How healthcare facilities prepare for hurricanes and other natural disasters

The end of hurricane season isn’t a time to relax for the healthcare industry.

The fact that several hospitals in the impact area remained functional during Hurricane Harvey wasn’t a stroke of luck, but rather the result of years of preparation, research and experience from designing, building and operating facilities that were meant to withstand such catastrophic storms.

In other words, the end of hurricane season signals the beginning of discussing and implementing new ideas learned from previous storms.

At the 2017 Healthcare Facilities Symposium & Expo, I joined a timely discussion with experts who have been involved in planning for and responding to tropical storms such as Hurricanes Sandy, Ike, Katrina, Alison, and now Harvey. With each storm offered unique learning opportunities that have been put into practice in order to keep hospitals operational during the most traumatic experience many people will face in their lifetimes. Our job, as designers and healthcare professionals, is to focus on protecting the life, safety and welfare of patients and occupants during these dire circumstances.

My colleagues on the panel included Kate Renner of HKS, David Gruber of the Texas Department of State Health Services, Maggie Duplantis of Houston Methodist Hospital and Patrick Casey from the University of Mississippi Medical Center.

Collectively our panel answered questions and conveyed what we’ve learned from years of experience in emergency planning and disaster recovery situations, including details of preparing for massive storms that can arrive with little warning. The following lists detail some common themes and issues to plan for.

Staffing Considerations
• When heavy storms such as hurricanes restrict access in and out of a hospital, staff may experience burnout from unusually long and intense shifts. Prepare staff mentally for what will be required in an emergency situation.
• Carefully plan the necessary logistics for getting staff in and out when an emergency situation arises.
• Designate “ride-out” and “recovery” teams and make sure that ride-out teams have a surplus of clothing, food and other necessities in the event a storm makes landfall.
• Determine ways to provide essential accommodations such as daycare and pet shelters on-site that can also make it easier for staff to remain throughout the event.
• When FEMA and local responders arrive, it’s important to provide the required passes for staff to travel in and out of the disaster area.

Evacuation Considerations
• Know where your transfer facilities are in case you have to evacuate. The average proven rate for transferring 100 patients is five to six hours using 50 to 60 ambulances. It’s also helpful to evaluate patients’ status and discharge those who are able to safely leave in advance of imminent storm damage.
• Stage ambulances in specific locations to ensure that all geographic areas are covered and that ambulances need only travel limited distances to reach destinations within their identified area.
• Air evacuation can be challenging. If helicopters are descending without air traffic control, consider how to manage these situations.
• Plan ahead for your capacity. Know how many transfer patients your facility can safely receive, and don’t forget about patients who can’t be transferred safely through the storm’s duration. With numerous facilities under siege such as occurred in Houston, New York and Miami back-up facilities fill-up quickly. With Hurricane Harvey, patients were transferred as far away as Austin, San Antonio and Dallas. Know your exit capacity limitations and your location in regard to the eye of the storm as it makes landfall.

Facility Considerations
• Avoid housing mission critical functions in basement levels that can’t withstand flooding. Elevators and utilities should be isolated and located at least 20 feet above sea level in renovated facilities and 25 above sea level in new facilities, especially for emergency generators.
• Utilities are essential. Reserve resources and equipment is necessary for faster recovery. If possible, have your own water supply. Relying on external water access during an emergency situation can be a major risk. On-site gas tanks and pumps can be beneficial when trying to get fuel vehicles that transport employees in and out of the emergency zone or ensuring that ride-out and recovery teams can safely transition when necessary.
• Coordinate your plans with those of other health systems, especially if you’re sharing services. Plan how you might rely on one another in the event of unexpected loss.
• If your campus has a tunnel system underneath the hospital, considering adding submarine doors that can divert flood waters and prevent rising water from the lowest level of the facility.

Prepare, Prepare, Prepare
• All hospitals should run drills to plan for extreme weather conditions or other natural disasters common in their area: hurricanes, tornadoes, fires, earthquakes. These simulations should be as realistic as possible. The demand and stress on resources cannot be underestimated.
• All situations should be considered. Unfortunately, hospital space is often limited in an emergency. Every drill to prepare for these scenarios should simulate the real thing. Use life-size mannequins to prepare staff for what will be required physically in the event that space becomes limited or patient transport is needed with limited equipment.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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