Drill Expertise Exported to Turkey
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The Need Under a special affiliation agreement, Johns Hopkins International experts were instrumental in planning the design, educational programs and staff training for the 209-bed Anadolu Medical Center (AMC), perhaps Turkey’s finest private acute care hospital. Yet one aspect of modern medical center management was missing: disaster preparedness. Opened in February 2005 on a 42-acre site east of Istanbul, the AMC is spared the din of the city’s downtown, just 25 minutes away. Within an 18-mile radius of it, however, are approximately 100 chemical plants and similar facilities. That proximity to potentially dangerous sites, as well as the fact that the medical center had never conducted a complex disaster drill, caused some concern among the hospital’s leaders and their JHI colleagues. Under Hopkins’s guidance, AMC aims to comply with Joint Commission requirements—which include emergency preparedness drills. Addressing the Preparedness Problem Last October AMC’s Chief Medical Director, Metin Cakmakci, contacted JHI’s Baltimore-based assistant director Burak Malatyali about the need to have an emergency preparedness drill at AMC. Malatyali called James Scheulen, executive director of Hopkins’s Office of Critical Event Preparedness and Response (CEPAR) for advice on how to plan, conduct and evaluate the effectiveness of a disaster drill at AMC. Representatives from AMC later visited Baltimore to meet not only with Scheulen and Malatyali but Christina Catlett, Hopkins’s associate director for health system preparedness, and Dianne Whyne, a veteran organizer of Hopkins-wide drills who is CEPAR’s director of operations and preparedness coordinator for the Department of Emergency Medicine. “We wanted to help them benefit from our successes and learning when holding drills here,” says Whyne. “We took our ‘best practices’ and validated them in Turkey.” Planning and Conducting a Drill Overseas Along with Carrie Jenkins, JHI’s global services project administrator, and Ilkay Baylam, Anadolu Medical Center’s project specialist in Turkey, the team began what Scheulen calls the “amazingly fast” planning of a three-day preparedness education and drill exercise requested by Cakmakci. In an e-mail from Istanbul, Baylam praised Scheulen, Catlett and Whyne’s “non-stop effort” on behalf of the hospital. Beginning on January 14, the exercise included a day-long, internal conference for medical center personnel featuring lectures and workshops conducted by Scheulen and Catlett. Another day-long regional conference on January 15 included presentations on handling disasters and associated injuries, as well as creating an emergency management system. These two conferences were followed by a comprehensive drill on January 16. A Realistic Scenario—And Eager Volunteers The AMC drill involved a scenario based on a fire and the shattering of a 100-gallon pesticide storage tank in a fictional plant two-and-a-half miles south of the medical center. “We designed a scenario that could be realistic and would challenge their system, both in terms of capacity and capability,” Whyne explains. With the help of 25 volunteer victims, the medical center’s ED responded to six types of patients—those exposed to the pesticide chemical; those burned in the plant fire; those with minor traumatic injuries; those needing emotional support; and one person with heart problems exacerbated by the incident. Systems had to be established before the drill to create an incident command structure; undertake mass decontamination of patients, and provide for hospital staff protection from chemical contamination. Overall, about 70 medical center personnel participated in the exercise. “Everyone with a role in the drill was excited and enjoyed it,” Baylam said in his e-mail from Turkey. “We had very fruitful discussions and feed backs after the drill for making the next one better. We will immediately start to make plans to improve our process and wish to conduct another drill after doing all the training, improvement studies and preparedness.” Exporting CEPAR’s Expertise Elsewhere JHI’s Carrie Jenkins says that the AMC combination of the workshop, conference and drill “was extremely successful,” and JHI plans to “inform our other affiliates of what CEPAR can offer in terms of education and consulting for emergency medicine and preparedness.” Should any of Hopkins’s other overseas affiliates want to undertake disaster preparedness efforts, Scheulen says that CEPAR is “happy to work with our colleagues in Johns Hopkins International” and is “ready to provide service wherever and whenever needed.” The next stop for a CEPAR team will be in Lisbon, Portugal, next month, where they will participate in an emergency department conference held by another JHI affiliate, Grupo José de Mello Sańde, one of the premiere hospital groups in Portugal, with three hospitals and four ambulatory care facilities. About Anadolu Medical Center Built under a 10-year affiliation agreement signed in 2002 between JHI and the Anadolu Foundation, the medical center has diagnosis and treatment units in oncology, cardiac care, women’s health, surgery (including ophthalmology, orthopedics, urology and pediatrics), neurological sciences and such specialties as endocrinology and hematology. It offers specialty-based clinical lectures, seminars and training for physicians not only there but at Hopkins or via video conferencing. Its 639-member staff includes 115 specialists and 223 general practitioners, plus 47 nurses. Its 639-member staff includes 115 specialists and general practitioners, plus 210 nurses. For more detailed information, go to www.anadolumedicalcenter.com < Top of page | 
