During last year’s catastrophic hurricane season, it wasn’t luck that kept many hospitals in impacted areas functional: it was preparation. Hospitals must routinely research and update plans in order to reduce damage, remain open, and recover quickly. Hospitals are a critical infrastructure asset for the community and need to provide care to those in need after the storm has passed. Coming off one of the worst hurricane seasons in modern history, it’s crucial hospitals and other healthcare facilities are prepared for the worst.
The 2017 season comprised of 17 named storms and 10 hurricanes – six of which were major hurricanes – ranking it as the fifth-most active season since the beginning of records in 1851. The ravages left by last year’s hurricanes severely and negatively affected communities within its path.
Still, healthcare facilities in the U.S. continuously fall short in disaster planning and preparedness. With the recent news of Hurricane Maria’s misreported death toll in Puerto Rico – and one-third of those deaths directly ensuing from delayed or interrupted medical care – many healthcare facilities are woefully underprepared to withstand alarming rates of injury, as seen during the catastrophic effects of Harvey, Irma, and Maria last summer.
Weather industry experts are predicting 14 named storms, 7 hurricanes and 3 intense hurricanes this season. Unfortunately, meteorologists are unable to predict how many will make landfall. Subtropical Storm Alberto has already impacted the United States, arriving a week before the start of the official hurricane season, which began June 1.
Here we cover four ways healthcare executives can prepare their facilities to withstand the shattering effects of hurricanes this season.
The paramount action a hospital can take to protect itself against hurricanes is to plan. Having a specific plan that covers monitoring, pre-landfall activities and equipment staging, operations during the storm, and post-storm recovery is crucial to reducing damage and costs, as well as maintaining operations.
The Centers for Medicare and Medicaid Services (CMS) require healthcare providers to meet certain conditions of participation (COPs) to receive payments. These COPs were recently updated last fall and include not just hospitals, but other providers such as ambulatory surgery centers, transplant programs, and long-term care.
Planning includes performing a risk assessment that includes vulnerabilities to water and wind damage, flood-prone areas of your campus, and generator capacity (e.g., seeing if your HVAC is connected to generator power). Mitigation strategies can include closing flood risk areas before landfall, lowering water levels of ponds, constructing flood walls, or pre-staging generators.
One unforeseen hindrance many facilities run into with their emergency management program is leadership – or a lack thereof. Some hospital executives view emergency management and safety as a line item in a spreadsheet. Consequently, many leaders choose to drastically reduce costs in this department in order to save facilities money. However, a decision like this can have long-lasting, damaging effects. It is important hospitals are able to remain open during a disaster for vital patient intake and continued quality care; therefore, leaders must acknowledge the importance and value of such a department and continue to place weight on these programs.
Likewise, when leadership understands the importance of emergency management programs, they’re more likely to dedicate resources and focus. They’ll also ensure the right people are managing the program, rather than assigning the oversight as an additional duty to someone already overwhelmed or lacking the experience and knowledge necessary to oversee emergency program simply because the government mandates it.
In the case of a storm, leadership will play an integral role in decision making. Critical decisions such as additional resources and patient evacuation need to be made at least 48 hours before landfall, and many times the impact area and intensity are still unsure. The leadership team will also be responsible in determining staffing plans, canceling elective procedures, and closing off-site locations. Decisions should be coordinated with other hospitals in the impact area to ensure coordination. For example, if one hospital chooses to evacuate patients 48 hours ahead of landfall, while the other fails to evacuate and is unable to get out due to lack of resources or planning, that will greatly impact a community and its residents.
Communication is essential to proper disaster preparedness. Whether communicating with staff, patients, government agencies, or the public, healthcare facilities should not ignore the importance of communication.
Staff communication should begin as part of the planning process. Understanding which staff are available to assist during a disaster, and any needs they have (such as child, family, or pet care), is crucial. Some hospitals may elect to set up a child or pet care area in the facility; others may prioritize the use of staff with fewer needs.
Patient and family communication is also critical. The patients’ families may need to evacuate the area, but the hospital’s ability to communicate with them about the patient is still important. Patients should understand you have a plan to continue to provide care and keep them safe. If patients are evacuated, communicating with family members on where they are being moved and how to contact them is also important.
It is important to communicate early, often, and accurately. Withholding information is no longer an option; with the rise of social media, it is imperative you control communication through regular updates. A method to do this is through a public information team.
Public information teams coordinate messages, whether internal communications, print, TV, radio, or social media. These teams should also monitor social media and other information outlets to answer questions, track rumors, and dispel misinformation.
Plans should be updated annually, and after each event, a thorough after-action review should be completed, including input from staff, patients, and community response organizations. If any corrective actions are needed, a specific corrective plan should be written with leaders and timelines assigned. Once the corrective plan is completed, the updated plan should be tested through exercise and staff should be reeducated on any changes to the plan.
As we enter a predicted above-average hurricane season, healthcare facilities are in a unique position to safeguard patients, staff, and communities. How is your facility preparing for these storms?
Scott Cormier is the Vice President of Emergency Management, Environment of Care (EOC) and Safety at Medxcel, specializing in facilities management, safety, environment of care, and emergency management and provides healthcare service support products and drives in-house capabilities, saving and efficiencies for healthcare organizations that, in turn, improve the overall healing environment for patients and staff. Cormier leads the development and implementation of emergency management, general safety and accident-prevention programs for a national network of hospitals that Medxcel serves.