Clinical Center News
Fall 2019

Being ready for the Unexpected – Jim Howson focuses on Clinical Center emergency preparedness

Jim Howson
Jim Howson, the Emergency Coordinator at the Clinical Center.
Jim Howson's ID
Jim Howson's Word Trade Center identification.

Tucked away on the 6th floor of the NIH Clinical Center is a man who spends all day thinking about what can go wrong. Jim Howson, the hospital's Emergency Coordinator, coordinates and plans responses to possible disaster scenarios that could occur at the Clinical Center.

"I look at what can go wrong and how can we keep it from going wrong," said Howson. Upon his arrival to the Clinical Center in 2018, he said, "The thing that impressed me most is how the staff takes care of patients, and if something does go wrong, how committed staff are to making sure that it doesn't happen again."

Emergency management at NIH has evolved over the years. After the 9/11 attacks, emergency planning at the Clinical Center focused on caring for overflow patients from Suburban Hospital and Walter Reed in the case of a mass casualty event. More recently, the Clinical Center has pivoted to a new role: providing specialists to be resources for the other hospitals in the case of an emergency. The Clinical Center and the NIH are uniquely able to tap into specialized expertise on specific emergencies like Ebola virus exposure.

"This role makes more sense for us as we're less likely to take in patients since the Clinical Center doesn't have an emergency room and isn't used to taking patients off the street," said Howson.

In addition to reviewing the hospital emergency policies and approaches, Howson sees effective communication as one of his major responsibilities. "9/11 was a big motivator to think about disasters, but we're almost 20 years on, what can we improve? How do we let people know we're in an emergency situation and improve our communication in getting the message out?" he asks.

Howson came to the NIH with a breadth of experience. He served as a member of the National Disaster Medical System (NDMS), a partnership of the U.S. Departments of Health and Human Services, Homeland Security, Defense and Veterans Affairs. Through his work in the NDMS, he helped mobilize field hospitals under Disaster Medical Assistance Teams, which were usually deployed in response to natural disasters.

On the morning of Sept. 11, 2001, Howson was called within an hour of the planes hitting the twin towers. His focus was on treating the injuries of rescue workers and supporting the recovery work focused on retrieving remains from the wreckage.

After 9/11, Howson worked for the New Jersey Hospital Association developing education and training programs focused on disaster management. Then he moved on to Booz Allen Hamilton where he traveled the country working with Veterans Administration medical centers to hit baseline requirements on their disaster preparedness planning.

He later moved to U.S. State Department to provide tactical paramedic instruction. The job quickly evolved as Howson focused on training embassy staff how to provide emergency first aid, and then was consulted on the design and planning of U.S. embassies to keep the embassy and staff safe.

In late spring, Howson and the NIH Clinical Center were ready for an unannounced emergency management simulation – a derecho storm that could douse the NIH campus with inches of rain over the course of several hours and high winds that had the potential to blow out windows, damage labs and severely impact the operations of the hospital.

This time around, staff and patients weren't soaked – it was all a part of a Code Yellow exercise undertaken by the Clinical Center's leadership.

A Code Yellow is any type of disaster or potentially harmful event that affects the Clinical Center. It's an occurrence that the Clinical Center hopes not to experience, including severe weather events, pipe breakages and power outages. But when these happen, the command staff is activated to respond.

Howson says he even feels that failures during simulations are instructive, because they provide examples of where systems break down and indicate how things can be improved.

This Code Yellow exercise was a partial surprise, but hospital leaders didn't want it to disrupt patient care, so staff were given a general indication that something was coming but were not provided with any specifics.

The Code Yellow simulation for the derecho was planned as a joint exercise with three months of regional preparation. Montgomery County, Md., ran the exercise along with Walter Reed Military, the National Military Medical Center, with the Clinical Center joining in to help practice its planning skills, to strengthen ties with the community and to maintain the Clinical Center's role as an international, national and regional resource.

The Joint Commission (the independent, not-for-profit organization that accredits and certifies nearly 21,000 health care organizations and programs in the United States), recommends that health care facilities host two emergency exercises a year.

- Robert Burleson and Donovan Kuehn

Pharmacy symbol icon
NIH Clinical Center releases Strategic Plan
Mary Sparks receiving a flu shot
wristband with ALLERGY on it
Awardees Elise Ferré, Maureen McDonnell, Ruth Parker and Dr. Douglas Rosing
Language Interpreters Program staff
Dr. Harvey Klein
Julianna Nickel playing the flute
CC Research Nursing Department trains University of Guam Nursing students and Faculty
Dr. Francis Collins, Thu Cao and Dr. Jim Gilman
Dr. Jo Shapiro
Jim Howson
Screen capture of Meet Our Doctors, a new feature of the NIH Clinical Center website
Dr. James Gilman, NIH Clinical Center CEO, addresses staff clinicians
Michael Murphy at a podium
Nurses working on a pedigree diagram within a patient's medical record
nurse kneeling beside a pediatric patient
people gathered around computers
Patient standing with care providers
The metabolic kitchen staff creating precisely measured ultra-processed and unprocessed meals for study participants
Attendees of the Open Notes session gathered together
Pediatric patient ten-year-old JoJo with Dr. Cynthia Tifft
Branden Bolivar proposes to Marissa Amuso, a patient, May 9 at the NIH Clinical Center
Tom Kaminski with Dr. Sherman Souther
Kayden Reinke, at the age of 2, holding Lammie
Project SEARCH graduates and team
Dr. Marijo Bilusic
Singer-songwriter and pianist Chris Urquiaga
Three women photographed with an award
Man in fatigues talking to care provider
A pediatric patient with her mother and members of the NIH Blood Bank
NIH musical group led by Dr. Collins performing on stage
Dr. Eric Betzig at the podium
Children conducting a science experiment
Trina Davis
Graphic of a cochlear implant
Staff member using a sewing machine
Dr. Saul Rosen
a patient's wristband getting scanned upon checking in or out
Michael Bard, a volunteer medical musician, holds his guitar in a patient room
Nancy Holmfeld
Rare Disease Day logo
People dancing in the atrium
people taking a selfie
Health Information Management Department staff posing for a photo
Young boy holds up a sign that says I love clean hands
FEVS logo