Hospitals try to stay open and to care for patients already hospitalized and for those who suffer injury or illness from a storm. Here’s how they do it.
Planning is paramount
Each hospital is required to have an emergency plan, usually approved by the hospital’s accrediting body. A hospital director and emergency leadership team are responsible for implementing the disaster plan.
A hospital typically convenes a top leadership team and activates the hospital’s Incident Command Center (ICC). Team members coordinate with weather experts, local governments, local law enforcement, ambulance companies and first responders, and communicate with patients and their families.
One of the most difficult decisions facing a hospital’s leadership team as it prepares to face a storm is the decision to evacuate some or all of the hospital’s patients.
Hurricanes can be classified as an expected event, unlike other extreme events that happen spontaneously and without warning, like earthquakes. When a hurricane is predicted, plans are focused on the “zero hour,” or when the hurricane is predicted to make landfall. Major milestones in the emergency plan are performed according to a predetermined schedule in the hours and days leading up to the zero hour.
Hospital staff prepare the hospital to weather a storm. Supplies and equipment must be moved to higher floors in case of flooding. Security must be on hand because of the threat of vandals and looters. At the same time, patients must be continually cared for.
On the patient side, patients who can be discharged from a hospital before a disaster strikes are discharged. New patients are not admitted. Elective surgeries are canceled. Pregnant women and patients who need specialized care, such as the babies in Savannah, may be transferred to facilities out of harm’s way. But transferring a patient is a decision made with great care, as any transfer could produce shocks that put patients in grave danger.
Preparing for the worst
The medical staff of doctors, nurses and technicians are typically divided into an “A team,” who would be in place in the hospital when the disaster strikes, and a “B team,” who would be on standby to report to the hospital after the disaster and relieve the A team. Sometimes, the B team is already at the hospital and goes into action to relieve the A team as necessary.
There is no difference in ability between the A and B teams; they are merely called A and B to distinguish between the two groups. That said, staff members with disaster experience are prized employees.
Dealing with the chaos after a storm
In the aftermath of a disaster, hospitals may suffer power loss. Emergency plans call for backup power and other contingency systems. Uninterrupted power is critical, since some patients may be connected to lifesaving equipment.
In southern states, where most hurricanes in the U.S. first hit land, air conditioning is vital to patient comfort. Therefore, hospitals in states such as Florida, Georgia and South Carolina must have a plan to ensure air conditioning, when possible.
Hospitals must also be prepared to be self-sufficient in the event that responders cannot reach them. Plenty of food, water and medicine must be on hand. Emergency supplies are always on hand in hospitals, but hospitals order even more if the threat of an extreme event is real, as was the case with Irma.
Lessons from previous extreme events
Any time a disaster occurs and a hospital’s ICC is activated, there are lessons to be learned. Hospitals’ experiences in Hurricane Katrina, Hurricane Sandy and other extreme events brought some of those lessons to the forefront.
First, it is especially important to construct resilient building systems, such as electrical, gas, water and sewers. Emergency planners should plan for a backup system to activate should a main system fail. For example, backup generators, which typically had been placed on first-floor or basement maintenance rooms, are now often placed on higher floors after they were wiped out in previous hurricanes and floods. Many hospitals also have their own wells on site (or wells that can be used in emergency).
Second, hospitals must plan to be self-sufficient, in a worst-case scenario for up to a month. Hospitals should be prepared with greater quantities and fuel and critical supplies. Agreements with partners made in advance of disasters can open up channels for faster delivery of supplies.
When disaster strikes, protecting lives is a top priority, and hospital staffers are surely some of the bravest people working to save lives.
Hospital communities should take comfort in their preparation of a disaster plan, and then execute it with adaptability and flexibility. Advanced planning for extreme events allows hospital staff to focus on what they do best — compassionate patient care — when a disaster strikes.