Lessons from Hurricane Sandy

Backup plans, and backup plans to the backup plan, are essential for any healthcare facility

By Christopher J. O’Connor

As severe weather incidents have become more common in recent years, healthcare facilities, and hospitals in particular, have developed effective protocols to maintain order when disaster strikes. These protocols allowed the safe evacuation of thousands of hospital patients and nursing home residents before, during, and after Hurricane Sandy, which struck the New York City region in late October. Yet as we began post-storm assessments, there were lessons from Sandy that could benefit your facility the next time you experience severe weather.

Backup power is essential
The goal of any healthcare facility during severe weather is to avoid evacuating patients unless absolutely necessary. Hurricane Sandy reminded us just how essential backup power for facilities is, and that it must be drilled into the hospital culture. Having been through Hurricane Irene just 14 months earlier, hospitals and nursing homes in the New York City region’s low-lying – and therefore most flood-prone – areas were well versed at preparing for the predicted storm surge. Unfortunately, the actual surge proved to be far worse than weather forecasts indicated, forcing some facilities to evacuate during or after the storm.

Testing backup generators on a regular basis and in the immediate days before a storm is a critical emergency preparedness element. Sandy taught us that in addition to testing, facilities should evaluate the placement of backup generators and other necessary equipment. Depending on the type of risk you are facing, the basement or the very top level may not necessarily be the best location. Consider the possibility of storing multiple generators in different locations.

You also need to consider the ability to fuel that generator for multiple days after the storm has passed. You may have weathered the storm, but the damage in your area may be so great that power to your facility may be disrupted for days or weeks. Finally, have a plan in place to quickly access another generator through your supplier if yours is damaged during the storm.

‘Shelter in place’
We advise facilities to prepare to “shelter in place,” in case they become unable to receive deliveries for multiple days. They should have, at a minimum, 72 to 96 hours’ worth of critical supplies, such as non-perishable food items, linens, pharmaceuticals, and cots or air mattresses for staff. Facilities should also ensure that an adequate amount of diesel fuel is added to their “critical supply” list. During Sandy, as some of the hardest-hit areas became more difficult to access and ports of entry were closed to deliveries, obtaining fuel for generators, ambulances, and vehicles for other key personnel became an enormous challenge. Additionally, when travel restrictions were imposed to help ease congestion while mass transit was slowly coming online, getting into and out of the city became more difficult for delivery vehicles and healthcare workers.

Your group purchasing organization is also a critical component of your first response team. The GPO mission – delivering the right products to the right patients at the right time – becomes more critical when trying to ensure continuity of care during an emergency. When Sandy made it difficult for facilities to communicate with their suppliers, we were able to use our network of manufacturers and distributors to ensure that necessary supplies were delivered.

Communicating during the storm
We have become so accustomed to receiving instant communication on our smartphones and other devices that we rarely think about what would happen if they didn’t work properly. The ability to communicate with first responders and other government officials during a storm is essential. When Sandy hit the New York City region, cell phone service became spotty at best, as part of the power grid was shut down preemptively, and the storm disrupted power elsewhere. Getting in touch with key contacts at facilities across the region became challenging.

When developing a master list of key contacts to communicate with during an emergency, ensure that the list is printed out in advance and includes both cell and landline numbers. In extreme cases, you may not be able to avoid spotty communication, but it’s best to have as many numbers as possible at your fingertips, especially if you are in danger of needing to evacuate patients, or in need of emergency supplies to keep your facility functioning.

Weathering the storm
Healthcare facilities are a 24/7/365 operation, and ensuring the continuity of safe patient care during an emergency is mission critical. A crisis often brings out the best in people and joins communities in ways we don’t see on a daily basis. This is especially true of the healthcare community.

During Sandy, many hospitals and long-term-care facilities remained open with little or no disruption to patient care. Some stepped up and received patients from neighboring facilities that were incapacitated during the worst of Sandy. Others shared precious resources when neighbors were in need.

Many elements contributed to the safe evacuation of so many hospital patients and nursing home residents without a single adverse event occurring. The first was an incredible amount of cooperation and collaboration among many agencies. The entire healthcare community rallied together with the support of New York City first-responders; city, state, and federal emergency management offices and health departments; and other government agencies.

The second element was the incredible amount of work done by dedicated teams of people who communicate year-round. Having an emergency preparedness plan in place before severe weather occurs is truly half the battle. Constant communication between your facility’s core team and the outside agencies and entities who will be your partners during the storm is crucial to any successful plan. Your plan should be regularly updated as you learn from your own experiences and the experiences of others.

Adhering to the three Cs – cooperation, collaboration, and communication – will help to ensure you are prepared when severe weather strikes. Perhaps the biggest lesson we learned during and after Sandy is that not only is a back-up plan essential, but having a back-up to the back-up plan is necessary to help your facility weather the storm.

Christopher J. O’Connor is executive vice president of GNYHA Ventures, Inc., the for-profit arm of the Greater New York Hospital Association, and President of two GNYHA Ventures companies: GNYHA Services, Inc., an acute care group purchasing organization, and Nexera, Inc., a healthcare consulting firm. He is chair-elect of the Association for Healthcare Resource & Materials Management (AHRMM).