys are a Level 1 trauma center. Obviously, you see trauma every day. This was labeled terror. Did it feel different to you? Lacy Yes.