Gulf Coast Hospitals Use Lull to Prepare for Storm

Major hospital systems on the U.S. Gulf Coast are not letting their guard down when it comes to preparing for the 2018 hurricane season.

Despite forecasts of a mild-to-normal season, hospital systems in Texas, Louisiana, and Mississippi are taking advantage of the relatively calm summer months to prepare for the fall months, when extreme and unpredictable storms can arrive in the Gulf Coast from the Atlantic Ocean.

Hospital executives continue to focus on emergency coordination efforts with local governments, including ensuring hospital staffs are engaged in storm preparedness activities and applying lessons learned from prior storms, as they plan for this year’s hurricane season.

Safety Net

“Houston’s the third largest city in the country; we’re the safety net for a region with over 6 million people. If we lose operations pre-hurricane and certainly post-hurricane, that will impact the community,” said Tom Flanagan, vice president for trauma services and disaster preparedness at Houston’s Memorial Hermann Health System, the largest nonprofit hospital system in southeast Texas.

Preparing for hurricanes, tropical storms, tropical depressions, and extreme weather is a fact of life for residents and hospitals in the U.S Gulf Coast, Flanagan told Bloomberg Law. “As a former ER nurse, I would say typically before a hurricane, our emergency departments are fairly quiet, eerily quiet. Where the problem comes is post-hurricane,” Flanagan added.

Memorial Hermann’s hospitals can get inundated with patients suffering from injuries during post hurricane recovery activities, including repairing roofs and clearing debris such as downed trees, limbs, and other heavy materials, Flanagan said.

“If the health-care system can’t prepare, secure facilities, and be operational, then that becomes a huge issue for the workforce and the business community down the line,” Flanagan said. For Hurricane Harvey in 2017, “we were completely operational, including our air (ambulances) were flying, because unfortunately people do get sick or hurt during hurricanes, and they need to be taken care of and transferred to the appropriate centers. ”

Flanagan said that Memorial Hermann’s 15 hospitals and four joint-venture hospital facilities, are required to follow emergency preparations guidelines established by the Joint Commission, an
accrediting and certification body for nearly 21,000 U.S. health-care facilities.

Prior to hurricane season, which lasts from June 1 to Nov. 30, the system’s hospitals conduct their own preparation drills and work with the city of Houston’s emergency services on its preparation drills, two to three times a year, Flanagan added.

Shelter in Place

“Nowadays, sheltering in place is a major part of most hospitals’ emergency preparations, including Memorial Hermann’s,” Flanagan said.

As soon as the National Weather Service projects when and where a storm might make landfall, Memorial Hermann puts its emergency plans into action, preferably a week out before the storm hits, Flanagan said.

The system’s hospitals discharges patients, who are capable of returning home safely to shelter in place, Flanagan said. Only patients who need to be in the hospital and certain staff remain. Hospital staff who are single parents or have other dependents, such as elderly or ill relatives, are sent home. Memorial Hermann’s hospitals are also required to have 96 hours of food, water, medical, and pharmaceutical supplies on hand.

A week before Hurricane Harvey hit Texas in late summer of 2017, construction at Memorial Hermann’s hospitals ceased, and debris was secured, Flanagan said. Also during that week, emergency
coordinators at Memorial Hermann’s hospitals were required to give Flanagan daily reports on medical, pharmaceutical, food, and water supply levels, along with staff and patient counts.

Mississippi, Louisiana

Preparing for storms in Southern Mississippi has unique challenges, Wayne Landers, director of public safety at Forrest General Hospital in Hattiesburg, Miss., said in an email to Bloomberg Law. The college town with a population of 46,000 was ravaged by Hurricane Camille in 1969 and Hurricane Katrina in 2005.

In the 36 years that had passed between the hurricanes, Landers said that it had been a challenge to keep the community focused on being prepared for the next big storm.

Denice Eshleman, director of emergency management at LCMC Health, a nonprofit hospital system that manages many prominent hospitals in New Orleans, including New Orleans East Hospital and University Medical Center, said she focuses on engaging staff on hurricane preparation, “because complacency, particularly after years without hurricane activity, is always a challenge.”

LCMC also conducts an “After-Action Review,” to evaluate the hospital’s response to emergencies and works with a state-led coalition of local and regional stakeholders that helps the system prepare and respond to disasters, Eshleman said in an email to Bloomberg Law.

Lessons Learned

Forrest General Hospital “thought we had a good emergency plan before Katrina; however, Katrina was catastrophic,” Landers said.

In the aftermath of Katrina, the hospital’s two generators failed, leaving 1,600 staff, doctors, family members, and 300 patients without electricity or water, according to press reports.

“Since Katrina, Forrest General Hospital replaced in-house generators with larger more robust units, and we built an external 7.5-megawatt (MW) generator plants,” Landers said. “There are three 2.5 MW generators in the plant currently, with room to add another 2.5 MW generator in order to expand to a 10 MW plant.”

Landers said the hospital’s generators and fuel cells hold enough diesel fuel to power the hospital’s plant for four days.

“We also have emergency fuel supply agreements with two different suppliers (one local and one regional),” Landers added.

Since Katrina, Forrest General has invested $20 million in facilities, equipment, and training. In recent years, two tornadoes have also forced Forrest General to add to the hospital’s emergency
preparation plans.

“We have had two strong … tornadoes in the last five years (Feb. 10, 2013 and Jan. 21, 2017), events that caused us to activate emergency management plans,” Landers wrote. “This experience helps us be prepared for future tornadoes that may spin-o during a hurricane.”

To contact the reporter on this story: Karn Dhingra in Houston at kdhingra@bloomberglaw.com

To contact the editor responsible for this story: Brian Broderick at bbroderick@bloomberglaw.com

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