This Is Not a Drill: An Emergency Staffing Plan in Action

The call came in about noon, Sept. 2, 2005. The familiar voice of the nurse administrator on the other end of the line said, “I’m calling in my capacity as emergency planning chief.”

I normally worked with her in my job as HR manager at Mayo Clinic in Rochester, Minnesota. Since she was the planning chief, that meant I was the Labor Pool Unit leader, and I needed to initiate our emergency staffing plan.

I had always imagined that a call to activate the Labor Pool Unit would make my heart stop. I had dreaded this day, but two things worked together to keep me calm. First, the disaster was caused by a hurricane in Louisiana, nowhere near our campus or community. Second, I was ready, and so was my part of the disaster plan.

Mayo’s modification of the Hospital Emergency Incident Command System (HEICS), created by the County of San Mateo (California) Emergency Medical Services in 1993, was a strong starting point from which I built my department’s emergency plan. The main premise of HEICS is “to minimize the confusion and chaos common at the onset of a medical disaster by narrowing the activities assigned within a management structure.” That’s where the “Labor Pool Unit” title came from.

Initially, the MEICS (“M” is for Mayo) leadership team thought we might hear from National Disaster Medical System authorities to make 100 to 200 hospital beds available for victims of Hurricane Katrina. That was an “easy” scenario, similar to the “mass casualty” events we routinely plan for. The HR role requires finding additional staff to meet a large influx of patients.

That day, in addition to determining where extra nursing staff would come from over the Labor Day weekend, a new “front” emerged. Other states were receiving evacuees from Louisiana, and we thought we would be asked to do the same. This new twist meant we would have to find volunteers to assess and treat the evacuees arriving here in Minnesota.

My first task was to create a pool of volunteers. That would be the beginning of a long, round-the-clock weekend receiving calls from our employee volunteers and filling the staff roster requested by MEICS leadership.

I was soon to learn an important principle of disaster management: The only thing you can really count on is that circumstances will change. By Saturday it was all over the news that Minnesota Gov. Tim Pawlenty had agreed to receive 3,000 evacuees from Louisiana. They would arrive early the next week in groups of 100 for temporary housing in the National Guard barracks at Camp Ripley, Minnesota, and we needed to send physicians, nurses, social workers, pharmacists and support staff.

Even though our staffing plan was not designed for this scenario, we put many of its components to use. Our database contained the names, job titles and home phone numbers of every Mayo employee.

In this scenario, we could use only those who had volunteered. The data on volunteers soon surpassed the capabilities of our original spreadsheet, so we transferred everything into a new database accessible to multiple HR users. When we needed employees with specific skills, we ran a report from the original database in order to call specific employees.

The busloads of Louisiana residents never arrived, but we wouldn’t know that until 40 employees as well as equipment and drugs had been transported to the camp. That first group of Mayo volunteers was disappointed to miss out on a chance to help, but the good news was that we had learned a lot while staffing this first team. No doubt about it, this was a real disaster with real chaos.

One of our family practice physicians was an active member of the American Refugee Committee, an international, nonprofit humanitarian aid organization. The ARC was “boots on the ground” in Louisiana, and had asked their Mayo member if he could secure additional help from the clinic.

After our physician had assessed the situation, our top leaders agreed to partner with the University of Minnesota to send help. With the proper authorizations from Louisiana Gov. Kathleen Blanco and the state’s Department of Health, we began supplying teams of volunteers to care for patients in Louisiana.

Each team spent 17 days, including travel to and from Louisiana, providing evaluations, immunizations and medications to anyone who needed them. The first team left on September 12, and the last group returned on November 8. During that period, HR staff pitched in periodically, filling various roles we had defined in the Labor Pool Unit plan. Rotating in and out assured that we also got our regular jobs done.

Please read: Part 2 — When A Disaster Strikes, Will You Be Able to Staff It?

With each wave of volunteers, we got better at identifying the employees required to fill rosters and coordinating our efforts with other Mayo Health System sites, the University of Minnesota and the College of St. Catherine in Minneapolis. One of the toughest tasks was assuring that the “home” work units weren’t left short. We worked through leaders in key departments and obtained permission from supervisors before anyone was confirmed on the roster.

The easy part was carrying out the last-minute details before each team departed. Everyone was told to pack lightly, and to plan to wear “anything you can wash out in a bucket.”

We answered questions at each orientation session, checked names off the lists and waved goodbye as the buses left our campus every other Sunday morning. The Labor Pool Unit “stood down” after filling the final team roster on Oct. 21, 2005.

Whether it’s for a natural or a man-made disaster, you need an emergency staffing plan that fits your own industry. In the next installment of this two-part series–“When A Disaster Strikes, Will You Be Able to Staff It?” — I’ll outline the steps I took to create our plan at Mayo Clinic. With proper preparation, you will be calm and ready for any major emergency event you might face.