As a level one trauma hospital, Sparrow already had a detailed protocol for mass casualty events, Martin said. When code triage is enacted, the first step is for managers of every unit to evaluate their current staffing and call in emergency staff if necessary.

Then, the hospital has to evaluate its capacity and determine where and how rooms can be opened up if needed.

“It really has us look at current staffing, how we can urgently add to our staffing, but then how do we, in a rather short amount of time, create capacity or open beds in the hospital that can help us again care for a massive influx of patients,” Martin said.

Martin said that the shooting showed the hospital that their preparation was effective. Although only five individuals were admitted that night, Martin said he believes they could have handled more casualties.

“Would it have gone as well if we had 20 (victims)?” Martin said. “I think it would have. We had a lot of capacity that we didn't use that evening.”

Although the protocol worked well in the case of the MSU shooting, Martin said the hospital has begun to analyze how big of an event they could handle and expand the strategy to target specific events differently.

Specifically, seeing the effects of a recent mass shooting in Maine, in which up to 50 individuals were initially believed to be injured, has pushed Martin to consider how Sparrow would react in a much larger event. Martin said they have also begun to think more critically about possible events like plane crashes or chemical disasters.

Because the necessary care plan varies greatly from injuries like gunshot wounds to chemical burns to traumatic wounds from a crash, analyzing every kind of possible event is important in having the correct resources prepared, Martin said.

“It has made us think more broadly of the type of incidents that we may need to respond to and even just on a larger scale,” Martin said. “(If) 50 people or 100 people came in, how would we care for that number?”

Martin said that so far, nothing specific has been changed within the hospital's code triage protocol, but thinking creatively about how to open space has been an ongoing priority. He said the COVID-19 pandemic has prepared the hospital well for being flexible in creating space.

“We were using spaces like the operating room for an intensive care unit,” Martin said. “So, we know how to flex up and use other spaces in the hospital in a different way when we exceed our capacity and we need to take care of more patients.”