Article - March 16, 2020
How mature is your emergency response plan for severe weather? With every major storm, there’s always an opportunity to make tweaks and improve your processes. We asked three emergency management experts at top U.S. healthcare systems who utilize StormGeo decision support solutions to share how they prepare for emergencies, as well as the lessons they’ve learned.
Half of the hospitals under HCA Healthcare are located in hurricane zones, so David Hughes, AVP of Enterprise Risk Management and Business Continuity Planning, has been through many rounds of planning throughout his 19 years with the organization.
“Planning for hurricane season for us starts in early spring, when we hold division meetings to discuss procedures,” says Hughes. Part of this preparation involves refreshing plans, doing emergency exercises and refresher training on StormGeo solutions. HCA Healthcare’s supply chain also takes part in these preparations and updates its contact lists accordingly.
“It can actually be great if we have a storm early in the season that fizzles out because it gets everybody thinking about it,” says Hughes.
Scott Cormier, VP of Emergency Management, Environment of Care and Safety for Medxcel, oversees 162 hospitals and over 2,600 sites of care across 21 states. He says his organization starts disseminating information as early as January, with the bulk of preparedness exercises carried out in spring.
“When we’re thinking about hurricanes in January and February, we ensure we’ve updated our emergency facility-use maps. In March and April, we look at who needs training and who needs their training refreshed. Then we have a large-scale tabletop hurricane exercise to refresh people’s minds as to what we’re doing and why.”
In the spring, Cormier says they review practices, policies and procedures. “In May, we move our extra supplies in to prepare for storms that may come. Our organization has over 200 incident command activations every year, so we take that experience and advise our healthcare executives on the best thing to do in an emergency.
“We also have national contracts with vendors to provide food, shelter, remediation, etc. so that if we anticipate a weather event, we can get the necessary resources. At the local level, our hospitals have weather event practices every year.”
James Mitchell, Director of Organizational Resilience for Texas Children’s Hospital, says his organization’s preparations are similar to those outlined by Hughes and Cormier.
“I would add that it is totally essential that our staff show up and are prepared when we need them to respond to any kind of disaster. For us, that begins as soon as a new employee starts. There has to be a culture in the organization where people want to stay and help patients during a crisis.”
“We protect the safety of our patients and staff by investing in emergency notification systems, news alerts and weather data,” says Mitchell. “We have our contract with StormGeo so that we can, among other things, give good data to our staff as to when they need to come in.” This type of weather data can is not only used for scheduling staff, but also to make critical decisions, such as closures and evacuations.
During Hurricane Irma, Medxcel received decision support from StormGeo for three facilities in Florida, including a nursing home and two hospitals. However, they were advised by local authorities to evacuate one of their hospitals due to the anticipated level of storm surge and flooding that would accompany the storm.
Cormier, understanding the weight of an evacuation, pushed back. “We know that if you’re going to evacuate a hospital, you have to make that decision at least 48 hours before [a hurricane’s] landfall. However, 48 hours before landfall, you don’t necessarily know where that hurricane is going to land. We knew we would get some property flooding, but would we need to evacuate?”
After the storm, the hospitals at risk only received minor damages, as StormGeo predicted. “To have our hospital standing there after the storm to treat the people who were injured and not have it closed because we evacuated is important, and we take that seriously,” says Cormier. “The things we do during weather disasters, whether it’s moving patients to hallway or ceasing operations, everything impacts the care of our patients, so we have to have the accurate data, and that’s why we invest in StormGeo.”
Mitchell recognizes that no matter how mature your emergency plan may be, things will never go exactly according to plan. “When you do this type of [emergency planning] work, you have to improvise sometimes. No situation will ever develop exactly the way your plan is written. You work out everything that you possibly can beforehand so that when you are improvising, you’re only doing so with the minor details,” says Mitchell.
Tweaking, adjusting and fine-tuning a disaster plan is a continuous process for all three emergency management professionals. As Mitchell says, “Year after year we run exercises, we experience real events, we write after-action reports that generate corrective actions—we track all of these things until they’re done in a quality manner. From an emergency management perspective, it’s just tweaking, adjusting and fine-tuning—adjusting job action sheets and making sure we’re doing the right training.”
“At the end of every hurricane season, we review what happened during that season and make plans for the next one,” says Cormier. “At the end of the snowstorm or tornado season, we do the same thing.”
Cormier says they also make changes during each storm season. “That’s important because the lessons we learn are immediately available after a storm but six months later they will fade away, so we want to make sure we capture that.”
Hughes says his organization made many changes to their plan in 2019 in the wake of the 2018 hurricane season. “For every one [storm], you learn something different.” One thing Hughes said they learned was that they didn’t actually know all the details of each facility’s infrastructure, the surrounding areas for every hospital or the associated risks.
“We fixed that, and now we have a database with 180 data points on each hospital. Basically, we know everything—from the location of alternate landing pads for helicopters to dam hook ups if we bring in water tankers,” says Hughes.
“We have all this data so we don’t have to ask those questions during or just prior to an event. This helped a lot with Hurricane Dorian. We knew, for example, whether the affected hospital had new strong hurricane-proof windows. That was a big jump from the year before.”
Cormier, Hughes and Mitchell all agreed that learning and practicing how to use an emergency plan before being in the grip of a severe weather event is key to making it through such a crisis.