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Community Spotlight: Elevated Motor Vehicle Crash Death Rate

Tioga, North Dakota:

Last fall, 20 high school students participated in a hypothetical situation where an oil rig semi-truck crashed with a school bus. The students were caked with makeup to resemble blood and bruises, which added to the experience. Each student wore a sign that detailed their injuries and enabled emergency crews to practice their triage skills.

This mock event stemmed out of a Community Health Needs Assessment from Tioga Medical Center (TMC), which had identified "Elevated motor vehicle crash death rate" as a prioritized community health need. While this need is not surprising given the increase in traffic from oil rigs, it falls outside the scope of the hospital and its services.

To address this need, TMC spearheaded an initiative to host a mock motor vehicle mass casualty incident. They partnered with Williams County Emergency Preparedness, North Star Helicopter Services, Guardian Helicopter Services, Tioga Fire Department, Tioga Ambulance Department, Ray Ambulance Department, Powers Lake Ambulance Department, and Tioga Public School.

According to Ryan Mickelsen, VP of TMC, the purpose of this exercise was “to test the abilities of the local EMS as well as Tioga Medical Center in the event of a mass casualty incident, with the goal of successfully reducing the number of casualties and ensuring patients receive definitive care as timely as possible.”

One of the aims of the Community Health Needs Assessment is to promote community engagement by assessing the strengths and gaps of the community. As part of the Affordable Care Act, identified needs must be addressed, but hospitals are often left with scarce resources to implement activities. The emergency drill is an example of a community program that is making a difference and fostering collaboration and cooperation among community resources.

It took months of planning to implement an activity of this magnitude, but all community stakeholders wanted to participate to test their capacity and improve their systems. Lessons learned stemming from this mock event include improving the field triage process. As an all-volunteer emergency squad, this event highlighted the need for more training to better prioritize patient load and assess which patients to treat first and which, among the walking wounded, could wait for treatment. Additionally, it underscored the need for more EMS education regarding diverting less seriously injured patients to neighboring hospitals to decrease patient loads.

The mock test also revealed strengths in the current health communication system with an "all hands on deck" page going out to all employees. Employees who did not receive the page were flagged as needing to update their contact information.

While the cost for emergency planning and preparation drills like this can be high, the only money TMC dispensed was for make-up and the pizza and pop for participants to enjoy afterwards. The amount of in-kind contributions from local businesses and community organizations—in the forms of equipment supplied from the oil company, schools, fire and ambulance departments—conveys their commitment to community health.

One year later, Tioga Medical Center is realizing the benefits from this mock event in the form of more cautious driving which in turn has led EMS responding to fewer vehicle crashes involving the youth. Additionally, there are improved relationships and a more open dialogue among the EMS crew, hospital staff and flight crews.

"In general our medical center feels more confident in the abilities of our local EMS in managing a mass casualty scene appropriately," said Mickelson. "Our EMS providers are more confident in the medical center to be able to manage the patients that are brought to them as well as the decisions to divert patients to other facilities."

Future plans for continued training and commitment to community health are witnessed by Mickelson’s willingness to host another event every couple of years to keep everyone sharp in their responsibilities.

For more information about this mock event, contact:

Ryan Mickelsen
Tioga Medical Center
(701) 664-3305