With community hospitals close to maximum capacity daily, many cities are facing the need for community collaboration to meet the potential of natural or bioterrorist mass casualty response. The El Paso County/Colorado Springs community collaboration has formed DR HELP (Disaster Response for Health in El Paso County). This partnership was created by the efforts of the El Paso County Medical Society (EPCMS), El Paso County Department of Health and Environment, city and county Offices of Emergency Management, hospitals, schools, and other agencies. It is working to meet the challenges of medical and public health response to a massive disease outbreak or bioterrorist event, as well as other occasions involving overwhelming mass casualties.
Combining forces to make DR HELP our community’s Medical Reserve Corp are: 100-150 EPCMS physicians, 75 area mental health professionals, approximately 450 nurses, approximately 50 PAs, the dental society, the veterinary society, the City of Colorado Springs Office of Emergency Management, El Paso County Office of Emergency Management, Colorado Springs School District 11, and the El Paso County Department of Health and Environment.
No one medical or public health agency can deal with the potential onslaught of demands for services in a massive natural disease outbreak or bioterrorist event causing hundreds of casualties. By working together in existing structures, capacities can be increased and infrastructure established to face such events. This program is innovative in that it takes the President’s recommendation of a Medical Reserve Corps and realistically distributes authority and responsibility throughout the medical community to minimize demand on community hospitals, which are already operating at near capacity and unable to accept much additional surge capacity.
El Paso County Medical Society (EPCMS) began DR HELP because they realized that the hospitals in their region would be overwhelmed should a massive catastrophic event occur.
El Paso County Department of Health and Environment (EPCDHE) is involved in all aspects of planning. It developed charts entitled: "Can you recognize these public health threats in your facility?" and "Steps to take for suspected exposure to biologic or other terrorism agents."
The Mental Health Association of the Pikes Peak Region provides mental health professionals to respond to the mental health needs in an emergency.
Over 400 nurses from our area have registered with the Colorado Department of Public Health and Environment (CDPHE) Nurse Alert program, a voluntary data collection and information program.
Physician Assistants (Pas), The El Paso County Dental Society and The Colorado Springs Area Veterinary Society are coming aboard with a willingness to contribute to DR HELP.
The El Paso County Office of Emergency Management and The City of Colorado Springs Office of Emergency Management are both highly involved in this activity.
The City of Colorado Springs, a Metropolitan Medical Response System (MMRS) City, has been instrumental in the planning process by submitting a grant request on behalf of DR HELP and arranging for the City Police Department to provide the City’s Automated Notification System (ANS) for emergency notification of selected personnel in the event of an emergency.
Memorial Hospital and The Penrose-Saint Francis Hospital System work closely with EPCMS and EPCDHE, hosting CME training and providing standardized identification cards for credentialing using the Medical Reserve Corps logo.
School District 11, the primary City school system, will most likely provide the majority of the Alternate Treatment Medical Facilities. It will provide not only the hard shell building and amenities, but also security, parking, probably IT support, and possibly even food service.
Program costs have been an issue and to date have been covered by the hospitals and the Medical Society. A local bank, Western National Bank, sponsored the syndromic posters for physicians' offices. Other costs have included printing of CME material, food for training, and other miscellaneous printing costs. The partnership anticipates that any costs for credentialing identification cards will be covered either by the hospitals or, more likely, by the individuals volunteering. To date, City OEM, and EPCDHE have submitted four grant requests for training costs as well as supplies/equipment for the Alternate Treatment Medical Facilities. The partnership has not yet been successful in these endeavors.
DR HELP has provided two CME sessions and a tabletop exercise for approximately 200 health care professionals. Approximately 1,000 individuals have volunteered to be part of DR HELP.
The partnership will continue to seek State Health or State Public Safety grant funding; however, with the generosity of the hospitals, they are meeting demands for training. The most pressing issue will be providing equipment and supplies for the alternate facilities.
Challenges encountered include:Bringing together a diverse group of extremely busy professionals.
Impressing on these professionals the fact that planning needs to happen prior to an event. Responding to a catastrophic event is not the time to meet people and see who is going to do what.
To meet those challenges, the EPCMS, through the two hospital systems in Colorado Springs, has had continuing medical education sessions covering bioterrorism in general and, more specifically, the operation of the Alternate Treatment Medical Facilities. Sessions on chemical agent epidemiology, treatment, and decontamination are planned. On its Web page, the medical society has a letter from the society president (and chair of the DR HELP Task Force) inviting the organization’s membership of 900 to 1,000 medical professionals to consider becoming involved with DR HELP and encouraging their staff to also become involved. Physicians are willing to volunteer, yet often have no formal training in disaster response. DR HELP is filling that gap.
Other lessons learned: To date, the partnership has not been very successful at getting reimbursed for such costs as printing, equipment, and training. Having additional monies to assist in marketing DR HELP to the members might have helped the partnership in the past and is necessary as it progresses.
Minimum key elements include:
A competent and dedicated executive staff for the medical society.
A cadre of dedicated professionals from each of the various organizations and disciplines, who not only represent their agency or interest, but also transfer information both ways to and from these agencies.
The unwavering support of the emergency managers and health department of the community. The partnership is fortunate in having that from all parties.