At Abbott Northwestern Hospital, some key staff members put their heads together in the "incident command center" last Thursday morning.

The flurry of activity was the beginning of a full-scale evacuation -- not an actual one, but a drill.

Under the scenario, a hypothetical tornado had hit the building, causing some areas to lose electricity and water and injuring numerous patients and staff members.

Following protocols for an orange alert that signals a disaster, the hospital determined that "patients," portrayed by 30 community volunteers, should be relocated to Mercy Hospital in Coon Rapids and St. Francis Regional Medical Center in Shakopee.

As an added wrinkle, the elevators were out of commission, so some bedridden patients had to be carried down several flights of stairs in specially designed chairs and heavy-duty cardboard slides.

The volunteer patients, whose diagnoses varied wildly, were labeled with triage cards that described their condition. Behind-the-scenes, their medical records were transferred electronically to other facilities.

Abbott emergency manager Candice Washington said this drill is the biggest one she's been a part of. "We need to know that we're ready for the worst-case scenario, that the staff are educated and know the plan well," she said.

Overall, it's a complicated process that involves coordinating several hospital divisions, outside emergency medical services, local fire departments and multiple Allina hospitals.

It's worth it, Washington said, because "we want to know where the gaps are to make the plan stronger and better. Patient safety is our ultimate concern."

Meanwhile, everyday work at the hospitals continued while the drill went on. "We would never jeopardize patient care for a drill," she said. "Patients hopefully felt no ripple."

A surge at Mercy

A couple of Mass Casualty Incident buses borrowed from area fire departments were used to transport patients to the suburban hospitals. The 20-person capacity buses, which are among 27 such vehicles nationwide, are equipped with cots and devices to monitor vital signs.

Once they arrived at Mercy, patients were checked in and assigned to beds, virtually.

In reality, no beds were available at Mercy, which is the norm for the hospital, according to Dallas Anderson, a safety specialist in the emergency management area at Mercy and Unity hospitals.

On a theoretical level, "We determined what to do to make beds available," which included discharge planning, freeing up some surgery areas and using rooms that wouldn't normally be for patients, he said.

Anderson, who also juggled the role of planning section chief for the drill, serves on an Allina disaster committee that started developing a standardized system-wide evacuation plan about a year ago.

As such, each of the Allina hospitals is putting that evacuation plan to the test. Already, Unity Hospital in Fridley has gone through it with United Hospital in St. Paul, while other hospitals will do so in the coming weeks.

Learning from Joplin

The experiences of medical professionals who dealt with the Joplin, Mo., tornado earlier this summer helped inform the situation, Anderson said. "It's great to have good plans, but you have to look further downstream," he said. "You think you're going to have phones and electricity, but all of that may go out the window and you're left with nothing."

Webster resident Juanita Kruchten, an emergency room nurse at St. Joseph's Hospital in St. Paul, volunteered as a patient to see how other hospitals work in a disaster situation.

She took on the role of a 71-year-old woman in a wheelchair who had an oxygen tank. "I thought it was an organized kind of chaos," she said, adding, "I got some ideas to bring back to my hospital."

Anna Pratt is a Minneapolis freelance writer.