BOIL ORDER PUTS STRAIN ON HOSPITAL

SteveJurvetsonPhoto by Steve Jurvetson

Many people who called the Escondido hospital were seeking advice on whether to use tap water — but not necessarily for themselves, said Dr. Jerry Kolins, the hospital’s chief medical quality officer.

Some asked about watering their tomatoes. Others wondered if their pets would be safe lapping up water that was not considered safe for humans. Suddenly, Palomar’s emergency-department staff was expected to be an authority not just on people but on all manner of flora and fauna.

“I knew that the hospital was positioned in the eyes of many as a place to get information on all health-related matters, but I didn’t know that expectation went beyond human health,” Kolins said with a chuckle.

The Rincon del Diablo Municipal Water District declared the boil-water order on Aug. 15, after detecting fecal coliform bacteria in part of its system. The order lasted through the weekend; tap water could not be used unless first boiled to erase any possibility of bacterial contamination.

It forced the hospital to quickly rethink its approach to serving patients and staff.

Rather than having orderlies running around the hospital’s nine stories with pots of boiling water, Palomar’s administrators decided to temporarily set aside everything linked to tap water. That meant every ice machine, every coffee maker, every dish, every cup, every utensil in the facility.

Palomar’s food staff switched to paper cups and plates and disposable utensils. Bottled water replaced filtered tap water, and instant coffee stood in for brewed beans.

All in all, patients took to the sudden changes without much complaining, said Valerie Martinez, the hospital’s director of infection control.

“I think the biggest complaint was coffee. We did have instant coffee, but I guess it just wasn’t the same,” Martinez said.

Ice was a larger challenge, she remembered. With no way to know for sure whether the hospital’s many ice machines were contaminated, ice runs became a necessity.

“We had to make sure it came from a source that was outside the water district,” Martinez said.

There were 200 patients, on average, in hospital rooms over that boil-water weekend and several hundred more people when Palomar employees and visitors were included.

Unlike food service, the hospital’s surgical department was able to keep working throughout the weekend. Martinez explained that the autoclaves used to sterilize surgical equipment are so powerful that there is no concern of contaminated water causing an infection.

The boil-water order ended on the night of Aug. 17, but that did not mean everything immediately went back to business as usual.

All appliances that use water had to be cleaned and sanitized according to manufacturers’ directions, a process that took a day and a half to complete. While there was still plenty of cleaning work left to do, the food services department resumed serving lunch with flatware by lunchtime Monday.

In the end, Kolins said having the hospital’s water supply suddenly stopped up was a learning experience that he didn’t expect.

“This is something we didn’t prepare for in medical school,” Kolins said.

Article by Paul Sisson of the Union Tribune
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