FUKUSHIMA Lives on the Line

213access to the story of life and work in Fukushima.BK: What would you say is the big take-home message for health facilities and blood centers looking to learn something from your experience in Fukushima Medical University in the wake of the tsunami?KN: Treasure the knowledge of long-term employees, and welcome the insights of newcomers and visitors from other institutions. It has been my privilege to work in three countries, and participate in academic discourse on five continents, but travel per se has not been the essential element of my experience. In fact, what I brought to Fukushima was not my experience at all; rather, it was the collective wisdom of others in our profession who had overcome seemingly unique problems. Their solutions can become our solutions, if we take the time to listen.(1) Changes in medical examination system (shifted immediately following the earthquake to focus on outpatients with critical symptoms→gradually restored examination capacity later)●Friday, March 11, 20111st (Green): Orthopedic outpatient care2nd (Yellow): Internal medicine (new) outpatient care3rd (Red): Emergency medicine outpatient care(Broadcasted message via media body Telop, informing about “Shift to treating patients with critical symptoms and suspension of general outpatient services” on March 12)Green: 93 patients, Yellow: 44 patients, Red: 30 patients, Black: 1 patient; Total: 168 patients●Monday, March 14, 20111st–2nd: Surgical Division…Orthopedic outpatient careInternal Medicine Division…Internal medicine (new) outpatient care3rd: Emergency medicine outpatient careSpecial outpatient care: Otolaryngology Division, Ophthalmology Division, Pediatric Division, Psychosomatic Division, Dermatology Division, Endocrinology DivisionTotal arrivals: 400 patients●Thursday, March 17, 20111st, 2nd (Surgical Division, Internal Medicine Division): Internal medicine (new) outpatient care 3rd: Emergency medicine outpatient careAggregate special care total (excluding Psychosomatic Division only): 364 patients●Tuesday, March 22, 2011Reopening of Internal Medicine Divisions (reserved patients only): Circulatory Medicine Division, Hematology Division, Gastroenterology Division, Rheumatology and Collagen Disease Division, Kidney and Blood Pressure Medicine Division, Diabetes and Endocrinology Division, Neurology Division, Respiratory Medicine Division, Pediatric Division, Psychosomatic Division, Radiology Division, Obstetrics DivisionSurgical Division: Emergency patients handled by Orthopedic Surgery Division.Surgical Division restarted surgeries (three operation rooms and one room for emergency operations).Emergency outpatient care: Tertiary response●Thursday, March 24, 2011Resumed accepting new patient arrivals to Surgical Division; restarted all patient examinations (reserved patients only)(Friday, March 25, 2011, 18:30: Completed survey and division of patients at hospital.)●Monday, March 28, 2011Outpatient care returns to normal operation.●Monday, April 4, 2011Operating rooms return to full operating capacity.(2) Background surrounding restricted examination policies●The Hospital was forced to implement a restricted examination policy. This was due to a severe decrease in examination capacity because of suspended water service, shortage of drugs and examination supplies, and the inability of personnel to commute to the hospital due to gasoline shortage.Performing dialysis, biochemical examinations, and sterilizations/disinfections were particularly difficult under the circumstances. Water service was restored on Friday, March 18, 2011, and the hospital was able to reopen its Internal Medicine Division for outpatient care on Tuesday, March 22, 2011, thanks to resources and support provided by MEXT and other entities.Overview of Post-quake Medical Examination System and ResultsHospital Administration Department