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Trip to Alabama Helps Prepare for Emergencies at Johns Hopkins

Johns Hopkins faculty and staff participate in federally sponsored emergency preparedness training.


Johns Hopkins faculty and staff participate in training at
the Center for Domestic Preparedness in November 2019.

Imagine — it’s Friday morning in Noble, U.S.A. A local reporter highlights the news of the day during a TV newscast. All of a sudden, the camera begins jerking around violently. The lights in your room flicker. It is a magnitude 7.0 earthquake. The earthquake causes extensive damage to Noble Hospital, where you work. Then there’s a subway tunnel collapse, a chemical plant explosion and a potential nuclear disaster. Ambulances rush patients to the hospital in masses. What do you do?

These events aren’t from a TV medical drama, and Noble, U.S.A., is a fictitious town. It’s part of an exercise by the Federal Emergency Management Agency’s (FEMA) Center for Domestic Preparedness in Anniston, Alabama.

Since 2017, about 60 faculty and staff members in various roles across the Johns Hopkins Health System and university — ranging from physicians and nurses to emergency managers and pharmacists — have participated in the training. FEMA fully funds the training, including travel and accommodations. More than half the faculty and staff who have attended the training did so in November 2019.

For a majority of the Johns Hopkins participants, the Johns Hopkins Medicine Office of Emergency Management helped coordinate the training to enable them to attend.

Faculty and staff “have their day-to-day responsibilities, and it’s really a challenge to set aside time focused on disaster preparedness,” says Bob Maloney, senior director of emergency management for the Johns Hopkins Health System. “This is an opportunity for them to travel to Anniston to focus and not only interact with very knowledgeable staff, but exchange best practices with their colleagues from around the country.”

Many Johns Hopkins faculty and staff members have attended either the center’s Healthcare Leadership for Mass Casualty Incidents (HCL) or the Hospital Emergency Response Training for Mass Casualty Incidents (HERT) courses. Each course takes about five days to complete.

“I always have had an interest in learning more about disaster management,” says Peter Hill, M.D., senior vice president of medical affairs (VPMA) for the Johns Hopkins Health System, who attended the HCL course in November 2019. “But in my role as VPMA, I was particularly interested in learning more about hospital command structure and potentially how we would integrate and work within our health system if we need to respond to particular disasters.”

The HCL course is a mix of in-class training and mini drills designed to address disaster preparedness at the facility and system level. It also teaches the basics of emergency management, including hospital incident command structure and the composition and need of a hospital emergency treatment team during a mass casualty incident. The HERT course is hands-on training focusing on health care response at the operations level for the facility and personnel. Attendees learn the basics of hospital incident command, how to wear personal protective equipment, how to respond to a hazardous materials incident and how to decontaminate patients, among other topics. On the final day, participants in each course, which run concurrently, come together to put their knowledge to the test in a full-scale exercise called the Integrated Capstone Event (ICE).


Kimberly Fisher and Cagla Oruc, both emergency
planners in the Johns Hopkins Medicine Office of
Emergency Management, in Level C personal protective
equipment during a HERT class in November 2019.

“[The exercise] was phenomenal to say the least,” says Amyna Husain, D.O., pediatric emergency medicine physician and director of pediatric emergency disaster management, who took the HCL course in 2017. “They really test our limits and push our ability to manage different issues thrown our way.” Some of the “curveballs” she experienced during her training included concern that the incident might be related to a terrorist attack and determining the order to treat patients, particularly when one mock patient was a first responder’s child.

“It was incredible to see how much unfolded from the little we knew Monday morning when we first got there to our ICE on Friday, and watching all of our training come together,” says Morgan Scott, R.N., who works in the Johns Hopkins Bayview Medical Center emergency department and attended the HERT course in November 2019.

People in a variety of roles, including executives, patient services, clinical staff, infection control staff, social workers, public health representatives and more from around the U.S. are able to participate in the trainings.

“Everyone was actively involved, and it really showed how much it takes a team, a hospital, a region to manage a disaster,” Husain says. “It’s not one person; it’s not one division; not one department. It really takes a village when something as tragic as a mass shooter or any mass casualty happens.”

Overall, many Johns Hopkins participants have praised the courses.

“I think I’ll be in a better position to understand, represent and publicize the importance of this work throughout the rest of the hospital and to leadership,” Hill says.

Gabriel Innes, V.M.D., veterinarian liaison for emergency preparedness at the Johns Hopkins School of Public Health and member of the CEPAR-affiliated Johns Hopkins Go Team, took two of the courses, including the HCL course, in July 2019. “I would absolutely recommend this course to everyone who can attend and has a mandate to respond to emergency situations,” Innes says. “It was a worthwhile and impactful experience.”

Based on the experience, staff members at Johns Hopkins Bayview attained in the HERT course, they have formed a HERT team at the hospital composed of staff members from the emergency department and across the hospital who could support the ED during a mass casualty incident. “The training and knowledge that I have gained will help me at Bayview, because I am now able to train others to be part of our HERT team, and ensure we are prepared for the worst,” Scott says.

The Johns Hopkins Medicine Office of Emergency Management is continuing to coordinate training for future courses.

“I’m thrilled with the level of participation from across the enterprise,” Maloney says. “We continue to increase the number of personnel trained to efficiently and effectively manage crises and ensure the continuity of our mission.”

“Training more people in emergency management enhances the preparedness of Johns Hopkins,” says Cagla Oruc, emergency planner in the Johns Hopkins Medicine Office of Emergency Management, who attended both the HCL and HERT courses. “We believe in that, and that’s why we are trying to send more people down to Alabama to train with FEMA.”

Anyone interested in attending training at the Center for Domestic Preparedness can email Cagla Oruc in the Office of Emergency Management at coruc1@jhmi.edu or jhmoem@jhmi.edu.

Read more news and information from CEPAR’s Hopkins on Alert