University of Virginia Health System played a key role in caring for people injured during a white nationalist torchlit march Aug. 11 and a "Unite the Right" rally Aug. 12 in Charlottesville, Va.
The health system, also in Charlottesville, cared for roughly 30 people affected by the events. Most of the patients treated had experienced trauma from an incident Aug. 12 in which a person drove a car into a crowd, says Tom Berry, director of emergency management at UVA Health System. All patients treated at UVA Health System were discharged by Aug. 21.
Mr. Berry recently discussed with Becker's Hospital Review how UVA Health System prepared for and responded to the rally. He also offered advice for other health systems in areas where similar rallies are planned.
Note: Responses have been lightly edited for length and clarity.
Question: How did the health system prepare for the rally?
Tom Berry: We did intelligence collection. It was primarily unclassified information that really anybody could pick up through Facebook, Twitter, blogs and websites. I also talked to Charlottesville police a lot because they were getting intelligence through the law enforcement channels, some of which was from the state fusion center, which is part of the Virginia State Police. So that was one part of how we prepared because that helped me and my team understand what the situation was and what the threats were. And that helps as you go through the rest of the preparedness or the planning process.
I also had probably seven or eight small working groups, and they were the ones doing the planning, the coordination and the work to prepare. And those small working groups were organized in general terms around clinical operations, logistics and what I would call plans/communications.
Additionally, I had two meetings that included our incident management team — one was two weeks out and one was one week out. Those meetings contained about 60 people not only from across the system but also our partners in the community and in the region like the Charlottesville Fire Department, which oversees rescue, as well as Charlottesville-based Sentara Martha Jefferson Hospital and also emergency medical services. I didn't see those as really a planning/coordination meeting as much as information sharing. It was an opportunity where experts from across the health system and in the community had a chance to share what they were doing to prepare.
The fourth piece of the preparedness phase was coordinating with the local, regional and state entities. I was integrated with the University of Virginia meetings with the college president, and I was talking to the Virginia Department of Health. It was really me sharing my plans with UVA, the department of health representatives, our sister hospital Martha Jefferson, Charlottesville fire officials, Charlottesville police, university police and the local emergency manager.
Q: What was it like to go through the preparedness process?
TB: I joined UVA Health System in 2007. Before that, I had spent 22 years in the U.S. Army, and I worked in the medical task force kind of environment, but always closely aligned with the deployed units, not necessarily in hospitals. From a hospitalization and medical treatment and medical transport perspective, I would say many of the concepts we developed in our plans and in our response were very similar to how you would respond to a mass casualty situation in a humanitarian or even in a hostile fire kind of situation.
Q: What was preparedness like on the hospital grounds?
TB: We started on Aug. 8 looking for opportunities to what I call decompress the hospital, meaning let's try to discharge patients safely and then look for ways to make sure the emergency room and inpatient areas have capacity. We start Aug. 8 and on Aug. 12 we're as decompressed as we possibly can be to absorb a large volume of patients.
Hospital officials also looked at the operating room schedule, especially for Aug. 12, and ultimately decided to cancel elective surgeries that day. We still did emergency and transplant surgeries.
Q: What was staff morale like during the weekend events?
TB: With technology the way it is, everybody could see what was happening on Twitter. People could go on the periscope and see the live feeds or Facebook live feeds, so not just in our command center where we see that and hear it on the radio. We started to notice as things were building Aug. 12 that employees, team members and visitors were becoming anxious because even though it was happening downtown and we had restricted access and heightened our security in the building, when you're seeing that stuff on TV it immediately translates to anxiety and "Am I safe?" So we countered that with frequent huddles that originated from our command center. But then it was kind of a ripple effect where leadership took the information from the command center and they disseminated that to the employees, patients and visitors.
We also had our employee assistance program experts on call as part of the plan. They work with employees on a daily basis on various types of things but have the ability to do crisis intervention, including counseling and other efforts. So what I did is pull them in and say "Hey, I just think you need to circulate throughout the hospital, make sure people are OK, communicate what you're hearing in the command center huddles and just reassure people and then bring information back to the command center that you may think is relevant so we can apply other options as necessary."
Q: What is your advice for health systems that may be in similar situations?
RB: Charlottesville is not a real small town, but it still has that small town feel so a lot of times people think [these kind of violent events] won't happen here. But I think after this incident people realize it could happen in Charlottesville. So communities whether they're small, medium or large I think can all benefit from going through the planning process. I said throughout the planning process phase and the preparedness phase it's not the plan we end up posting on our website, it's the process. It's making sure you have the networks and the relationships [with local entities] so when it does happen you're not developing those on the fly. It could happen anywhere and the planning process is much more important than the plan.