Centralized Disaster Response
Richard Serino heads development of a center for multi-agency coordination during large-scale disasters
- 2009 Apr 1
In November 2008, Boston EMS officially opened a state-of-the art regional communications and command center, called Lawlor Medical Intelligence Center, for managing the medical aspects of public health and mass casualty emergencies. Known as the "MIC," the center provides space for multi-agency coordination of medical logistics and response during large-scale disasters. And a major force behind its creation was Richard Serino, Boston EMS chief.
Inside the MIC
Despite its newness, the MIC is already a national model for other large cities because of its technology. It has a seating capacity for 68 individuals, with Internet access, power and telephone connections at each station. Laptop computers purchased for the MIC are on a single network, allowing for file sharing in real time. Departments and agencies that require representation at most events have a designated seat and phone number; other representatives at the center occupy one of the "temporary" seats for more incident-specific events.
The center is equipped with television screens for viewing news stations, projecting briefing materials and monitoring Web-based systems, such as the Web EOC hospital bed reporting or patient tracking summaries. Video conferencin g capabilities allow for communication with multiple external locations, including the Mayor’s Office of Emergency Preparedness, Boston Emergency Operations Center, Unified Command Center, Boston Fire Department headquarters, Massachusetts Emergency Management Agency and other regional coordinating centers.
"With 26 health centers and 10 primary receiving hospitals within the City of Boston, the city’s EOC (Emergency Operations Center) was not large enough to accommodate each health-care institution or agency that plays a role in a disaster response," says Serino. The extra space provided by the MIC expands opportunities for more comprehensive representation, encompassing not only EMS and public safety, but also liaisons from hospitals, public health departments, community health centers, long-term care facilities and other first responders.
"A lot of EOCs across the country include [representatives from] public safety and EMS, but some don’t include the hospitals," says Serino. "It makes a lot of sense to bring in people from the medical community, too."
One of the benefits of including hospitals in the EOC lies in coordinating efforts among multiple institutions with similar needs. "An EOC is dealing with a lot of things, and you don’t want to have a lot of separate EOCs," says Serino. "For instance, when we had week-long drills, we found that the hospitals were doing simple things like getting staff in from outside the city. They would send a bus to the city to pick up some of their staff. Another hospital was doing the same thing. And another hospital was doing the same thing. We wondered, ‘Can’t we consolidate this?’"
In addition to serving as an intelligence center during disasters, the MIC is also used as a site for drills, exercises, training and weekly briefings related to emergency preparedness. "Another purpose of the MIC is information sharing," says Serino. "It’s a place for the medical community, the hospitals, EMS, public health, community health centers and others, who may not always be in the information sharing, intelligence loop, to meet.
He adds, "When we had the initial concept of the MIC, one of the things we were looking for was a place to bring people together, both from the intelligence side and the integrated emergency management trainings that we have for people, from all different disciplines."
As news of the opportunities for information sharing afforded by the MIC grew, so did the number and type of agencies wanting to participate. "When we started talking about the idea to the law enforcement community, the FBI asked to be a part of it so they could be aware of the medical community’s needs," says Serino. "They get information on the latest emerging diseases because we have someone from the CDC giving updates, as well."
He adds, "The fire department and the Massachusetts Port [the airport fire department] are part of it, too, as well as the Boston police. Other agencies, like the transit police, were interested, so now they come."
Serino underscores the importance of the briefings as a chance for participants to become acquainted with leaders from other agencies. "At the weekly briefing, everyone getting to know each other is key," he says. "You don’t want to be exchanging business cards at the scene of an incident or disaster. You want to have a good relationship with people beforehand. You want to be able to pick up your phone at three in the morning, and, with the relationships you’ve built, get things done."
The concept behind the MIC grew out of lessons learned while preparing for Boston’s hosting of the Democratic National Convention in 2004. "We brought together the medical community and were able to manage the event so well that the Secret Service recognized us with a Director’s Award," says Serino. "We helped Denver and Minneapolis-St. Paul with their conventions; they used our plans as templates. We already had good relationships with the hospitals, and hosting the Democratic National Convention helped us go to the next level. We needed to figure out how we could build on that."
Funding for the development of the center came from the Urban Area Security Initiative grant funds, through the Boston Mayor’s Office of Emergency Preparedness, and from a Partnership for Effective Emergency Response grant, managed by Boston University and awarded by the Assistant Secretary for Preparedness and Response (ASPR) office of the U. S. Department of Health and Human Services (HHS).
Boston EMS responds to more than 100,000 9-1-1 calls annually, placing the system at the heart of the city’s emergency care. "We look at EMS as being a link to bringing different people together," he says.
The EMS Chief feels his department has been able to successfully bring a variety of stakeholders together with different perspectives, but shared interests, for problem solving and innovation. "First responders are trained in a certain way and are reactionary. On the other hand, public health sits back, slows down and studies things," he says. "You have to be able to bridge that gap, and we’ve been able to play a key role in bringing the different groups together."
Always Innovating
Another example of where public health, safety and medical interests converged, with a bit of help from EMS, occurred in November 2008, when Boston EMS used their patient tracking system to track recipients of a vaccine at a flu clinic. The technology was purchased in 2006 to track patients in emergency incidents, and Boston EMS had used the system during disaster exercises—to keep tabs on injured runners during the Boston Marathon and to monitor first aid stations during July 4th celebrations. The data gathered during the flu clinic presents multiple potential public health uses, such as tracking batch numbers and vaccine types and serving as the basis for comparison with results of past flu seasons.
Serino foresees many other opportunities in the future for inter-agency collaboration. "Nothing is set in stone. We will continue to change because people have different ideas, and we’re learning as we go," he says. "There isn’t one agency or one city or one group of people that can manage any large incident by themselves. I think that’s been shown clearly over the years. But there are many opportunities to continue to build relationships and connect people who may not already be connected. And this is something that EMS can continue to foster."
Chief Serino continues to champion efforts of his department to obtain the best training; perform the best prehospital care; secure funding sources for equipment and training; and collaborate with area first responders, hospital and health-care agencies, as well as private ambulance companies.
His background certainly qualifies him to spearhead many of these initiatives. He began his career with Boston EMS in 1973 as an EMT. Over the years, he became a paramedic, rose through the ranks, and in 1999, became chief of the department, with the title of assistant director for the Boston Public Health Commission, which was added in 2007.
Despite his many accomplishments, Serino is quick to emphasize that the credit for what EMS has been able to achieve in Boston rests squarely on the shoulders of his colleagues. "A good EMT or paramedic is somebody who must be able to effectively talk with police officers, firefighters, family members and physicians in a way that everyone can understand," says Serino. "And it’s the women and men of EMS, the EMTs and paramedics, who are the ones who really make things happen."
No comments:
Post a Comment