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Hurricanes and Hospitals: A First-Hand Report on Preparedness

September 18, 2017 Leave a comment DRI Admin

Previous large-scale events like Katrina and Sandy have taught us to look to healthcare facilities for lessons in preparing for the worst and responding to the overwhelming force of a natural disaster when it arrives.

In responding to Hurricane Harvey, about 16 hospitals had closed by Aug. 31 due to flooding, and nearly 1,000 patients have been moved from medical facilities throughout the state on 140 emergency missions.

In downtown Houston, St. Joseph’s Medical Center floodgates held, but as a result became more in-demand  It quickly created a triage center in an hour and 20 minutes, setting it up on a loading dock to handle an additional influx of patients quickly.

On the other end of the spectrum was Ben Taub Hospital, a Level 1 trauma center usually known for taking in patients, needed to transfer some who were more seriously ill after its basement flooded and a sewage pipe burst, shutting down parts of the kitchen. Two of those patients had to come back due to high water.

With an evacuation order already in place, south Florida hospitals put their own evacuation plans into effect by Sept. 7, days ahead of Hurricane Irma. Patients were evacuated (sometimes via airlift) to other counties and even neighboring states outside of the storm. Of those facilities that had to stay open, prepwork entailed putting up storm shutters, stocking up on food and water, topping off fuel for generators, and clearing debris that could become deadly projectiles.

But Irma had a catastrophic impact on the Virgin Islands, with some hospitals unable to prepare for the devastation, as reported by the Virgin Islands Consortium. In St. Thomas, the Schneider Regional Medical Center’s roof was destroyed. The government’s Emergency Operation Command said the hospital relocated all patients from the third and fourth floors to the second floor due to flooding caused by roof damage.

Mike Mastrangelo, CHPCP, and Program Director for Institutional Preparedness at the University of Texas Medical Branch at Galveston, prepped for the worst reasonable case before Harvey hit landfall (a nine-foot inundation scenario), and UTMB remained operational throughout. He also provided some details on how his organization weathered the storm.

Among the highlights:

  • They used computer modeling of the campus (>100 buildings) to determine which buildings, building floors, and building systems (lowest point of vulnerability) would be affected by that scenario
  • Large research animals were moved to a safe location outside of the affected area, and
  • Over 100 babies were born at the three UTMB hospitals while the Emergency Operations Plan was activated

“Because we had prepared for the worst reasonable scenario prior to landfall, UTMB was in a good position to deal with the change in scenario, which went from possible hurricane force winds and storm surge to flooding rains and riverine flooding,” Mastrangelo said. “The Healthcare Shelter-in-Place with Patients plan essentially consists of healthcare staff remaining in the hospital (logistics sets up food service and sleeping areas for them) and working in shifts to provide round-the-clock care.”

“Another issue that came up immediately after the storm passed was that patients were not able to refill their prescriptions due to pharmacies being closed. I contacted the state to remind them that they had a ‘Private Sector’ plan with pharmacy companies for flu pandemic and bioterrorism, and encouraged them to implement that plan. I also began contacting pharmacy corporate offices and was able to get lists of their open locations and plans to restore services at damaged locations.

“As for insurance, UTMB has a fairly high level. We can use our modeling tool to estimate cleanup costs, restoration costs, or rebuilding costs. We can enter an inundation levels and get a fairly good estimate of these costs. I met with our finance group two weeks prior to Harvey and we agreed that they would try to build a model for determining an estimate of business interruption losses so that we could get order of magnitude estimates on costs quickly after an incident. This tool was not ready in time for Harvey, but at least the finance section was primed for that task. We have a fairly detailed damage assessment plan in place. For Harvey, most damage was limited to clinic sites.

“Since the storm, the Main Campus and League City Campus have deactivated the emergency operations plan. Angleton Danbury Campus hospital remains activated due to flooding of the Brazos River. Texas City, Beaumont, and Orange clinic sites remain activated.”

DRI will continue tracking the impacts of these hurricanes in the region and beyond. If you’re a resilience professional in the area, please let us know how your organization handled the disaster. You can also aid recovery efforts by giving to the DRI Foundation’s Hurricane Recovery Fund.