Progress for tomorrow: Preparing for the next disaster
KELLERMAN: I'll give a couple of quick answers. First, just to put in a plug to the audience, in probably June, the Institute of Medicine is actually going to release three reports on the future of emergency care in the U.S. health system, and I am on that committee. I hope that people will keep their eyes and ears open for that report and its recommendations, which will touch on this issue and a lot of others.
Secondly, I can tell you 10 years ago I was standing at the ambulance bay of Grady the night of Olympic Park bombing. Now, that was not pandemic flu, but we received about 40 or 50 severely to critically injured patience in the space of about 90 minutes. I was able to take virtually every patient - it was the then the busiest ER in Georgia, and either move them upstairs to beds on the floor or get them out the door before that wave of casualties came in. We took care of those patients and were back on operational footing in five hours.
This is the cornerstone of the disaster system in Atlanta at Grady. We could no more do that today than fly a man to the moon again because we don't have the capacity in our system, we don't have the nurses, we don't have the empty beds, and we don't have the policies in place that would allow us to do such basic things as take a stretcher out of an ER hallway and park it in an in-patient hallway.
So the first thing we need to do is to recognize as the Israelis have for years, that a hallway is a hallway is a hallway, and there is nothing magic about having 30 or 40 admitted patients in an ER hallway on the first floor and having now patient in any hallway in the rest of the hospital. In an extreme circumstance, everybody has got to play together as we played the night of Olympic Park and step up to the plate. That is exceptional increase in capacity. You have got lab there; you have got X-ray there; you are going to care for far more patients than you had ever chose to, but it's better than not providing with care at all, and every hospital in America should have the capacity to do that, the willingness to do it, and practice it now before they need to.
HEALY: Do we need more exercises?
KELLERMAN: Absolutely.
HEALY: Do you think our hospitals –
KELLERMAN: Well, we need more exercises and we need them to be real, and we need to start boarding some patients on in-patient hallways if necessary and not having every admitted patient stranded for hours or even days in an ER of a private a public hospital. It is crazy to block the most time-critical access point in the American healthcare system on a routine basis and divert ambulances to other hospitals. It is absolute lunacy.
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