Hospital Teamwork Credited for Weathering Fierce Storm in North Carolina

A healthcare professional’s natural disaster survival guide.

Editor’s Note: Dr. Zirkman, Chief Medical Advisor for CarolinaEast Medical Center, spent the last week preparing for and weathering the wrath of Hurricane Florence, which, at the time, had left at least five dead, necessitated dozens of rescues, and cut power to a million people. Here he offers best practices for healthcare professionals in similarly dire straits.

Fortunately, natural disasters are rare occurrences, but when they do happen, a hospital must be prepared for conditions that will likely stress systems well beyond what they are designed to manage.

The keys to surviving an event such as hurricane are advanced preparation and real- time responsiveness. Hurricanes are seasonal visitors to the eastern U.S. coast, and CarolinaEast Medical Center has experienced enough of them over the years to understand the importance of preparedness. In preparation for Hurricane Florence, we followed four basic steps designed to offer the best chance of handling any contingency or emergency.

Step one: Advanced preparation

Several days prior to the storm, materials and supplies were stockpiled to provide at least seven days of standalone hospital operations. This included food, pharmacy items, water, linens, and maintenance equipment (e.g. sand bags, pumps, spare generator parts, etc.). The hospital’s backup generators were topped off with fuel to ensure 7-10 days of continuous power.

Step Two: Securing the Facility/Physical Plant

Machinery and critical systems were inspected, tuned, and secured against weather-related exposure and damage. This included building makeshift dams around vulnerable areas, particularly the generators and the fuel tanks.

Step Three: Onsite Staffing

One day before the storm, the hospital bunked up to three shifts of staff: nursing, support services, and maintenance. Essential personnel were requested to stay overnight, while non-essential personnel were asked to volunteer to provide support services (e.g. kitchen, house cleaning, patient transport, etc.). Bedding, coffee, snacks, and movies were planned and provided for. Physician staffing in-house was done on a volunteer basis, with arrangements made for sleep and showering facilities. The hospitalists voluntarily provided two rotating shifts to cover admissions and follow-up care 24 hours round the clock.

Step Four: Incident Command

Staffed by key administrative, clinical, and physical plant personnel, this key group responds to any challenge, unexpected event, or emergency condition. The group is kept small, with one person typically overseeing a particular service or facility. The group meets face-to-face three times each day and provides a structured platform for overseeing the entire hospital operations, including the following:

• Monitoring for changing conditions
• Reacting to changes in conditions
• Issuing updates
• Resolving new issues as they arise

For a system as complex as an acute-care hospital, managing a catastrophic event such as Hurricane Florence can never be left to chance, nor can there be attempts to figure things out on the fly. The key to ensuring the safety of patients and staff requires thorough attention to detail and planning well in advance of the event.

We are very fortunate at CarolinaEast Medical Center to have experienced, skilled leadership members who have developed and promoted a culture of excellence, as well as that desire to always go that extra step to ensure that our patients receive the best care. Hurricane Florence has been one of the most severe tests the hospital has ever faced, but those efforts to prepare for the worst of conditions is paying major dividends as we weather the storm.

PHOTO: Members of the CarolinaEast Medical Center Incident Command team are seen here during a midafternoon status update on Saturday, Sept. 15. Members of the team had been at the hospital for the past three days responding to the impact of Hurricane Florence which had made landfall the previous day. | PHOTO CREDIT: Daniel Zirkman, MD

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