Support for the initiative, which was begun in 1999 to serve as a national resource for emergency preparedness and response, was included as part of the FY 2005 Labor-HHS appropriations bill included in the omnibus spending measure signed by President George W. Bush.
Housed at Washington Hospital Center, ER One will stand as a state-of-the-art facility designed to handle an influx of critical patients in the event of a severe emergency. The Hospital Center committed to use the funds appropriated by Congress to develop a schematic design for the facility, the final phase to precede construction.
"ER One will dramatically improve the national capital region's ability to prepare for and manage mass casualties or injuries resulting from a major natural disaster, catastrophic event, emerging illness or terrorist attack," said Mark S. Smith, MD, chairman of the Department of Emergency Medicine at Washington Hospital Center. "Our nation's capital is a prime target for terrorists as evidenced by the horrible attack on the Pentagon on September 11. We need to move from planning to design to implementation – as rapidly as possible – in order to help the region in responding to catastrophic emergency."
ER One, which will serve as a demonstration facility for the nation, will have the capability to mange explosive, chemical, biological and radiological events. It is designed to scale up operations robustly and efficiently during a crisis, serving more than five times the number of patients than a traditional hospital cares for during the first 2 hours of an emergency.
ER One will have specialized isolation, decontamination and security features, including the ability to transform every room into a negative pressure isolation room with 100 percent nonrecirculated air, multi-modal decontamination capability throughout the facility, and portal control with zoned security protection to mitigate the emergency room as a target. To avoid emergency vehicle gridlock, ER One will offer multi-lane access, allowing for efficient management of incoming patients during an emergency.
The hope is that ER One will serve as a model on which future emergency care centers will be based and current centers retrofitted. It will be a testing ground for new concepts and new technologies in emergency care and hospital facility design, which will be disseminated nationally through conferences, site visits, education, and training.
The Key Recommendations of Project ER One include:
Scalability
- Universal patient care rooms that are configurable for any purpose
- Single patient rooms that are reconfigurable to accommodate up to three patients
- Rapid conversion of non-patient care space into clinical space for four to five times scalability
- Modular and mobile solutions rather than dedicated built-in equipment
- Convex multilane vehicular access
- Emphasis on portability and modularity at every scale
- Instant access to all data for any patient at any moment
- Person-to-person communications net independent of other communications systems
Capability
- All rooms with negative pressure capability and 100 percent non-recirculated air
- Every room an isolation room with separate ventilation and separate toilet facilities
- Ability to isolate single rooms or entire zones and sectors
- Multimode decontamination capability in every area of the facility
- Portals for access control and threat detection
- Universal docking capability for portable external modular treatment units
- Robust real-time data-sharing with local, state, and federal health authorities
Threat Mitigation
- Self-decontamination surfaces
- Offset parking away from building footprint
- Single-room and single-zone modular compartmentalized ventilation systems
- 100 percent air filtration
- Assured water supply with internal purification capabilities
- Blast protection walls and blast deflection strategies
- Elimination or encapsulation of building materials that can shatter during an event
- Built-in radiation protection
- Advanced security and intrusion detection technologies