Melvin Moton, who works for material management contractor SI International, helps unload the contingency station in the Clinical Center.

How can NIH best serve during a disaster? Flanked on the east and west by two other medical facilities, how can NIH harness the unique resources available from each? These questions were answered by the emergency-response partnership formed in 2004 by the Clinical Center and its neighbors, National Naval Medical Center and Suburban Hospital. The CC’s role in the partnership was tested during Hurricane Katrina, when the hospital’s capacity flexed to accommodate about 100 patients from the Gulf Coast region.

The need wasn’t realized, but the preparations were a real-life test of the hospital’s capability to accept an influx of patients. Accommodating such a surge is a major role for the CC under the partnership. Navy and Suburban can transfer or divert certain types of patients to the CC so incoming sick and injured can receive care at the facility best suited to provide it.

“The partnership hospitals have complementary strengths,” said CC director Dr. John Gallin. “The Clinical Center has physicians who represent almost every medical and surgical specialty and subspecialty. Naval Medical Center staff are skilled and trained to respond to all kinds of emergencies and Suburban Hospital is a level-II trauma center.”

HHS recognized the partnership’s potential early on—it’s the only such collaboration that includes hospitals from the private, government and military sectors—and earmarked a 250-bed contingency hospital for its support. The contingency hospital consists of pre-positioned supplies and equipment ready to set up within the CC. This “within the walls” deployment is both practical and unique, noted Dr. David Henderson, CC deputy director for clinical care and liaison for the partnership. “We have space to put the beds and staff from throughout NIH who have volunteered to provide the care.”

Capt. Elaine Ayres inspects contingency hospital inventory.

The CC was to have received the nation’s first of 10 such pre-positioned hospitals. But Katrina intervened and supplies and equipment being assembled in Atlanta were redirected to areas affected by the hurricane, explained Capt. Elaine Ayres, project officer for the contingency hospital.

It took months, but the CC’s contingency hospital— 200 containers covering 3,000 square feet—has now been reassembled, delivered and stored. “The inventory, tailored to supplement what we already have at the CC, allows us to be self-sufficient for at least 72 hours,” said Ayres. If the hospital is activated in response to an emergency, staff here will simply unpack the containers and set up the beds, equipment and supplies in predetermined areas throughout Bldg. 10.

The boxes are color-coded, meticulously inventoried and precisely arranged to simplify logistics. They include everything from beds for patients and cots for staff to IV poles and blood-pressure cuffs.

There are no pharmaceuticals and few supplies that can’t be stored indefinitely, she said. Ayres, CC assistant director for ethics and technology development, was the Public Health Service team leader for another contingency hospital sent to Mississippi in the aftermath of Katrina and staffed by NIH volunteers. The experience, she added, provided insight into how such resources can best be set up and used.

The partnership staged its third preparedness drill last month. Previous exercises provided opportunities to practice and refine response processes under fairly realistic circumstances. “Our goal is to be flexible and creative in our response to emergencies,” Henderson said.