MHPC Establishes Role as Liaison During Civil Unrest in Charlotte

What happened?

Following an officer involved shooting on September 20, 2016, the Charlotte area experienced episodes of civil unrest. While peaceful at times, intermittent episodes of violence continued throughout the duration of the event, lasting until roughly September 25.

Initial protests began late afternoon on Tuesday, September 20, only hours after the shooting occurred. Incidents of violent protest began later that evening, primarily in the University area. CHS corporate Emergency Management notified MHPC that a crowd was within two miles of the CHS University campus. There was early discussion centered on alteration of service provision at that facility. During this time, CHS University went on alert status and increased its on-site security and local and neighboring EMS agencies discontinued patient transport to this facility when possible.

MHPC’s Role

Based upon the impact that these violent outbursts had on hospitals in the immediate region, MHPC began daily coordination calls with leaders from MEDIC, CHS, and Novant Health. These coordination calls established a process whereby MHPC became the liaison between local hospitals, area EMS agencies and the command center. In addition to virtual/remote operations, MHPC personnel were posted within both Carolinas Medical Center and Novant Health Presbyterian at various times throughout the event.

What went well?

This event was dynamic, both in terms of its varying threat of violence, as well as in terms of its physical location. It was identified early into the incident that protests, particularly within the Uptown region of Charlotte, could affect patient transport to hub facilities undertaken by out of county EMS agencies.

In addition to the mobility of the existing crowds, new groups of protestors could have assembled rapidly. There was concern that regional EMS agencies may unknowingly transport into areas experiencing active riots. Road closures were also frequent throughout the event, potentially altering outside agencies’ ability to transport into the area. Similarly, changes in levels of hospital service provision could require EMS agencies to divert to a different facility.

Communication with outside counties allowed incoming units to remain aware of potential safety hazards as well as of factors affecting patient transport times. Further, this process was used to help out of county units understand that hospital service provision was uninterrupted with all departments open.

Many EMS agencies reported that, regardless of whether or not they utilized direct telephone communications with MHPC, they were able to utilize email and/or the MHPC website in order to maintain situational awareness.

 This was the first large-scale/sustained utilization of the Medical Intelligence Coordination Center. The overall concepts, as well as several underlying processes were validated. We were able to gather large amounts of data for AAR/process improvement and we sustained and grew regional relationships, extending in to South Carolina, particularly with EMS agencies. MHPC was able to provide a single point of contact for unified command to share information with local hospitals and regional EMS partners. The MHPC website was proven to be an effective status notification tool and the Duty Officer phone number worked well, providing good information for outside agencies. Social media was crucial in monitoring crowd movement and levels of violence. It was also proven an effective communication tool.

Areas for improvement

Although the MHPC website was proven to be an effective status notification tool, we learned that it could have been implemented earlier in the incident. We also learned that an additional line of communication, i.e., a dedicated radio channel for EMS to use to contact MHPC would have been beneficial.

This event also highlighted the importance of implementing a mass notification system such as EverBridge. It was proven that the use of text messaging and emails were not an effective way to get information to people in a timely and efficient manner.

Most importantly, we learned that we need to put focus on working with partners to define a process and create job action sheets based upon feedback from the AAR. We also need to establish pre-defined criteria for information sharing — what type of information needs to be shared and when.

In closing, this event justified the work that we have put into the Situational Awareness and Information-Sharing project. It stresses the importance of finishing the associated planning as well as the implementation of this project.