DHMC Staff To Analyze Outage Issues

Area Hospitals Pitched in While Medical Center Worked on Power

Lebanon — The power is back on and all systems have checked out OK after a power outage disrupted Dartmouth-Hitchcock Medical Center over the weekend .

Now hospital leaders will spend the coming weeks and months assessing the crisis to better prepare for future incidents.

“They’ll be looking at all these different ways to figure out are we hard wired the right way. Do we have necessary backup? Do we have adequate coverage? Are there redundant systems? Is there a better way?” said DHMC spokesman Mike Barwell on Monday. “These are all the kinds of things we’ll look at. And it’s going to take a while to do that.”

By early Monday morning, the crisis had passed and medical center was back to running on all cylinders, Barwell said. The costs to fix damaged equipment is not yet known, he said.

It was a challenging weekend at the Lebanon hospital, one that temporarily shut down access to patients’ electronic records and forced staff to stay hours after their shifts ended in order to ensure patients were cared for while DHMC made adjustments, hospital officials said.

No patients nor employees were hurt during the outage that began around 6 a.m. on Saturday after a melted fuse in an overheated power transformer cut power for several hours.

Power was restored by 9 a.m. But any disruption, however brief, can be a significant challenge for an organization as complex as Dartmouth-Hitchcock, hospital officials said. For several hours on Saturday, the Twin States’ largest health care provider returned to 20th century technology, taking down physician orders on paper and then reentering the information into the patient records when the computers were running again later that evening. The paging system also went down and clinical equipment, such as that used to perform CT scans and MRI tests, could not be used.

Once the systems were running again, the rest of the weekend was spent assessing the damage and then repairing equipment during a “controlled shutdown” on Sunday afternoon. No patient records were lost nor was care interrupted, hospital officials said. The staff “did amazing” in responding to the situation and following an emergency plan designed for such technological failures, said Collette Culver, a nurse and DHMC house supervisor who is responsible for day-to-day operations of the facility.

“We love the beauty of technology in health care, but we also understand that it is not a 100 percent full-proof system,” said Culver . “It’s part of our plan. We have down-time procedures so we always have a back-up system, or procedure if you will, for times when our computers are not up and operational.”

The effects spilled beyond the main campus in Lebanon and highlighted Dartmouth-Hitchcock’s central role in the region’s health care system. Dartmouth-Hitchcock had to send some incoming patients to other institutions as it dealt with the power issues, shifting the burden to other hospitals in the Upper Valley.

Dartmouth-Hitchcock notified smaller community hospitals about the outage Saturday morning, and the small hospitals also coordinated among each other.

New London Hospital brought in an additional emergency department physician after getting a call from Alice Peck Day about the issues at DHMC, said Steven Powell, New London’s chief medical officer. The hospital received a “smattering” of 20 patients over the weekend from DHMC, he said, and was able to treat everyone that came through the doors.

“Nothing critical,” Powell said. “There were no negative effects on patient care.”

Valley Regional made alternative arrangements for several patients that it otherwise would have sent to DHMC, said Valley Regional spokesman Rolf Olsen. One of those patients was sent to Cheshire Medical Center in Keene, N.H., and another was airlifted to Boston, he said. Valley Regional admitted a third person to the hospital that it otherwise would have sent to Lebanon.

“(Valley Regional doctors) were prepared for it and prepared to deal with it,” Olsen said.

Not every hospital was affected. Spokeswomen at Gifford Medical Center and Mt. Ascutney Hospital said there was no major change in operations as a result of the power outage at DHMC. Nevertheless, smaller hospitals play a crucial support role for Dartmouth-Hitchcock during a crisis, said Thomas Trimarco, Dartmouth-Hitchcock’s medical director for emergency management.

“Being the institution and the tertiary care center for such a large region around here, obviously we’re clearly aware that any incidents or issues that we have affect not only our immediate patients, but all the patients that would be normally coming to us, all the surrounding referring facilities,” Trimarco said.

As for the patients inside DHMC, few if any had a clue that the hospital was dealing with a significant problem, he said.

“The overwhelming impression was we were business as usual from the patient standpoint,” Trimarco said. “Most patients, especially in the emergency department, had no idea that we had a major incident going on.”

Throughout the weekend, DHMC staff continued to deliver babies, tend to trauma victims and care for around 320 patients at the hospital, some of them the sickest people in the region, Barwell said.

“We’ve had other things like Hurricane Irene and real time things where we knew we had training to handle that,” Barwell said. “So when it actually did happen, we were well prepared. The best part is we had no patient injuries.”

In a statement posted Monday morning to Dartmouth-Hitchcock’s internal website, CEO Jim Weinstein commended the institution’s staff, particularly those who are a part of the “Incident Command” team, in responding to the situation and ensuring no patients or hospital employees were harmed.

Weinstein said there “is no doubt that we have a lot to learn from this incident,” and that the extensive notes taken by the Incident Command staff would be examined to determine “what worked, what needs attention, and what can be improved to prepare for any future events we may experience as a medical community.”

The power outage and resulting problems have passed, Barwell said. But the lessons to be gleaned from last weekend may have long-term impact.

“For the most part, the incident is over,” Barwell said. “It’s now just cleaning up the details and assessing what happened and how we can improve. It’s a great learning (opportunity).”

Chris Fleisher can be reached at 603-727-3229 or cfleisher@vnews.com.

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