Pope Francis arrives in Philadelphia tomorrow, the last stop on a multi-city visit to this country. While his stay in the city will only be for two days, preparations at each of Penn Medicine’s hospitals in the city – Hospital of the University of Pennsylvania (HUP), Pennsylvania Hospital (PAH), and Penn Presbyterian Medical Center (PPMC) – have been ongoing for months. How much medication and nonmedical supplies should be stockpiled? How many clinical staff will be needed to care for what could be hundreds of patients? Where will employees sleep… and on what?
Teams – both within each of the hospitals and overseeing the overall strategy within Penn Medicine – have met on a regular basis to ensure uninterrupted patient care throughout the two-day event. “A huge cross section of people have been involved in the planning,” said Bernard Dyer, director of Safety and Emergency Management for the Health System. “The depth and willingness of people to help out is amazing. All groups have stepped up to do their part.”
Due to the traffic restrictions throughout the city, an estimated 2,000 Penn Medicine employees have already set up camp at their respective hospitals to spend the weekend. For the majority of HUP employees working the weekend, Penn Tower returns to its roots as a hotel (it was originally the Hilton Hotel). “Up to 650 people can sleep in Penn Tower each night,” COO Carolyn Jackson said, adding that another 350 – those working the night shift – will take their turns during the day. Others will stay in the hospital itself, in offices, conference rooms or on-call rooms. The Hospital and Healthsystem Association of Pennsylvania and the city will provide many of the necessary cots and air mattresses.
Nearly 600 staff at PAH will sleep in offices vacated when Penn Medicine Washington Square – PAH’s outpatient facility -- opened in October 2013, and in various units throughout the main hospital complex. In a recent WHYY Radio article, John Wierzbowski, manager of Safety and Emergency Preparedness at the hospital, said that in addition to inflating and placing 500 air mattresses in various locations throughout the hospital, they’ve stockpiled extra linens, toothpaste and toothbrushes.
Penn Presbyterian anticipates more than 400 faculty and staff staying over each night, and that’s in addition to those who are regularly scheduled to work. In addition to identifying spaces and stocking up on linens, Enrionmental Services staff at PPMC will also have sleep masks on hand for anyone who might need them.
Providing daily showers for these employees was a challenge, especially for HUP. As Penn Tower nears demolition, the building has only one working shower! The solution? Portable shower trucks, each with eight showers and changing rooms, are now set up onsite to supplement in-house showers available to employees. Showers are available at PAH but everyone bunking at the hospital will have an assigned time to shower and only 20 minutes to do it, Wierbowski said. When staff was told, “They said, ‘Does that include blow drying your hair?' Yes!”
PPMC has identified more than 30 shower locations, including a trailer of portable showers, for employee use over the weekend. Staff there have set up a large poster for each shower where staff can sign up for a 20-minute slot any time of the day or night. EVS has also stocked up on additional bath soap and other toiletries for anyone in need.
Food Services at all three hospitals will ramp up their efforts during the weekend, offering extended cafeteria hours and more substantial meals in the late evening and early morning hours to accommodate all shifts. The hospital cafeterias will also stock up on supplies. PPMC is bringing in an extra 1,200 pounds of food while HUP is ordering 560 pounds of chicken fingers alone! PPMC is also stocking up on pasta and other supplies needed for themed meals, including an Italian dinner in honor of the Papal visit. PAH ordered food supplies to cover the weekend and an additional four days beyond that in case the need arises.
In-hospital pharmacies are stocking up with two weeks of supplies. At HUP, they’ll have five days worth of 500 different drugs!
What type of entertainment will employees have when not working? Movie marathons, football watching party – the Eagles are playing that Sunday – and viewing the Papal event. PPMC and PAH will each hold bingo sessions, with prizes (a Papal toaster at Presbyterian!). PPMC employees can also try their skills at karaoke and Papal Jeopardy.
While the major issues have been tackled, sometimes it’s the smaller, less obvious matters that can cause the big problems. Planning teams have spent months trying to cover every eventuality. What if some piece of critical equipment breaks? Or an elevator stops working? No worries. Representatives from equipment vendors will be on site or near-by in case repairs are needed.
Getting to the Hospital
Due to the traffic exclusion zone, getting patients in and out of the restricted zone for emergency situations proved to be another hurdle.
Penn Police stepped up to the plate to help for HUP. “They are one of our big allies,” Dyer said. “When the city extended the restricted area to include HUP, they worked with Philadelphia police to allow access.” Whether it’s a patient needing to get to the ED or a woman in labor, “we’ll coordinate their access to HUP through the hospital command center,” Dyer said. “We’ll tell the patient which way to come and the Penn police will be waiting.” PPMC, home to Penn Medicine’s Level 1 Trauma Center, is outside of the restricted zone so emergency patients have access to its ED.
Women expected to deliver this weekend have been one of the focal points of pre-planning for the Papal visit. Sindhu Srinivas, MD, director of Obstetrical Services at HUP, said teams across Penn Medicine feel very comfortable with the plans that have been put into place. "Each of our patients has a detailed contingency plan that takes into account their medical history and where they live," she said, adding that the staff has worked closely with the city on possible transportation issues. OB patients have also been given a copy of their medical records in case, for some reason, they end up having to give birth at another hospital.
Penn Police will also help HUP’s and Presby’s daily deliveries and pickups get through. And the same goes for trash pickup. Penn Police will escort these trucks through the restricted area and back out … between midnight and 4 am each day. But HUP will also have onhand a three-day supply of linen… just in case. PAH has rented a 53-foot trailer to hold soiled linen until pick-up service resumes and six 40-yard dumpters to accommodate waste.
Ready to Handle Whatever Comes
Clearly no one knows exactly how many people will come into Philadelphia for the Pope’s visit but planners are basing preparations on 1.5 million. Using a FEMA (Federal Emergency Management Agency) algorithm, which takes into account a variety of factors, including the hospital’s distance from the event, HUP expects between eight and nine percent of the total ED visits generated to come there. Pete Sananman, MD, of Emergency Medicine, and chair of the Papal Task Force for Penn Medicine's three EDs in the city, said Presby is planning for two to three times the typical number of emergency-room visits and hospital admissions over the weekend.
In addition to scheduling more staff who will be both on site and in the area in case of emergency, preparations for the Penn Presbyterian ED and Trauma Center have included amassing a surplus of burn kits, ventilators, stretchers, and other supplies, Sananman told The Philadephia Inquirer.
ED staffs from all three UPHS city hospitals are working together and will be able to help each other if necessary. “We think the people who come will differ from our usual, with more of an elderly population or those with chronic health problems,” said Robin Weingarten, ED nurse manager at HUP. Potential language barriers for over 150 languages will be resolved using one of more than 200 translator phones available across the three hospitals.
Staff in PAH’s Hall Mercer Community Mental Health Center have been called on by the City of Philadelphia to help man the medical tents offering psychiatric first aid, for example, someone with an anxiety disorder suddenly can’t cope with crowds. Any cases the staff can’t handle at the tent will be safely transported to PAH. The Homeless Outreach Program responses teams will provide around-the-clock coverage, covering four of the 10 zones within the blocked-out area.
“We looked at many scenarios, from mass casualties to a decontamination incident. We’re trying to be prepared from every angle,” Weingarten said. “This is the same kind of mindset that we had for Ebola. It’s a potentially huge thing. We prepare the best we can … and keep everyone calm.”
“As a major trauma center, we think through all the worst case scenarios and train for those regularly,” Sanaman said. “I’m excited. I think this is a great thing for Philadelphia, and I hope people can enjoy it knowing we’re prepared to help anyone in need of care.”