A major natural disaster poses a unique challenge to hospitals—even in Florida where the community has plenty of experience dealing with extreme weather events.
Susan Grimwood, director of clinical logistics, patient flow and observation services at Sarasota Memorial Health Care System, told FierceHealthcare in an interview that although the hospital has protocols in place to react to a hurricane, they weren't prepared for the Category 5 strength of Hurricane Irma when it struck the Atlantic region in late August last year.
The 829-bed hospital was forced to conduct an internal evacuation, moving patients, boarders and staff into more hurricane-hardened parts of the facility.
Michele Earnest, senior business analyst for Brevard County-based health system Health First, said it faced a similar problem when a major leak at its command center forced an evacuation for which it wasn't prepared.
Moving the hurricane command center forced the emergency response team to confront unfamiliar systems and other issues while simultaneously dealing with the effects of the storm, she said.
"Your equipment may not be the same setups," Earnest said. "Logistically, we didn't count on or plan for that."
Due in part to the strength of the storm, many Florida hospitals were magnets for people who didn't need medical care but were desperately seeking shelter, said Lisa Maples, R.N., director of centralized patient logistics, registration and the access center for Health First.
The hospital set up a special needs shelter to serve those arrivals separately from patients seeking care. But it was difficult to decide when it might be safe to send boarders home, she said.
"When the winds get below a certain level we call an all-clear. Once the weather started to lighten up—do you let them go? Do you keep them?" Maples mused. "It's not safe for people to travel—how do you handle that situation?"
Charlotte Damato, the lean six sigma quality coach for Sarasota Memorial, said that hospitals should always expect to receive more people than projected during a natural disaster such as Irma, since people always bring along family and friends to take shelter.
The number of people coming in for shelter also forces a hospital to examine the available supply of items it might not ordinarily consider, such as sheets and pillows, she said.
Grimwood said the system re-examined its food menus to avoid shortages, cutting its offerings down to the basics to make sure there was enough food to go around.
Another lesson, Damato said, is that employees need support and care during an emergency, too.
"I know we always have to put patients first, but we also have to think about the employees," Damato said.
"The ones that come to the hospital for the 'A' team shouldn't have to worry that when they finally leave the hospital they go into a mess at their homes."
A crucial element of that support is an engaged C-suite. Maples said seeing leaders involved in the on-the-ground response is "huge for morale."
Plus, executives benefit from a firsthand experience with the hospital's emergency response.
Damato said interactions between frontline staffers and executives in high-stress situations humanizes the C-suite a bit, as employees see leaders are there "around the clock like they are and dragging just like they are."
"It works well both ways," Maples said.