'This might be the last time I see the place': How hospitals are navigating wildfires

On the last day of 2021, Centura Avista Adventist Hospital CEO Isaac Sendros took off work to go on a skiing trip with his family. As they were heading to the mountain, he got a call from the hospital's facilities director letting him know there was a wildfire outside Boulder, Colo., threatening their hospital. 

The wind was picking up, so he and his family turned back and headed toward the hospital, located in Louisville, Colo. 

The staff made the swift decision to evacuate the hospital, which was managed in under two hours. The fire came within a few feet of the hospital — and a few feet from the highly flammable liquid oxygen tanks — but never hit the facility.

"I remember looking at the hospital, took a picture and said, 'This might be the last time I see the place,'" Mr. Sendros told Becker's. "Thankfully, that wasn't the case."

The Marshall Fire, which was driven by 100 mph winds, burned more than 6,000 acres that day and destroyed about 1,000 homes and businesses in the towns of Louisville and Superior, The Denver Post reported.

As the height of summer approaches, wildfires are becoming a more prevalent danger to hospitals out West. And each year the wildfire season arrives earlier, hospital executives told Becker's. When these disasters threaten facilities, hospitals need plans to keep their patients, employees and facilities safe.

Protecting patients and workers

Steven Herber, MD, president of Adventist Health St. Helena (Calif.), was driving home from work May 23 when he received a stark reminder that wildfire season is approaching.

That day, a road about a half-mile from his house was closed because a hillside had burned.

"It brought back memories," he said. "This is not supposed to happen until fire season."

Specifically, Adventist Health St. Helena was forced to evacuate twice in 2020 due to wildfires. The first evacuation was in August of that year after Napa County in California issued a mandatory evacuation order that included the hospital. The evacuation was prompted by the Hennessey Fire, which started after a lightning strike. About a month later, on Sept. 27, 2020, the hospital was forced to evacuate again due to the Glass Fire in Napa Valley.

For the August evacuation, the hospital was able to maintain a small crew of engineers in the facility that kept delicate systems and equipment going, Dr. Herber said. The hospital worked with the California Department of Public Health and reopened about two weeks later.

With the Glass Fire in September, the fire swept around the hospital campus and damaged about 100 homes in the neighboring community of Deer Park. The hospital campus was saved but was forced to evacuate and turn off all power. The hospital was not able to reopen for months.

Dr. Herber said 2020 was the first time the hospital was evacuated in 144 years of operations at its St. Helena location, and it happened twice in less than two months. He said 2021 was the first time in several years a fire did not threaten to close the hospital.

Avista's evacuation at the end of 2021 was just as harrowing. It began with its level 3 neonatal intensive care unit, and the babies went to the hospital's sister facilities via ambulance.  

The hospital then addressed its intensive care unit and then its labor and delivery department, where a woman was in the middle of labor and had to be transferred. After that, it saw to its medical-surgical units and the rest of the hospital. 

"When [the ambulances] began to come, they had to come through fire to get here. … They were at one point cut off from getting to us," Mr. Sendros said. "It was something I've never experienced." 

Mr. Sendros added there were team members who went outside with buckets of water and hoses to dampen the building.  

"They were heroes that day to risk their lives to help protect the building," he said. 

One of Aurora, Colo.-based UCHealth's hospitals was on watch during the Marshall Fire, though the fire was not as close as it was to Avista, Shannon Bryant, senior director of benefits at UCHealth, told Becker's. She said what was scary about the Marshall Fire is it was in a city, when in years past fires mostly have been confined to the mountains. 

"The Marshall Fire was just of magnitude unimaginable, and so close to so many of our employees' homes, as well as not far from one of our hospitals," she said. 

Financial and emotional support

Even if a hospital is not physically affected by a wildfire, its employees often are. 

In Avista's case, more than a dozen workers lost their homes in the Marshall Fire.  

Those who were affected were offered temporary housing and given up to $20,000 to help cover costs and paid time off. 

UCHealth had about 60 employees affected by the Marshall Fire and two who lost their homes completely, Ms. Bryant said. The health system gave between $1,000 and $5,000 in financial assistance to those affected; those who lost their homes automatically received $5,000.

Dr. Herber said more than half of the St. Helena workforce does not live close to the hospital. Although some take advantage of hospital housing, most employees live in other neighboring communities. This means a number of workers were affected during their drive to work when the fires broke out, not only close to the hospital but in other areas where there were fires, such as Lake County and Sonoma County. The hospital has supported employees through its associate assistance fund and its philanthropic foundation. 

Avista provided free counseling to its employees, and members of human resources kept in contact with them to help them navigate any emotional distress, Mr. Sendros said. 

UCHealth also had a psychologist on staff to work with its employees. Ms. Bryant said the fires combined with COVID-19 and other recent events weigh heavily on its workforce. 

"It's a lot of stress on someone," she said. "We're all a little bit more paranoid now when we see a windy day, dry conditions. … Everyone gets more alert. Unfortunately, I think this is what we're gonna have to deal with for a long time." 

The recovery process

Avista was closed for 19 days following the Marshall Fire, Mr. Sendros said. A disaster relief company was hired to clean its facility and get it ready to reopen.

"They cleaned, they touched every surface of this hospital up to seven times," he said. 

The air quality was twice as bad inside the facility as it was outside the day after the fire, Mr. Sendros said. Air filters had to be replaced. The hospital also set up 200 air scrubbers for three weeks to purify the air. All equipment had to be thoroughly cleaned, inspected and tested before going back into use. 

"It was a very nuanced process … everything was well orchestrated," Mr. Sendros said. 

Despite the challenges, Mr. Sendros said he is proud of the way his team worked to get the hospital back up and running. 

"Everyone came together," he said. "Everyone had a job to do and it didn't matter if you're a director or a manager or a nurse. … It was somewhat healing to bring everyone back to the place that we all left." 

The importance of preparation

As fires continue to be a potential threat to hospitals out West, executives note the benefit of preparation. During St. Helena's second evacuation, the hospital was able to get 100 patients out, including nine ICU patients that left in helicopters.

"I think the thing that made it possible for us is that we've had previous events where we've had to activate our incident command and emergency management services," Dr. Herber said. "I have personally learned how important it is to practice emergency procedures and know how to quickly assemble the appropriate teams in an emergency."

Dr. Herber encouraged hospital executives to take advantage of such exercises and drills because unexpected events are not confined to Northern California.

"Think of all the places in the country that experience severe weather, such as tornadoes and hurricanes," he said. "Gaining experience is essential, so you can do it with expertise and not look at each other and wonder what to do next; you must be able to spring into action. Opportunities to do drills and practice for emergencies are really valuable when you have to evacuate the hospital."

Centura's Avista hospital performs monthly drills to ensure everyone in the hospital understands the protocol in the case of a fire. But Mr. Sendros added there are moments that will require further adaptation.

And as the peak wildfire season nears, hospitals are making sure they are ready.

"There will be a heightened sense of awareness," Mr. Sendros said.

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