As Maryland homeland security officials paraded through the "decon unit," set up for a demonstration outside the emergency room doors at Shady Grove Adventist Hospital in Rockville, Md., Joe Novello pointed out its features the way someone might show off a new car.

"This is a completely self-contained trailer," said Novello, the hospital's security director, of the decontamination unit. "It has a heating system and a water bladder, so water can be pumped out. It has a generator and decontamination showers separated by gender."

Outside, a man in a HAZMAT suit posed, smiling, for photos.

The politicking surrounding homeland security issues sometimes overshadows what people like Novello -- and other hospital administrators in Montgomery County, Md. -- have been plugging away at month after month.

Five Heads Are Better Than One

In a move that's comparatively rare -- especially given the competition for state and federal homeland security grants -- Shady Grove Adventist Hospital and four other hospitals in the area decided to pool their homeland security grants and work together.

They formed the Montgomery County Hospital Collaborative Task Force on Weapons of Mass Destruction. The name may sound like a combination of bureaucracy and doomsday, but Montgomery County is immediately adjacent to Washington, D.C., where several anthrax attacks occurred in October 2001.

In 2003, the task force trained 169 people from the five hospitals to respond to a mass casualty or contamination incident. In 2004, the team trained another 219 people. The hospital system is now better prepared to respond not only to a bio-terrorism incident, but also any HAZMAT incident, such as a chemical train derailment.

It's a big change. Hospitals, usually competitive entities, have now taken to working together, said Deborah Yancer, president of Shady Grove Adventist Hospital.

"But here we are in a fast-growing community, and we are at a point in time when thinking about security requires a lot of change."

Do hospitals feel more ready? Yes, executives said, but the question becomes: What's going to happen next?

Decontamination trailers won't protect people against attacks on the water supply, for example.

"We are working much more closely together," said Peter Monge, president and CEO of Montgomery General Hospital. "But everything we know today changes tomorrow."

Today's hospitals are using intricate warning systems that closely tie hundreds of health professionals, monitor constantly changing pharmaceutical stockpiles and expand current response knowledge during new threats. Hospitals also bear the added burden of preparing for a terrorist attack while serving everyday patients.

In planning such sophisticated, coordinated response, there is the simplest element of relating to each other as community-level responders, said Susan Glover, who chairs the task force.

"We're now cell phone buddies," she said. "We purchase together. We train together."

Being Ready

As officials went through the decon unit, their voices quieted. Walking through the unit, it's difficult to ignore the seriousness of such a response to a large-scale chemical attack. Equipped with tent walls and showers, the unit can decontaminate approximately 70 ambulatory or nonambulatory patients per hour.

The unit can feed people directly into a quarantined room in the hospital, where they can receive further treatment. Winding around the hospital corridors, at the building's center is the hospital's incident command center -- Novello's headquarters.

"We are at a continual state of readiness," he said, adding that he can lock down the entire hospital by touching one button on his computer. "We've got radios, manuals, TVs, fax machines, computers. We monitor the entire hospital -- inside and outside, the whole campus -- 24 hours a day, seven days a week."

The five Montgomery County hospitals now can communicate through PS2000 radio system, which connects them not only to

Susan Kim  |  Contributing Writer