Memorial Hermann's VP of emergency management talks Harvey preparedness, response

Houston-based Memorial Hermann Health System was among the many organizations affected when Hurricane Harvey wreaked havoc on the Texas coast.

Less than a month after the storm, Becker's Hospital Review caught up with Tom Flanagan, the system's vice president emergency management, to discuss preparedness efforts and the recovery work afterward.

Note: Responses have been lightly edited for clarity. 

Question: When did you realize Harvey was headed in your direction and what was your initial reaction?

TF: Based on all the weather reports and the projections coming from meteorologists in the local market here, we knew that we were going to be getting what they call the "dirty side" of the hurricane. Typically, that comes [with] the wind and the rains and some flooding. So we knew that probably about a week out as it was moving into the Gulf [of Mexico], and they [meteorologists] were able to isolate the cone of influence from a hurricane perspective. So we started getting the warnings that we'd be getting tropical storm warnings and a tropical storm watch about five days out.

Q: What preparedness efforts did you begin at that point?

TF: Memorial Hermann Health System consists of more than 250 care delivery sites, [including] hospitals, freestanding outpatient imaging departments, freestanding emergency rooms, convenient care centers and post-acute [locations]. Each of our campuses has an assigned emergency preparedness officer, [and] typically throughout the year in the Gulf Coast region we [have] drill[s] four times a year for events such as hurricanes, tropical storms, a plane crash or bioterrorism. We connected with all of our EPOs and sent them a tool [they used to] assess their campus, looking at infrastructure, supplies, food and nutrition, nursing staffing, departmental staffing, length of stay, getting patients discharged, pharmaceuticals — those types of categories. So they [EPOs] started ... doing assessments on each of their campuses, and then we started having a daily call with the EPOs to go over their information and their data to see if there were any major concerns that maybe we weren't aware of. Some of our campuses are undergoing construction projects, so that was tied into where are we with the contractors clearing the projects and tying things down [and] securing cranes. That [process] started early on, once we knew it was coming. We had daily phone calls right up until we started setting up command centers Aug. 24 and Aug. 25 in all of our hospitals.

Q: What was it like during the storm?

TF: During an event like this, most emergency departments are fairly quiet because most people are listening to the news, they're off the roads, they're not out in the open while the storm is progressing. At the Texas Medical Center campus [in Houston], we had about 650 patients in-house at that time and we had discharged out probably more than 100 prior to the storm. The biggest concern most campuses were dealing with was the staff and physicians — do we have enough staff in the house to manage the patients that are in the house and do we have enough physicians in the house to manage as well. Then the next thing was trying to ensure our staff and our physicians knew not to risk [their safety] trying to get to the hospitals. Most healthcare providers ... when something like this happens, their first reaction is they have to get to the hospital to take care of patients and to relieve their co-workers. Pretty noble. However, what we were very clear about was their safety first and foremost — not getting caught in flood waters, not getting into water you didn't know how deep [it was]. Our big concern was making sure we had enough staff and the staff was safe, and the other employees stayed at home and on higher ground until they could proceed.

Q: What kind of effect can Harvey have on healthcare in Texas going forward?

TF: Just like all the other storms, we're going through the post-storm debriefing. All of our operations were normal operations during the storm and none of us [the facilities] lost power. All of our services were up and functioning ... throughout the storm.* So what you do afterward is you come back to the table and everyone starts debriefing. [You discuss] what worked well, what did not work well, what did you think of that we didn't think about before [and] what would you like to change. Each of our campuses and freestanding ERs are going through that process now. We'll gather all of that data and then we'll summarize it up to executive level at the corporate office and then make changes. We learn things out of each of these types of events — good, bad and ugly — but we always learn so we can do better the next time.

Q: What lessons have you learned through this experience?

TF: That's what we're trying to gather now. From a healthcare perspective, ... the community should be very proud of the health system. We are a safety net for the residents of the community in and around Houston, and all of our hospitals were up and running, and running on normal operations, and we were able to maintain that throughout the storm. All of our hospitals were off disaster [preparedness] status by Aug. 31 ... A good portion of our employees and our physician partners were affected — many lost homes, many lost motor vehicles and some lost both — and we're managing that and working with our families and our physician partners to support them through this hardship. But really from a healthcare provision perspective, I would say Memorial Hermann Health System did extremely well.

Q: Anything to add about Harvey preparedness and response?

TF: The response from our state government and our National Guard and from the federal response was positively overwhelming and very quick. The government many times gets criticized for some of these things both at the state level and the national level, and I will tell you absolutely without a doubt they were well prepared and executed extremely well on their response efforts. I just want to make sure people get recognized for that.


* One of the system's hospitals, Memorial Hermann Sugar Land Hospital, temporarily closed because officials proactively evacuated the campus. The hospital was open and operational once again within a couple days.


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