WellLink Health Alliance Coordinates Medical Response Surge Exercise Simulating Mass Casualty Incident

On Feb. 6, Northeast Ohio Healthcare Coalition (NEOHCC) members came together for a high-stakes, real-time disaster simulation coordinated by WellLink Health Alliance. The annual medical response and surge exercise (MRSE) brought together 25 hospitals and key coalition stakeholders, including county emergency management agencies and Centers for Medicare & Medicaid Services required entities, to evaluate how effectively the region could respond to a mass casualty incident while maintaining coordinated patient care across multiple counties.

A yearly requirement of the Administration for Strategic Preparedness and Response (ASPR) Hospital Preparedness Program (HPP) Cooperative Agreement, the MRSE evaluates the Coalition’s capability to handle a patient surge equal to 10% of the region’s licensed general medical/surgical bed capacity.

This type of exercise involves multiple agencies working together to identify communication gaps and improve interagency collaboration, and can be tailored to specific scenarios, such as natural disasters or terrorist attacks, making them versatile training tools.

“Medical response and surge exercises are critical to ensuring our region is prepared to respond quickly and effectively when a disaster occurs,” said Emergency Preparedness Program Manager Christina Fozio. “By bringing hospitals, emergency management, public health and community partners together in a realistic scenario, we’re able to strengthen coordination, identify gaps and build relations needed to protect patients and communities across Northeast Ohio.”

HPP and Regional Planning
WellLink Health Alliance has served as the Northeast Ohio Region II (Lorain, Cuyahoga, Lake, Geauga and Ashtabula County) subaward grantee of the ASPR Health Care Readiness HPP Grant program since the federal program’s launch in 2003. HPP supports regional collaboration and healthcare preparedness by funding the work of the Northeast Ohio Healthcare Coalition and its partners across hospitals, emergency management, public health and community organizations.

As the sole source of dedicated federal funding for healthcare system readiness, HPP plays a critical role in improving patient outcomes during large-scall incidents. The program helps reduce the needs for federal and supplemental state resources during disasters and supports faster recovery for communities affected by emergencies.

The Feb. 6 exercise included approximately 50 coalition members, including WellLink’s emergency preparedness team, Cleveland Clinic, University Hospitals, Mercy Health, MetroHealth, Cuyahoga County Emergency Management Agency, Lorain County Emergency Management Agency, American Red Cross, Centers for Dialysis Care, Northeast Ohio Trauma System, and local/county public health departments, fire and emergency medical services (EMS).

In addition to coordinating the scenario, WellLink played a key role in the exercise by coordinating situational awareness and sharing critical information with coalition members and the Ohio Department of Health. Serving as a vital layer of resource coordination alongside county emergency management agencies, WellLink also assisted hospitals in managing patient movement and balancing capacity across the system.
 
The MRSE Scenario
The exercise centered on a mass casualty incident occurring during the annual Thunder on the Strip motorcycle rally in Ashtabula County. In this scenario, a food truck’s propane system explodes, igniting nearby vendor tents and triggering a partial structural collapse that leads to a crowd surge.

Initial responders are overwhelmed and a mass casualty incident is declared as early estimates indicates up to 500 patients with injuries varying in severity. Local EMS, fire and law enforcement establish command, and notifications go to hospitals and the NEOHCC.

To further complicate the response, a severe summer storm is forecast to move into the region during the incident, bringing the threat of damaging winds and possible tornadoes, forcing responders and hospitals to manage both a large-scale casualty surge and the potential for additional weather-related emergencies.

During the exercise, a core coordination team operated from the University Hospitals Management Services Center in Shaker Heights, OH, while most participants interacted virtually from their own operations centers. Hospital operation centers included organizational leadership from bed management, emergency management, executive leadership, emergency department staff and incident management teams. 

Using “paper patients,” hospitals worked through the operational steps required to receive, triage and treat a sudden influx of patients from the disaster scene. Coalition and public health partners discussed support roles and actions to assist in the patient movement process and maintain hospital capacity. 

Key discussion topics included: 

• Mass casualty incident triggers
• Trauma response protocols at hospitals.
• The patient transfer process.
• The process for discharging stable patients from hospitals to home health care.
• Effective communication between skilled nursing and other agencies to open additional bed space for the most severe patients at hospitals. 

The exercise provided a forum for response and for support partners to discuss response plans and communication plans as well as understand the relationship networks needed to mitigate an emergency as efficiently and effectively as possible. It also helped determine what processes work and what processes need to be improved upon.  

Exercise participants receive immediate feedback during functional exercises, which is essential for learning and adapting strategies for real world applications. The outcomes of functional exercise often lead to updates in response plans, policies and training programs to enhance overall preparedness.

Coordinated by WellLink Health Alliance and funded through the ASPR HPP grant program, the exercise was facilitated by All Clear Management Group.

Visit Welllinkhealthalliance.com to learn more about WellLink’s Emergency Preparedness Program.