Broadway: anthrax threat intensifies focus on disaster preparedness - Executive Insights - Robert L. Broadway of Bethesda Healthcare System - Interview

Healthcare Financial Management, July, 2002

Robert L. Broadway, FHFMA, is vice president, corporate strategy, at Bethesda Healthcare System in Boynton Beach, Florida. He has been with Bethesda for eight years, previously serving as vice president of integrated services. Before joining Bethesda, Broadway was CFO of Good Samaritan Health System, a large community hospital, and CEO of Palm Beach Medical Group, a large medical group practice, both in the Palm Beach, Florida, area. He has 28 years of experience in the healthcare financial management industry. Broadway is a member of HFMA's Florida Chapter.

As vice president of corporate strategy for Bethesda, Broadway has been involved in revision of a disaster-preparedness plan for the organization, which was strongly motivated by the circumstances following the September 11, 2001, terrorist attacks and the subsequent cases of biological terrorism involving anthrax. In this special edition of "Executive Insights," HFM talks with Broadway about his organization's disaster-planning efforts and the circumstances leading up to them.

HFM: Please tell us about Bethesda Healthcare System and your responsibilities within the organization.

Broadway: Bethesda Healthcare System is a 362-bed community-based hospital with multiple outpatient service sites. I am responsible for the overall corporate strategy, physician services, marketing and planning, governmental and community relations, and business development.

HFM: When did Bethesda first know that it needed to be prepared to treat potential patients with anthrax? And how did the health system respond when it found out about the first anthrax case?

Broadway: Certainly, the events of September 11, 2001, brought a renewed interest for all hospital executives to be better prepared for events outside of our control. We were in the process of looking at our disaster plans on October 2, when the local public health department informed us of an anthrax case at a neighboring hospital. This gave us a considerable amount of time to prepare our ED staff and physicians before it became a national news story. The local health department officials worked with our staff so that we were better prepared to identify symptoms and administer treatment.

We already had a disaster plan in place. So we immediately notified all appropriate personnel, including our infection control coordinator, medical staff leadership, and our entire executive leadership. The board was notified that there was a potential for terrorist activity, and we went to the highest state of alert.

HFM: How did the system prepare its workforce for this situation? What special training and/or communications did staff receive? How did the employees respond?

Broadway: The number-one priority was to provide staff with factual information. We assured our staff that with appropriate precautions anthrax was not contagious, and that we were prepared to deal with the situation. We also had the appropriate antibiotics for treatment, ciprofloxacin hydro-chloride (Cipro), if there was an outbreak in the community.

The emergency department (ED) staff was provided with additional information on how to identify the condition and to distinguish coughs, fevers, and other common, cold-related symptoms from actual symptoms of anthrax, which requires a separate pathway of treatment.

From the executive level, we provided assurance that we had taken appropriate steps to protect all of our patients, employees, staff, and the community at large. We couldn't control what was happening in the community, but we certainly could address what was happening in our ED.

Our employees were terrific. They were positive in all respects in managing the appearance of illness versus the reality of illness in our community Hundreds of people who felt they had symptoms were coming to the ED. And EDs all over the county were having the same experience. Staff had to show patience, caring, and respect when treating every patient. They did a magnificent job.

HFM: Did Bethesda treat any patients diagnosed with anthrax?

Broadway: No. We had two or three possible cases that were tracked by the Centers for Disease Control and Prevention (CDC), but they were all negative. But a lot of individuals presented to our hospital and physician offices with what they believed was exposure to anthrax. Many of these people were neighbors or co-workers of the anthrax-diagnosed patient.

HFM: How did the community react to the publicity about a possible anthrax outbreak?

Broadway: The community began to panic. Only three weeks had passed since the September 11 attacks. People were in shock and terrorized that a mass contamination with anthrax could kill many times the number of people killed in New York. Closer to home, there was a fear that individuals might be using crop dusters to infect the population with chemicals or biological agents because of the fact that there are several flight schools and a large number of agricultural areas in central and western Palm Beach County Any time a low-flying aircraft or helicopter was heard over the community, law enforcement officials were inundated with calls of concern. Individuals who believed they had been sprayed, even though they were asymptomatic, were rushing to hospitals.