Need your advice! I have an appointment with our local hospital Y2K administrators to discuss Y2K (both their computer and contingency persons.) What questions would you ask under such circumstances? Is there a national compliancy medical-type board to which they must answer? This is a public hospital. I know that they only have 90 hrs. of fuel for their generator (which they are very pleased with...) Does anyone know of a web site with medical questions that would help me? Or are any of you on medical Y2K boards? suggestions please! Thanks so very much!!

-- Jen White (jenwhite@compuserve.com), December 22, 1998

Answers

Good question, Jen:

I work at a small local hospital, the only one in a 150 mile radius. The only discussion I've EVER heard about y2k is the ones that I (or one other nurse) starts. Most of the staff, including the floor supervisors, have NO IDEA. The CEO attended a conference (I was there) about y2k; his wife attended a talk given by Carla Emery (I was there); rumor (from a reliable source) has it that they have personally ordered 1500 pounds of dehydrated foods.....but the staff is still ignorant.

Here are the questions I'd ask:

What kind of training has your staff already taken for y2k contingencies? Nurses do most of the hands-on work with patients -- so they should have A LOT of training.

How many hours of training?

Is your lab compliant? What does compliant mean for your lab? What happens if test results are skewed or fail to process?

After 90 hours (less than FIVE DAYS!!!) of generator, what will you do for power? An earthquake or ice storm can knock out power for that long, for goodness' sake!

Are your cooking, refrigeration, and laundry facilities electricity dependent? Will they still run on generator power? If not, what are your backup options -- and are the backups dependent on electric power or natural-gas pumping facilities?

If the town's water system doesn't work, where will you get your drinking/washing water? How will you flush toilets?

How many days will your on-floor med supplies last (if you cannot get shipments JIT)? Dressings, sutures, syringes, IV fluids, tubing, masks and gowns for staff working with patients in isolation...

What happens if the elevators cannot function? Will staff be expected to haul patients up and down steps on gurneys?

If phone service is disrupted, what contingency plans do you have to call in staff? For staff that is working when power/services stop, what back-up relief will they have? How will nurses access doctors if phone service is down? Will you have several doctors on-floor at all times if no phone service is available?

What legal protection do you have for increases in y2k-related nosocomial infections? (That is, if patients get sicker after post-y2k treatments, is that going to be at the hospital's expense, or the patient's?)

If the hospital has certification (they can tell you), what contingencies does the certifying board require? If none, why not? If so, have they been met? Will they be met? What do they consist of?

How do you dispose of medical wastes? (Usually, a truck picks up and takes to an approved facility to burn the stuff.) What will you do if the trucks do not arrive?

Is there an on-site morgue? How is the refrigeration run (electric? generator?)? What happens if funeral homes are unable to pick up bodies? How many can you store? What happens when the generator runs down?

How much of hospital income comes from Medicare/Medicaid? (Ours gets about 63%). What happens if payments are delayed for weeks, months -- a year?

How much of hospital income comes from private insurance? What happens if payments are delayed or stop?

Is your employee payroll computerized? What percentage of payments are by direct deposit? How many employees will work if their deposits are slowed/stopped/wrong due to y2k-related banking errors?

What percentage of your staff is KNOWN to be y2k aware? What percentage is taking personal actions to prepare for possible disruptions? (If they say more than 10%, I'd guess they were giving you the spin-treatment -- even in California's constant earthquake country, a very small percentage of people actively prepare....and they KNOW what an earthquake can do!) If they say more than 10%, I'd politely ask to see written documentation of their assertion!

Gosh, this could go on and on....but this should be enough to get 'em squirming in their seats. If they're honest, they'll say, "We didn't think of that...we never thought of that....we're going to look into that..."

Anita Evangelista

-- Anita Evangelista (ale@townsqr.com), December 22, 1998.

Don't forget about the ivac's/pumps...they require regular maintenance which is monitored by an date chip. If it doesn't get done they don't drip right....or at all....TPN, Dopamine, NTG, levophed......moral of the story...Don't be in ICU in Jan 2000!:<

-- More Dinty Moore (not@thistime.com), December 23, 1998.