Plane crash readiness: Creating an emergency preparedness partnership
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April 1, 2019
In January 2009, all eyes were on the Hudson River when a plane flying out of New York’s LaGuardia Airport crash-landed in the river after striking a flock of geese. Thanks to fast acting by the pilots, all 155 passengers survived, with few major injuries. Trouble started afterwards, though, because of a communication breakdown between airlines and hospitals.
After the crash, victims were sent to multiple hospitals in New York and New Jersey. At the request of family and loved ones, US Airways called the hospitals to figure out where each passenger had been sent. However, fear and misunderstanding of HIPAA laws prevented the facilities from revealing that information, causing more distress for people wanting to find their loved ones and see if they were all right.
The disaster spurred officials at San Diego International Airport (SAN) and local hospitals to join forces to create an emergency preparedness partnership. A year after the crash, SAN and San Diego hospitals were holding regular meetings together, providing training, and developing contact sheets of whom to call should a crisis occur.
Sharon Carlson, RN, is director of emergency preparedness at Sharp HealthCare and is a regular attendee of SAN’s emergency prep meetings.
“I think it’s a great partnership, and I think cities with airports try to do it,” she says. “It opens the lines of communication and keeps everybody on the same page. But it takes some time, work, and energy and depends on who’s got resources available. We just decided that it was important.”
“If they haven’t done so already, I would highly encourage [airports] to reach out to their local hospitals to establish that relationship,” says Susie Preiser, manager of emergency preparedness at SAN.
Preiser says that after the crash—dubbed “The Miracle on the Hudson”—a colleague of hers at US Airways reached out to University of California San Diego Medical Center (UCSD) to come up with an emergency standard operating procedure (SOP).
“She [the US Airways representative] wanted to make sure that in San Diego that airlines had a good relationship with the hospitals,” Preiser says. “And that the hospitals would know after a plane crash or [a similar incident], when the airlines call to ask for passenger information, they’re not asking for the person’s condition. They just need to know if they’re at that hospital—so they can do passenger tracking and share that information with the families.”
The official at UCSD Medical showed the SOP to Preiser, who asked if there was a way to make it more universally applicable, for use by all the airlines. A generic version was made, and UCSD reached out to all the other hospitals and asked if they would participate as well.
“I was very much impressed by the fact they were willing to be so passionate about it and reach out to all the other hospitals on the airport and airlines’ behalf and get them all on board,” she says.
“On the airport side, quite honestly it was very easy for us,” she continues. “The airlines were all very interested and trying to streamline passenger tracking. I can’t speak for UCSD and how hard they had to work to get all the hospitals on board. But the representative from UCSD was very passionate about this, very persistent, and very successful—she got all the hospitals on board with what she was doing.”
The partnership between SAN, airlines, and local hospitals is now eight years old. In addition to creating an emergency contact list, hospitals have a seat at SAN’s monthly emergency planning meeting with airlines and airport stakeholders.
Part of the partnership is a San Diego County contact list that’s updated annually. Every year, airlines send their contact information to the hospitals to update the list.
And the list includes more than just names and numbers. If an airline representative goes to the hospital, the list tells the representative where to park, what door to enter, and which office needs to issue proper identification to start the rep working with hospital staff.
“That’s all information that’s really important to the airline and their corporate offices during emergency events,” says Preiser. “To have all that preset ahead of time and having all those hospitals update that information annually is very important to the airline.”
Carlson adds that all the airlines and hospitals have a copy of the list, and UCSD has a master copy.
“So god forbid there’s some air disaster, then each airline knows they can call each hospital to verify if that hospital has received any of the passengers by manifest,” Carlson says. “What they would do is they would either call or show up and say, ‘I’m from ABC Airlines and I’m looking for people who were associated with flight whatever.’ They can show us the manifest and we can say ‘yes, no, yes, yes, no.’ Or they can read it to us and we can say ‘that patient is not here’ or ‘that patient is here.’ ”
No information about a patient’s condition or personal details is given out, she says, only whether the patient is present or not present. This helps anxious family members find their loved ones as soon as possible.
“The quicker we can do that after any disaster, the better off [everyone is,]” Carlson says. “And you know, if you’ve followed the news, one of the hardest parts after a major disaster is reuniting people with their loved ones.”
Part of the need for the list is that different facilities have different positions as their contact person. For Sharp HealthCare, the point person for an air disaster is Carlson and the administrative liaison nurse, because both positions are on call 24/7.
The FAA says that airports like SAN are required to do mass casualty exercises every three years. Preiser says airports should include the hospitals in the planning, drilling, and conducting of those exercises, if hospitals haven’t been looped in already.
That said, though, meeting every three years isn’t enough to maintain the type of communications that SAN wants. So they invited local hospitals to visit more frequently.
“At our airport, we host a monthly meeting with our tenants, stakeholders, and outside agencies to review our emergency plans and do training of that sort, and have guest speakers,” Preiser says. “And the hospitals are included in that. The two main hospitals that we’ve really forged a great relationship with, Sharp [HealthCare] and UCSD Medical Center, they come to those meetings every month.”
The other hospitals are included in the passenger tracking contact sheet that is shared and updated annually with all of the airlines, she says. But Sharp HealthCare and UCSD Medical Center have led the charge when it comes to monthly meetings.
“Preiser will have training at the meeting for her staff or bring up things they need to know about,” says Carlson. “And we’re there mostly to make connections because she has representatives from all the airlines there. And we can say ‘hello, remember me, I’m from the hospital, this is how we can help you,’ etc.”
Preiser notes that airports and hospitals are similar in many ways, and the topics covered during the meeting are beneficial to both parties.
“The reason why hospitals like to attend [these meetings] is because they feel that the hospital environment is very similar to an airport,” she says. “You have your employees, but you also have your transient group as well. We have passengers traveling in and out, and they have patients that are in and out. And so a lot of the emergency management challenges we have at an airport they have at a hospital. They think there’s great value in attending our emergency review training with our tenants so we can share ideas and lessons learned.”
PSA Flight 182—how bad a crash can be
The last plane crash in San Diego happened in 1978, when Pacific Southwest Airlines (PSA) Flight 182 collided with a Cessna Skyhawk 2,600 feet over the city. The planes fell into a North Park residential neighborhood, killing several more people on the ground. The crash killed 144 people, injured nine, and fully or partly destroyed 22 houses—either by impact or the resulting firestorm. It was the worst plane disaster in California’s history and the 9th deadliest in U.S. history. The crash was attributed to pilot error and air traffic control’s decision not to use radar separation procedures. It should be noted that the crash happened on a clear day, with good flying conditions, and that the planes were being flown by two expert pilots with 38,049 flight hours between them.