Inside the walls of Echuca Regional Health’s buzzing incident control room, a sophisticated level of unseen planning takes place.
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In times of crisis, the incident control room is the beating heart of any hospital.
It is the space where key members of the hospital gather multiple times a day to plan for any potential interferences to emergency care.
ERH’s chief executive officer Robyn Lindsay said one of the greatest challenges the hospital faced during the initial stages of flooding was around staff access and staff shortages.
She explained that not only was access physically disrupted by road closures, but staff were often out protecting their homes, or had commitments to other agencies such as the SES or CFA.
“Limited staff access has meant that at times we had more than 100 staff who couldn’t attend work,” Ms Lindsay said.
“We didn’t quite know who was going to be at work each day so we needed to do a lot of complex planning to ensure continuity of service.”
As road closures began to spread across northern Victoria and detour signs began to pop up at every intersection, the hospital made the decision to start implementing air travel.
Initially staff were transported in and out of Echuca via Air Ambulance, but as time progressed other helicopters and small planes were chartered.
Ms Lindsay said extra staffing resources were also acquired from nearby hospitals such as Mildura Base Public Hospital, Bendigo Health and Northern Health.
“The support from other hospitals has been amazing. Sometimes processes take time to kick in but the fact that those other hospitals, particularly Mildura, could support us really quickly and put three senior nurses on a plane to help us was just amazing,” she said.
“We also utilised a service called the Health Service Resource Centre who we would escalate staff shortages to and the Department of Health would essentially organise staff to come out and assist us.
“We are now certainly looking at how we can support other health services downstream in places like Kerang, Cohuna, Swan Hill when they need that support.”
On top of coming up with contingency plans for staffing, ERH created back-up plans for every possible scenario.
Ms Lindsay said the hospital’s incident control team planned for situations such as having a diminished water supply or a power outage.
“In terms of water supply, the hospital has filtration systems, which meant that even with the boil water advisory, we didn’t need to boil our water but that does depend on what the water is contaminated with,” she said.
“If we weren’t able to use our water supply from the tap, we do have 30,000 litres of water that is ready to use and we’ve also put plans in place with Coliban Water to truck water in, if required.
“In terms of power outages, we have a generator that will keep the hospital running for at least a few days.”
Ms Lindsay said that in consequence to road closures, the hospital did experience interruptions to their supply chain.
“Our supplies probably didn't look that healthy at certain points in time, but we have managed to stock up,” she said .
“Moving forward, we're really well stocked for everything. We're now holding more than our usual level of supplies of everything, including pharmaceuticals, linen, food, blood and everything that we need to maintain critical and essential services.”
Along with ensuring the integrity of the site, ERH has been assigning nursing and psychological support staff to the Echuca Relief Centre.
At any one time they will provide three to four staff members, over a 24-hour roster.
In the relief centre, ERH personnel work alongside paramedics to triage and conduct initial health assessments in order to determine the kind of medication people require and to ascertain whether an individual may need to be transferred to the hospital’s emergency department.
As well as providing support to Echuca, ERH has extended support out to Rochester.
In addition to sending first aid nurses and psychological support staff out to Rochester, they have also held a number of maternity outreach clinics for women who have just given birth or are due to give birth.
Ms Lindsay explained that while Rochester and Elmore District Health Service was closed, ERH does anticipate an increase in patient intake.
She said the two hospitals would continue to work closely alongside each other to determine the kind of reinforcements that were required.
“Rochester currently have about 10 acute beds so we are planning for the situation that we may need to open some additional beds in the medium term to accommodate for that extra patient intake,” she said.
“It will be many months until their physical site is ready for them to provide services, however, they are already providing some pop up services, such as urgent care, which has recently commenced out of their local GP clinics.”
Ms Lindsay said the aftermath of the floods could impact the hospital’s recruitment strategy and on-boarding process well into the future.
“It really depends on how impacted the availability of accommodation is in town but we will be assessing that over the next couple of weeks,” she said.
Ms Lindsay said she was proud the community has not had to worry about the hospital not running.
“Initially there were discussions about whether we would need to evacuate but it became clear pretty early on that we would not,” she said.
“Our staff have gone above and beyond to keep the hospital running and I would like to thank them for their somewhat unseen level of contribution.
“We know the efforts that our staff have had to go to just to get to work and we know the great tension that has been felt. I’m just really grateful to all of them.”
ERH’s incident control centre will remain set up until the code brown has been deactivated.
The hospital has been in a code brown since October 16 and will continue to be in code brown until the Murray River drops to moderate flood levels.