Overview and Program Description

The Division of Emergency Preparedness (DEP) has three main goals:

• Educate physicians, nurses, and administrative staff about their roles and responsibilities in potential disaster events.
• Work with state and local partners to improve our collective policies and plans for emergency response to health threats.
• Conduct research to improve the nation’s preparedness and emergency response plans.

Led by Dr. Paul Biddinger, the DEP is closely integrated with the hospital emergency preparedness program and is supported by participation from clinicians on the MGH Department of Emergency Medicine faculty as well as MGH ED nursing and MGH ED administration.

Clinical Activities

DEP and hospital emergency management program members meet regularly with the leadership of many hospital departments and divisions including trauma surgery, nursing, the hospital safety office, and others. DEP designs and conducts regular training events and exercises within MGH to develop, disseminate and test emergency plans. The DEP and the MGH EP program support standing committees in overall emergency planning and preparedness, as well as preparedness for hazardous materials, and planning for hospital evacuation. The DEP designs and conducts between three and six full-scale exercises each year dealing with mass casualty, chemical hazards, and radiological hazards. All of the faculty members in the MGH Department of Emergency Medicine are required to participate in a DEP-sponsored activity at least once every three years.

In addition to the regularly scheduled exercises referenced above, in the past five years, the DEP has led hospital-wide preparedness exercises at MGH involving the following scenarios:

• unanticipated need for hospital evacuation
• fire in the OR suite
• helicopter crash on the helipad
• pediatric mass casualty event
• outbreak of a novel airborne infectious disease

Educational Programs

Fellowships

The DEP is a participant in the HMS Disaster Section, led by Dr. Gregory Ciottone of the Beth Israel Deaconess Medical Center, participating in the structure and design decisions of the overall program and opportunities for fellows. This Section (comprised of faculty from most of the Harvard teaching hospitals’ Departments of Emergency Medicine) has collectively developed a fellowship in Disaster Medicine (DM). The DM fellowship program is designed to provide qualified emergency physicians the opportunity to develop an expertise in the related fields of Disaster Medicine (DM) and Emergency Management (EM).

Fellows are based at one institution, but receive training experiences and education at all of the participating institutions. The two year program includes didactic lectures, seminars, readings, goal-related research in a specific area of DM and EM, and fieldwork resulting in a thesis. Upon completion of this fellowship, fellows are skilled in all aspects of the disaster cycle and have the ability to assume a leadership role on the local, regional, federal, or international level in the area of Disaster Medicine and Emergency Management. After graduation, fellows can assume a leadership position and be active in research and academics, eventually becoming an internationally noted expert. The MGH DEP has hosted fellows from the disaster section in its lectures and preparedness exercises, and fellows have met with Dr. Biddinger for mentorship.

Residency Training

Residents in the Harvard Affiliated Emergency Medicine Residency (HAEMR) receive regular lectures from DEP faculty as part of their core curriculum including:

• Disaster triage and treatment
• Medical surge management
• Management of blast injuries
• Management of biological, chemical and radiological hazards

In addition, all residents complete an eight-hour Occupational Safety and Health Administration (OSHA) Operations-level Hazardous Materials training developed and sponsored by the DEP to allow them to safely wear appropriate Personal Protective Equipment (PPE) in a hazardous materials event. Residents are also given multiple opportunities each year to participate in exercises to further advance their training in disaster response.

Medical Students

Medical students from Harvard Medical School, and also those visiting from other medical schools, are included in the HAEMR disaster curriculum lectures. In addition, medical students at MGH are invited to participate in the MGH disaster exercise program.

Post-graduate Education/Invited Presentations

Members of the Division of Emergency Preparedness have been invited to speak at local, national, and international events on topics of emergency preparedness and response. To date, DEP members have led more than 50 local and regional training events and have been invited to speak more than 70 times on emergency preparedness and response. Dr. Biddinger also leads a 2.5 credit course at the Harvard School of Public Health entitled “Public Health Response to Mass Emergencies.”

Research Activities

Below are key grants for Dr. Biddinger:

Dr. Biddinger has also completed work on four separate AHRQ-funded research projects on disaster preparedness in the past 5 years, and one Department of Health and Human Services (HHS)-funded research event in 2009. Since 2005, the DEP has published 11 peer-reviewed articles, 8 non-peer reviewed articles, chapters and reports, and presented 14 abstracts at national conferences.

Community Services

Members of the DEP represent MGH on several committees that impact the community of Boston:

• Conference of Boston Teaching Hospitals (COBTH) Disaster Committee: The committee is chaired by Maryfran Hughes, RN, ED Nurse Director and DEP member.
• Boston Urban Area Strategic Initiative (UASI): Members of the DEP represent MGH.
• Metropolitan Medical Response System (MMRS) committees: Members of the DEP represent MGH.
• Massachusetts Department of Public Health (DPH): Dr. Biddinger serves as an advisor on planning for standards of care in disaster situations.

The MGH Hazmat Team has won a special citation from the Mayor’s Office of the City of Boston, and is one of the most active hospital-based programs in the state. Its training curriculum was given to, and has been incorporated into, the federally-funded DelValle Institute for Emergency Preparedness in Boston.