Hospital disaster preparedness: best practices learned from Hurricane Irma

As Hurricane Irma bore down on Florida, officials at Baptist Health South Florida—a health system with 10 acute care in-patient facilities; more than 70 outpatient facilities including urgent care, imaging and surgery center locations; and more than 41 physician offices in the region—made the critical decision to close two of its hospitals in the Florida Keys. With 72 hours before landfall, Mariners Hospital and Fishermen's Community Hospital were directly in the crosshairs of the hurricane, so they shut their doors and evacuated patients to the mainland.

"Because of the predicted storm surge, we generally close these locations when they are in the path of a hurricane," said Dale Adamson, associate vice president of Supply Chain Services for Baptist Health. “Mariners Hospital and Fishermen’s Community Hospital in the Florida Keys were closed, and none of our other locations escaped prepping or experiencing this storm."

Other emergency plans designed specifically for a large-scale hurricane were implemented to serve patients, employees and members of the community. At most of its hospital locations, employees and their families, along with local community members, sheltered in place in a veritable indoor campsite, with tents and sleeping bags – everything except the campfires, said Adamson. While community members brought their own supplies, Baptist Health locations have become a safe haven for more than 1,000 people during Irma.

Now that the 2017 Atlantic hurricane season—one of the costliest and most devastating on record—has passed, Baptist Health assessed their efforts and shared three best practices that helped them endure Hurricane Irma while continuing to provide quality patient care.

Always be prepared

According to a recent Medical Group Management Association poll, nearly 20 percent of health system professionals say they do not have an emergency preparedness plan in place. After Hurricane Sandy hit the east coast in 2012, the U.S. Department of Health and Human Services found that almost 90 percent of hospitals in the area experienced “substantial challenges" in reacting to the storm.

While Baptist Health is a veteran of hurricanes, that doesn't mean the organization ever stops preparing and updating its emergency plans. In fact, one of the keys to weathering storms like these is monthly emergency preparedness team meetings with people from across the organization responsible for implementing and organizing responses during storms or other emergency events. Each year, Baptist Health also holds a live emergency drill mimicking a real catastrophic event, from plane crash to storm to epidemic.

"We all work really well under pressure," said Haley Flores, director of Supply Chain Quality Assurance at Baptist Health and a member of the emergency preparedness team. "Part of that is working together regularly throughout the year and understanding the different needs at various locations. During an emergency, that allows us to prioritize where supplies go and when."

While Adamson and Flores agree the organization deserved an “A" grade in its handling of Hurricane Irma, they still identified areas where they were less prepared. During Irma, the health system had unexpected shortage of some supplies and it was difficult to procure them.

"We don't like to miss things, but our hot button points change every time," said Adamson. “Unless you're a fortune teller, you won't know what those might be."

Baptist Health also had fuel shortages after the storm, with trouble refueling supply trucks and employee vehicles. At one point, the organization was experiencing a 25 percent employee call-out rate due to fuel concerns. "If you have the best plan in the world but your employees can't get to work, you can't complete any plan at all," said Adamson.

For the next emergency event, Baptist Health will bring in a fuel tanker to its main supply warehouse, and procure more of the supplies they needed during Irma.

Always be collaborating

Despite those setbacks, their plan held up strikingly well. For others in the healthcare industry, Baptist Health is a model for how to prepare and execute during a natural disaster. From tactical and simple reminders, to complex plan development, the organization has its disaster preparedness checklist dialed in.

It begins with a detailed disaster preparedness plan that can take months to finalize and implement. With power or Internet connectivity concerns during an emergency, each member of the emergency team has a hard copy binder with this plan alongside a contact list of every staff member, vendor, customer and partner.

Staffing plans, meanwhile, should be nailed down long before a disaster. In the case of Baptist Health, the staff is divided into three teams—one in place 72 hours prior to the storm, another that comes on just hours before the storm hits, and the last arriving immediately following the storm.

Baptist Health also activates pre-established emergency contracts with more than 40 vendors, including Cardinal Health, so their locations are stocked with appropriate supplies for at least 72 hours after a storm arrives, and are ready to be re-stocked as soon as the storm passes.

From a practical perspective, the organization gives radios to its emergency preparedness personnel so the team implementing the plan is always in contact. Flores also recommends staff members bring phone and radio chargers, and most importantly, keep their ID badges on at all times—both in and out of the hospital. During emergencies, roads are often closed and access restricted to the general public. However, emergency and medical workers with identification can bypass roadblocks and other restrictions in order to get to work.

Always be learning

While there are many more items on that checklist, Adamson and Flores believe a willingness to learn from mistakes, and make adjustments on the fly are key to getting patients, staff and the community safely through an emergency.
"My biggest lesson learned from this storm?" asked Adamson. "Even if you prepare the best way you know how, you can't think of everything."

Editor’s Note: A free disaster preparedness checklist is available for download on the original article page.

(Originally published January 23, 2018 on Cardinal Health Essential Insights)

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