Jessica Lussier, MSN, Director of Emergency Services, Cheshire
In our staff profile series highlighting the roles of individuals and their departments across the D-HH system, D-HH Connections visits with Jessica Lussier, MSN, director of Emergency Services at Cheshire Medical Center. She joined Cheshire, a member of the (D-HH system, in February 2013 as a part-time nurse and eventually became a clinical leader—a nurse managerial role. She was named director of Emergency Services in November 2018.
The Hancock, New Hampshire resident is a Connecticut native, and holds a Master of Science in Nursing (MSN) degree from Chicago’s St. Xavier University. She earned her undergraduate degree from Russell Sage College in Troy, NY, in 1998. Prior to her work at Cheshire, Jessica was an emergency department nurse from 2002 to 2013 at St. Francis Hospital in Hartford, CT. She served as a nurse in the U.S. Army from 1998 to 2002, and was stationed in Germany at the 67 Combat Support Hospital. Her service included a deployment.
What does your role as director of Emergency Services entail?
I oversee the Emergency Department (ED), the contracts related to the ED, the nursing staff, Emergency Medical Services (EMS) coordination for trauma services, the behavioral health team for the acute care side of the organization and the emergency management coordination.
How many patients does the ED serve?
Our average daily ED census is 60 to 65 patients. We treat approximately 24,500 patients per year. The ED has 20 beds and two triage rooms.
Shortly after taking the reins as director of Emergency Services, you were faced with a significant challenge—managing the complete evacuation of Cheshire Medical Center. What happened?
At 10:24 am on Thursday, April 25, 2019, I was working in the ED and everyone heard a loud bang. The boiler malfunctioned, which damaged the stack so the boiler could not vent. The Engineering Team called the Fire Department, and we heard it over the police scanner. It was discovered the hospital had no heat or hot water. We had to consider evacuating the hospital, but needed more information first.
What factors did you consider?
We weren’t sure if we could get heat back, but could handle operations without hot water. But we knew the weather forecast was poor—it was rainy and the temperature was going to drop into the low 40s overnight. Another piece of information we needed was the lowest threshold temperature for the lab, CT scan and other areas. If the temperature dropped below 65 degrees, it could cause issues in those areas.
What happened next?
Around 1 pm, the administrator on call transitioned Incident Command duties to me. I felt pretty confident we would have to evacuate. Our focus was always on our patients’ best interests. We gathered as much information as possible, because we didn’t want to rush and make mistakes. The fire chief contacted state agencies to alert them to the possibility of evacuation. The New Hampshire Office of Emergency Management and Department of Health and Human Services were instrumental in securing resources. The New Hampshire Knowledge Center sent an urgent message to emergency management teams throughout the state to ask for all available resources for a possible evacuation.
At 3 pm, we held another Incident Command meeting and agreed to evacuate. We had 69 patients to process, 47 of which needed to be transferred. We expedited those patients ready for discharge and arranged for the most critical patients to be moved first. We then determined placements for those with special needs, and started notifying family members about the transfer plans.
Were patients worried?
The inpatient team communicated with them, and they were thankful. The patients knew it would be too cold to stay at Cheshire. The team facilitated all of the patient movements and gathered their belongings and paperwork. They did a great job.
How did the evacuation work?
No one panicked because we were in control and had a plan. Fire Chief Howard coordinated the volunteer ambulances from New Hampshire and Vermont. At 5:25 pm, more than 20 ambulances arrived to transport patients to: Brattleboro Memorial Hospital, Catholic Medical Center, Concord Hospital, DHMC, Elliot Hospital, Monadnock Community Hospital, Mt. Ascutney Hospital and New London Hospital.
The ambulances lined up at the door, waiting patiently as we verified patient information—where they were going, their belongings, etc.—before releasing them for transport. We needed to control the patient flow and stay organized. It was really amazing to see all of these people show up after the call was put out that we needed help. The EMS personnel came voluntarily on their own time.
The last transfer was at 11 pm, so we evacuated 47 patients in five hours and 25 minutes! Everyone was great. They just asked, “What do you need me to do?” It didn’t matter what their role was, they just pitched in. I had a vice president getting dinner for people, and a front-desk employee who had come in at 8 am but didn’t leave until midnight when everything was over.
In the meantime, what was happening with the boiler?
The Engineering team did an amazing job locating a temporary boiler in Massachusetts after much research. The state helped expedite the permit process, and the team worked with Vermont Mechanical and Cheshire Engineering throughout Thursday night and all day Friday to fabricate 120 feet of welded pipe, install the boiler and get it operating without causing damage to the system. It needed to be inspected and certified by the state, and heat was fully restored at 8:30 pm on Friday, April 26.
When did you start seeing patients again?
We started admitting patients on Friday evening after when knew the HVAC system was properly regulated.
Did any of the discharged patients return?
The Incident Command Team met again Saturday morning and began coordinating patient returns. Some were discharged after their transfers and others were too sick to be transferred again. We had 25 patients return to Cheshire, with the last one returning Monday morning. I closed Incident Command on Saturday, as every patient had a transition plan or were remaining at the transferred hospital.
What was the feedback after the event?
We debriefed and the team was very positive. Everyone worked well together, no one was hurt, and there was amazing inpatient leadership. Communication can always improve, so that was one area we identified to work on.
Has the evacuation helped other hospitals prepare for emergencies?
Many of my emergency management partners have reached out to learn more about the evacuation. It was the only complete evacuation of a hospital in New Hampshire, so it was a great way to test the emergency management plan we had in place. It also helped our partners think about ways to improve their own plans.
What were your thoughts post-evacuation?
I was so thankful no one got hurt during this process. It was the right decision to evacuate. Parts of the hospital were 50 degrees—it was just unsafe for us to stay. Our state partners were fantastic. Everyone did their jobs without question. I’m so grateful it went so well.
Congratulations on an impressive job well done! Now for some semi-personal questions. What’s your favorite non-work activity?
Cooking. I have lots of cookbooks and enjoy creating new and different meals with my daughter.
What about you would surprise most people?
When I was growing up, I was a competitive tap dancer!