Significant numbers of RJW Training System subscribers are located on the east coast. Our hearts go out to each of them. If you would like to donate to relief efforts, consider giving through a reputable charitable organization such as the American Red Cross, the Salvation Army, Samaritan’s Purse, the United Way, World Vision or Operation USA. In the weeks ahead, we will devote RJWestmore blog space to lessons we have learned about disaster preparedness and recovery from Superstorm Sandy. This week, we will focus on the ways that hospitals, in particular, were impacted by the storm.
(We excluded my usual “firedogisms” in this post, out of respect for those who are still suffering from this storm’s devastating effects.)
Hurricane Katrina literally devastated the medical care community of New Orleans, with scores of hospital patients dying in flooded medical centers which were cut off from power. Unbelievably, the same thing has happened in hospitals across the east coast, as a result of Hurricane Sandy.
When Superstorm Sandy submerged large parts of New York City last week, according to a report by Yahoo News, 215 patients were evacuated from New York University’s Langone Medical Center after the basement flooded and cut electricity. One east coast patient, Kim Bondy, was indignant because hospital staff knew well in advance of Sandy’s projected approach, arrival and strength.
“There was no electricity and all the IV machines were going haywire. Didn’t you pay attention to what we learned from Katrina?” she asked.
According to a report by Time, emergency personnel including firefighters and medical staff hurried to transfer patients into ambulances for evacuation, often climbing several flights of stairs. CNN reported the hospital’s basement, lower levels and elevator shafts flooded with 10 to 12 feet of water.
The senior vice president and vice dean for clinical affairs and strategy at the NYU hospital, Dr. Andrew Brotman, explained the situation, “Things went downhill very, very rapidly and very unexpectedly. The flooding was just unprecedented.”
Equipment failures at east coast facilities brought to the fore what emergency experts have warned for years. Despite bitter lessons from the recent past, U.S. hospitals are far from ready to protect patients when disaster strikes their own facilities.
“I’ve been asking hospitals to look at their own survivability after a natural or manmade disaster, and I just can’t get it on their radar screens,” said one expert in emergency healthcare preparedness. “If you asked me the one city in America that has its act together, I would have said New York. So that tells you the kind of trouble we are in for in cities like Dayton, Detroit and Sacramento.”
For most hospitals, “emergency preparedness” means being ready to treat a surge of patients which emerge as a result of disasters outside their doors. Even the federal program that coordinates hospital preparedness at the Department of Health and Human Services has a mindset of focusing on planning for mass fatalities and quickly reporting the number of available beds, but not for reacting to internal redundant electrical system outages.
For hospital administrators trying to keep their institutions in the black, disaster-resistant infrastructure is expensive and lacks the sex appeal of robotic surgery suites and proton-beam cancer therapy to attract patients. After all, most people don’t select a hospital based on which generator it owns. However, modern medicine depends on electricity, from the ventilators that keep seriously ill patients breathing to the monitors that detect life-threatening changes in vital signs. So generators are the lifeblood of any hospital disaster preparedness plan.
The good news with regard to Sandy is that things could have been worse. The staff used flashlights to carry out evacuees. Police officers fanned through the building and on stair landings to help staff members carry patients to safety. Some of the transplanted patients were critically ill infants. FEMA had organized ambulances days ahead of the storm.
Unfortunately, Langone was far from the only east coast hospital affected by the Superstorm. Some fared better and others, worse:
- At nearby Bellevue, the neighborhood power grid failed as well as the hospital’s backup power. Staff members worked hard, hand-carrying fuel for hours. But, by Tuesday the situation became desperate. Eventually, Bellevue had to evacuate some 725 patients.
- Montefiore built a 5-megawatt co-generation plant for heat and electricity in 1995, which doubled its capacity. The plants now supply 90 percent of the power at its main campus, allowing the hospital to run for days if the electrical grid fails.
- Mount Sinai’s landlines and mobile phones failed throughout the city.
- According to the Huffington Post, patients had to be transferred from Coney Island Hospital and four nursing homes in Brooklyn and the Rockaways. In several of these places, backup power systems were inadequate for prolonged use or nonfunctioning, and city power had not been restored. The long-term health effects on vulnerable patients like these might not be immediately calculable.
What hospitals must do to harden themselves against disaster is determined by a patchwork of federal, state and local regulations. The Joint Commission mandates a long list of preparedness steps, including running disaster drills. But, according to Dr. Dan Hanfling, who is special advisor on emergency preparedness at Inova Health Systems, “many hospitals just go through the motions. Until events of Sandy’s magnitude come along, emergency preparedness is just a box that has to be checked.”
“We are definitely making progress in preparedness, but many hospitals are still trying to figure this out,” said Hanfling. “They would fare about the same should another storm like Sandy roar ashore.”
When a disaster strikes, prior planning and clear decisive action can help save lives. For the latest emergency management training for facility/building managers, contact RJWestmore, Inc. Our new Version 3.0 system offers the best emergency training system.