By MARY ANN GREIER
Before 9/11, Salem Community Hospital's disaster plan consisted of 20 pages of instructions.
A decade later, the detailed manual is 250 pages long and the hospital has upgraded equipment and procedures for communications, power and security - all due to the 2001 tragedy that sent shock waves throughout the community, the country and the world.
"Hopefully we never have to go through anything like that again, but we're better prepared," SCH Director of Public Relations Michele Hoffmeister said in retrospect.
Hoffmeister recently reflected on what she remembers about that day and the days following and how the hospital operations changed as a result.
"I grew up in the Vietnam era and I never thought about anybody doing anything on our soil. Wars were supposed to happen overseas. They weren't supposed to be where people I knew could be impacted," she said.
The day started like any other. The hospital's main entrance was under construction at the time and a temporary lobby was in place at the far east end of the cafeteria. Hoffmeister supervised the receptionists and she had gone to check how things were going when the receptionist on duty pointed to a television. There was footage of the first tower at the World Trade Center where a plane had hit the building.
She remembered thinking "what a terrible mistake," assuming a small plane had gotten off its flight path. She returned to her office and a nursing supervisor came in and told her the second tower had been hit by another plane. It wasn't a mistake - it was planned.
"Everybody was on edge that day," she said, noting that some people knew people in the affected areas and couldn't get in touch with them. "It was terrifying.
Everywhere she went, people were huddled around the televisions, trying to get updates on what was happening. Like everyone else, she said health care providers are human beings and they felt the same shock and disbelief as everyone else, but they were also able to set it aside.
"They had to comfort the patients. Business went on as usual, but it was a very tense day. Something had gone horribly wrong. There was a concern because nobody knew if more was coming or not," Hoffmeister said.
They dealt with the initial shock, looked at their disaster plan and monitored what was happening. That night on the way home, she remembered being in line for gas at the Vittle Village in New Waterford and she wasn't alone. People needed to connect with other people.
A few days after 9/11, the hospital employees raised $24,046 in a fund drive for the victims.
Now 10 years later, the initial shock has subsided, but the effects from 9/11 remain evident. Hoffmeister said the hospital's disaster manual outlines the hospital's response to any kind of disaster, with plans for the different types, whether bioterrorism, radioactive, pandemic or local weather event.
She explained the manual includes the use of hospital resources, from equipment to staff, how to care for existing patients and the expected influx of patients from the disaster, how to manage staff, includes memorandums of understanding or mutual aid agreements with area nursing facilities, the county and city health departments and spells out the Hospital Incident Command System which describes what each department is responsible for doing. The hospital personnel train by participating in disaster drills and also set up an incident command center.
Hoffmeister said the level that local agencies work together has changed also, with more collaboration and pulling together of resources. SCH is part of the Northeast Central Ohio Hospital Consortium, a group of 30 hospitals in 13 counties overseeing grant dollars for emergency management and coordinating regional responses, along with providing training events.
Through federal dollars, she said the hospital has been able to purchase additional supplies and upgraded communications with the Multi Agency Radio Communications System known as MARCS. Also purchased was a decontamination tent and some evacuation equipment.
The hospital built the central plant several years ago as part of the disaster preparations, with diesel-powered generators providing power to the hospital during a power outage. With two 20,000-gallon tanks for diesel fuel underground, she said the hospital could operate indefinitely as long as the fuel could be replenished.
Security improved with an upgraded video surveillance system, electronic door access and an increased scope to fingerprinting and background checks for employees, volunteers and physicians.
Salem City Health Department
When 9/11 happened, the Salem City Health Department didn't exist. The city contracted with the Columbiana County General Health District for health services. City Health Commissioner Richard Setty was working as Director of Environmental Health at the Mahoning County Health Department at the time and preparing for the annual rabies baiting project.
He was watching the television when the second plane hit the second tower at the World Trade Center, thinking "what's the world coming to?"
"It's one of those moments that's frozen in time in my brain," Setty said, comparing it to how people remember exactly where they were when JFK, or his brother Robert or Martin Luther King were shot.
The result of 9/11 was a lot more planning, with grants made available for preparing emergency response plans and training for emergency response.
"Local health departments historically and typically have not been considered first responders," he said.
With a small staff, he explained the city health department is kept in the loop by the county health department when it comes to Public Health Emergency Planning, through Bob Zehentbauer, director of Public Health Emergency Preparedness for the Columbiana County Health Department.
"We know we can depend on Bob and the rest of the staff at Columbiana County to work with us," Setty said, noting that county Health Commissioner Wes Vins used to work for him in Mahoning County.
If the city needed help, he could call on health departments in neighboring cities and counties for assistance.
"We've got to collaborate and cooperate," he said.
Mary Ann Greier can be reached at firstname.lastname@example.org