Navigating a Public Health Crisis: The Early Days of Managing an Emergency with Incident Command

Navigating a Public Health Crisis:

The Early Days of Managing an Emergency with Incident Command

By Gretchen Nicholson, MBA, MT, CPHRM, CPHQ AdventHealth Hendersonville Director of Office of Collaborative Improvement & Medical Staff Services

On Feb 26, 2020, when COVID seemed like a distant, but looming threat, our wise Chief Medical Officer pulled together our leadership with the clear direction that we needed to start preparing

immediately. Our Emergency Management Team quickly assembled a large group from across our service lines and departments and led them through planning and response to a pandemic surge. On March 2, 2020, North Carolina confirmed its first COVID-19 case. That same day, AdventHealth Hendersonville conducted a gap analysis and set in place the action plans to prepare our system for what was becoming a global pandemic unlike any we had seen before. Weekly preparedness meetings followed with a multi-disciplinary team of clinical leaders, including nursing. By March 7, screening stations were placed at entrances. Every patient and visitor entering any AdventHealth facility was screened for travel history and symptoms. Employee screening for the same soon followed. Any person screening positive was masked before proceeding. To prevent transmission of COVID-19 in our facility, we quickly implemented visitor restrictions.

By mid-March, North Carolina had 58 cases of COVID-19. AdventHealth Hendersonville administrators made tough decisions for the safety of our workforce. We became the first hospital in the region to cancel elective surgeries. We did this on March 13, a day before the Surgeon General advised all hospitals to do this. We activated Incident Command on Mar 13, 2020. With much uncertainty, Incident Command leaders were guided by the quote, “In the end, it will be impossible to know if we overreacted or did too much, but it will be quite apparent if we underreacted or did too little.” — Darrin M. Peppard, EdD Superintendant of West Grand School District 1. And so, AdventHealth Hendersonville became one of the most proactive hospitals in its response to COVID-19, both in our community and in our hospital system. Incident Command assigned nursing and other key leaders across the organization to serve as Unit Leaders for the many planning and oversight areas. As the needs of the organization grew, project teams and Incident Command structure expanded. Incident Command leaders worked daily out of the Executive Board room, tracking key state, county and hospital statistics. They engaged key stakeholders to roll out COVID-specific operations, troubleshoot issues, and acquire needed supplies. Incident Command has and will continue to adjust to meet the changes of the pandemic to maintain the access to safe and effective health care our community is counting on from us, now more than ever.