Fostering Community Resilience: How one Indiana Community Meshed its Resources to Improve Preparedness

By Justin Mast, RN, BSN, CEN, FAWM, Senior Crisis and Continuity Advisor, MESH

Seven years ago, Wishard Memorial Hospital, now Eskenazi Health, was one of five organizations to receive a $5 million grant from the Assistant Secretary for Preparedness and Response to create innovative public health and healthcare emergency response and management models.

To try something new, Dr. Charles Miramonti, an emergency department physician, looked at relationships, policy and technology. Ultimately, he created a team of healthcare leaders from all of the area’s major hospitals, known as the Managed Emergency Surge for Healthcare (MESH) Coalition, based in Indianapolis.

Initially, MESH created a framework for sharing resources, a centralized cache of supplies, protocols for coordinated emergency response efforts and training opportunities. All these efforts better centralized preparedness functions across the Central Indiana region.

After building the coalition, marshalling resources and creating efficiencies in public health preparedness, to continue our work, we hosted a work group to focus on disaster planning for children, mothers and expecting mothers.

Quickly, we realized that we had to build community resiliency and that there was a significant vulnerable population that hadn’t been fully addressed when it comes to preparing for emergencies: children who are dependent on electric equipment, most notably ventilators.

During weather events, we found that families with children on ventilators were coming to the emergency room to ensure they would have electricity. They often brought other family members and stayed for the duration of the storm.

To look at the problem, we took three steps:

1. Fact finding and research;
2. Creating a registry of children in the state who are dependent on ventilators; and
3. Writing an educational toolkit for families and providers (also in Spanish).

First, we wanted to see if there were places other than hospitals that would be able to maintain a power supply during an emergency. It would be beneficial to the entire community to keep people out of the hospital if they didn’t need urgent care at that moment—as long as we could safeguard their health.

We spoke with emergency personal in every county to get a sense of what resources existed and what needs there were—we needed to know if it was possible to give families another location they could go to during an emergency. Ultimately, we developed a database that includes 181 power safe facilities with nearly two locations for every county.

While having the alternate locations mapped was great, they would only be helpful if we could identify and inform the families that would need to use them. So, we built a HIPAA compliant registry that parents can use to register their ventilator-dependent children.

The third piece of the puzzle was informing and educating families and responders. We wanted to give families tools to connect with local resources because it’s far easier—in more rural areas—to get to those places during an emergency. We also wanted to empower families to reach out to these services and personnel, which would make the connections even stronger.

So, we created tools, including a video (also in Spanish), to educate families on how weather could impact the power supply their children depended on. The toolkit includes draft letters families can send to authorities—such as EMS and fire—to let them know in advance there is an electrically dependent patient in the household.

We then gave the toolkit to hospital nurses to pass along to families at discharge. And, throughout the development, we partnered with the Indiana Emergency Medical Services for Children (IEMSC), Indiana State Department of Health and other partners whom were instrumental in creating the toolkit and spreading the resources across the state.

We also worked with medical equipment providers and let them know that there are resources for families. They were extremely happy to provide information on the toolkit and registry to their patients.

It’s hard to believe that just five years ago each individual Central Indiana hospital and healthcare facility prepared to face a public health emergency on its own—completely apart from the other resources, infrastructure and partners, just down the road.

Now, the MESH Coalition is helping providers prepare for and respond to emergency events and communities remain viable and resilient through recovery.

We know that, by forging these innovative partners, we have saved millions of dollars on redundant equipment and emergency supplies. Through all of these efforts, the MESH Coalition is building resilience in the healthcare sector and improving everyday life for Hoosiers.