In the event of a natural disaster, resilience is a hospital’s prescription for success.
It’s all about bouncing back, recovering and then moving forward after a violent weather event. The proper response requires developing plans, then practice, practice, practice — and then putting those measures to work when the moment calls for action.
Whether our hospitals and medical facilities are safe and ready to help communities during and after weather events is a vital topic. Some areas are more prone to disasters than others, but it takes only one serious event to ravage a normally safe area.
Hurricanes, tornadoes and floods can cause casualties on a large scale, increasing the need for hospital readiness. But some disasters in recent years, such as Hurricane Katrina in 2005 and “Superstorm Sandy” in 2012, have inflicted damage on hospitals themselves.
Members of the American Meteorological Society (AMS) have recently added their concerns about hospital resilience in the aftermath of “high-impact” weather events throughout the country.
AMS suggestions include having medical centers look at their structural designs and, in some cases, relocate critical components to higher ground. When Katrina left large stretches of low-lying New Orleans submerged for weeks, it demonstrated the importance of having facilities that remain functional and accessible.
Health care’s critical problem in disasters is supply and demand. High-impact weather events create a pragmatic paradox, according to the AMS report. Supply decreases when health infrastructure is damaged, but the demand increases as the number of victims adds up.
What the American public needs to know is that “each hospital has the job of seeing how well they are prepared,” said Jim Blair, president of the Center for HealthCare Emergency Readiness, a consulting firm. “It’s a journey, not a destination.”
Blair questions whether hospitals are really ready to handle disasters when it’s been many years since their communities were struck. Institutional memories can fade, and a hospital’s vulnerabilities can become less obvious.
He refers to location intelligence when he’s working with health care clients. “Is there a dam nearby, or is the hospital close to an earthquake fault line?” asks Blair. “Where are the air conditioning, heating and ventilation power systems located?”
What about cesium-137, the most common radioactive material used in radiation therapy? Is it protected?
Sandy hit huge metropolitan areas of the Northeast in late October, leaving many communities in tatters and more vulnerable to the approaching cold weather. The storm did considerable damage to New York hospitals and other health care organizations.
Five acute-care hospitals in New York City alone were closed because of electrical and mechanical system failures, flooding and other storm-related issues. The closures were temporary, but all patients had to be evacuated.
Weeks after Sandy, four hospitals in the nation’s largest city remained closed for inpatients, leaving thousands of patients scrambling to find other medical centers.
Katrina was far worse for hospitals. According to a FEMA report, New Orleans hospitals suffered major interior damage such as collapsed ceilings, and emergency power generators became nonfunctional and shut down HVAC systems used to control temperature and humidity.
The bodies of 45 patients were found at Memorial Medical Center in New Orleans after the 2005 storm. Overall, more than 200 bodies ‘’were recovered from New Orleans hospitals and nursing homes as a result of the hurricane.
Blair says hospitals and health care facilities, in the midst of a disaster, must make the right decisions about sheltering in place or evacuating patients and staff.
It can happen here
History shows that Georgia hospitals are not immune to violent weather.
In March 2008, Grady Memorial Hospital, downtown Atlanta’s largest and most famous hospital, was damaged by a tornado that hit the heart of the city. According to claims reports, 15 buildings suffered significant damage, including the radiation/oncology center, Georgia Hall, Florida Hall, and the Hughes Spalding Medical Center of Children’s Healthcare of Atlanta.
Other health facilities have also met weather damage head on.
Seven years ago, severe thunderstorms moved across central Georgia, producing tornadoes that resulted in significant damage in several counties. Some of the heaviest destruction occurred at Sumter Regional Hospital in Americus.
That particular tornado’s path measured about 38 miles in length, with a maximum width of 1 mile, as it ripped through Americus. The hospital was evacuated after the tornado hit.
Fifty-five to 60 patients were in the building when it was hit. Three of them were in critical condition. All the patients were transferred to other hospitals.
Sumter Regional suffered major damage and later was demolished to make way for a new facility.
Dr. Thomas Frieden, the CDC director, recently reminded a Rockefeller Foundation audience that the first lesson is to build resilient systems that can be “scaled up” quickly.
In other words, know which systems are already in place that can be expanded on short notice to serve more people in a hurry.
“During the 2014 winter storms in Augusta, we lost power to several area nursing homes,” said Adrianne Feinberg, director of emergency preparedness at Georgia Hospital Association.
“A concerted effort among health care partners and emergency management agencies resulted in generators and other resources being allocated to the affected facilities,” Feinberg said. “Now we are working with a new federal program to help supply generators in the future — ensuring nursing home residents always have heat.”
Medical offices of all varieties and sizes are vulnerable to weather-related problems.
The same ice storm that brought Augusta to a halt also paralyzed Atlanta. There, in vitro fertilization (IVF) specialist Dr. Mark Perloe faced a time-critical challenge. “Retrieving eggs and caring for fertilized embryos are my first priority, no matter what the weather is doing in Atlanta,” he said.
All scheduled egg retrievals must occur as planned. IVF timing is critical for life. Because he and his staff planned ahead for access to the clinic (with some staff and patients staying in hotels close by), their backup system worked.
“You can close schools, banks and post offices, but when eggs are ready for their debut, we cannot let a little ice storm get in the way,” said Perloe.
Now that’s resilience.
Judi Kanne, a registered nurse and freelance writer, combines her nursing and journalism backgrounds to write about public health. She lives in Atlanta.