CONFLAGRATION FRIEND OR FOE? Dr David Alderson Consultant Haematologist Trafford General Hospital BBTS 16th October 2013
Trafford General Hospital formally Park Hospital Opened 1929 Workhouse Hospital for Barton Upon Irwell Poor Law Union 5 th July 1948 Aneurin Bevan inaugurated National Health Service 1 st Patient Sylvia Diggory Second World War handed over to Medical Corps for Canadian Forces First Hip Prosthesis in UK researched and developed by Sir John Charnley Later renamed Trafford General Hospital
CONFLAGRATION A conflagration is one term for a great and destructive fire [1] that threatens human life, animal life, health, or property. It may also be described as a blaze or simply a (large) fire. A conflagration can be accidentally begun, naturally caused (wildfire), or intentionally created (arson). Arson can be for fraud, sabotage or diversion, or due to a person's pyromania. A firestorm can form as a consequence of a very large fire, in which the central column of rising heated air induces strong inward winds, which supply oxygen to the fire. Conflagrations can cause casualties including deaths or injuries from burns, trauma due to collapse of structures and attempts to escape, and smoke inhalation. Firefighting is the practice of attempting to extinguish a conflagration, protect life and property, and minimize damage and injury. One of the goals of fire prevention is to avoid conflagrations.
Trafford s version of Conflagration 6am Tuesday 5 th October 1993 Receive a phone call from Chemistry BMS on-call Please come ASAP LAB ON FIRE!! Why me first? CD and live 5 minutes walk away
Quick Checks Phoned Switch Fire Brigade on way Phone key staff Ensure safety for on-call team
First Thoughts on arrival OMG Flames and smoke billowing from Transfusion Will any of the Lab survive? How does the Hospital manage without a Lab? NUMBNESS
Did we have a Contingency Management Plan and where was it? NO!! If we had one it would have been hard copy and gone up in smoke ( pre-digital era ) Now have QPulse electronic system ( web-based ) Individuals had no specific roles with no communication lines in place Lots of policy/procedure documents lost in fire e.g. SOPs
Management Decisions without a CMP Liaison with Manager on-call Discussion with Chief Executive Decision to Close A+E to Ambulance patients Try to organise help with other hospitals To become active again within 48 Hours
Laboratory Team Management Consultants/Senior BMS Staff meeting Arrange to contact Other Hospital Assess remaining capacity when electrics on Assess alternative sites with electricity Reconfigure estate of the Lab Inventory of Equipment/Consumables Rapid Gap Analysis
PARTNERSHIPS Local DGH ( Salford Royal Hospital ) and Manchester BTS Communication lines set up Transport arrangements made Transfer of urgent specimens Equipment borrowed Equipment ordered Consumables acquired
Rate-Limiting Factors No electricity to Laboratory No Transfusion Fridges No Transfusion equipment No Transfusion Consumables No Blood Stock No Blood Product Stock
Major Deficiencies Blood Transfusion Fridge Blood and Blood Products Transfusion Area within Laboratory
How Rectified Beg, Steal and Borrow!! Army Medical Corps phoned Agreed to loan Blood Fridge ( for local PR ) Temporary area used in Haematology Portakabin added adjacent to Haematology
Swinging back into action Demolition of unsafe building Rapid shoring up of walls/windows Facilities created temp/permanent electrics Reconfiguration workable in 48 hours
Rules and regulations now Would it be possible again? NO! HSE CPA MHRA
OPTIONS: Long-Term Future of Lab Assumed Outsource to another Hospital Averted with trying to maintain a viable A+E Rebuild lost section of Lab Not cost-effective with an ageing wooden Lab! New Build Thankfully agreed by Chief Executive and Board
New Lab Site adjacent to Old Lab Limited space so L-Shaped and 2-storey ( and BRICK ) Involved in grand Design Transfusion very spacious! Opened by Princess Margaret
Long-Term Future of Lab Actual Acquired by Central Manchester April 2012 Trafford converting A+E to Urgent Care Reduced Medical beds No Acute Surgery Elective Orthopaedic and General Surgery
Transfusion changes New Clinical Model No Transfusion Laboratory facility on-site after 12midnight Single LIMS for Central and Trafford Reorganisation of Cold work via Central Development of Electronic Issue Ensuring robust transport systems in place
OPTIONS?? Long-Term Future of Lab Reality and Full-Circle (Outsource) to another Hospital Occurring with inability to maintain a viable A+E Rebuild lost section of Lab Not cost-effective with an ageing wooden Lab! New Build New Trust Board considering demolition!