True Stories from Hurricane Harvey: Hospital Emergency Management for Severe Weather

by | Nov 14, 2017

Hurricane Harvey: Hospital Emergency ManagementThe impact of Hurricane Harvey is still being felt in Texas and Louisiana, months after it made first US landfall on August 25. With wind gusts as high as 130 mph and record-breaking rain, the devastation of this Category 4 storm put disaster preparedness plans to the test in Houston and surrounding communities. LiveProcess event logs demonstrate how area hospitals successfully maintained continuity of operations under these conditions from virtual hospital command centers. For the sake of privacy, we can’t share their individual stories or use their actual names. This composite account reflects actual events in hospitals affected by the storm and the measures they took to ensure safety and appropriate care.

Providing adequate hospital staffing

As Harvey approached the coastline, a hospital in the Houston metropolitan area (we’ll refer to it as North Hospital) initiated hospital incident command and began sending out general notifications to all staff.

“Harvey is a CAT 3 hurricane. Winds 110 mph. Location 80 miles southeast of main campus. Estimated landfall 10 pm CT. Keep lines of communication OPEN.”

Well before landfall, North recognized that one their most critical needs was keeping track of personnel and ensuring sufficient staffing. North incident command started by asking all Advance Response Teams and Essential Personnel to travel to the main campus prior to Harvey landfall. After calling a planning meeting, North Hospital recognized the need for relief staff. A call went out from North to its sister facilities in the wider health system network:

“North Hospital Main Campus in need of relief staff. Need volunteers for a 2-week stay in Houston.”

The message also indicated specific skills needed: RNs, wound care specialists, LPNs, social workers, respiratory therapists, infection control, MRI technicians, and nurse assistants. While waiting for a response, North kept tabs on the locations of essential personnel and their transport plans. If someone did not arrive as expected, North could provide that information to local officials. North also gave instructions to make sure that all staff would have adequate provisions for an extended stay.

“Essential personnel—Mandatory Check-in. In preparation for Harvey landfall, all essential personnel please report whereabouts to your immediate supervisors. Stand-by for further instructions.”   “Essential personnel—Travel on Highway 146 from Baytown to LaPorte is closed. Alternate travel via Hwy 8 and State Route 90 is passable. Please contact your supervisor with your travel route and time of departure.”   “Essential personnel—The following hotels have rooms available. Please make reservations for 3 nights. Bring clothing and food for 3 days. Your supervisor will be in touch shortly with further instructions.”

While these notifications were going out, North Hospital also sent mass notifications to all staff that non-essential personnel should take cover and stay away. LiveProcess delivered the message via text, email, phone or any other preferred mode to ensure that each staff member received critical messages.

“North Hospital is open only to authorized personnel. Stay in your shelter locations. Travel only during daylight hours. Do not attempt to return to the area if unsure of safety.”

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Collaborating with emergency management partners

Staff from West Hospital (not its real name) in the Dallas-Fort Worth area were among those that responded to the call for volunteers to travel to Houston to provide care for patients unable to evacuate. Staff with the needed skill sets were identified and chosen to provide relief on site.

“You have been selected. Please prepare for travel to Houston. Plan to be in the Houston area through 9/8. We are arranging transportation and hotel on your behalf. Please pack clothing, medication for 10 days. Food vouchers will be available upon arrival. Stand by for travel details.”

Not long afterwards, travel was confirmed, and a message again went to volunteers via a sidebar conversation:

“Please be at West Hospital, Parking Lot A. Transport will be leaving at 6 p.m. Please plan to arrive 15 minutes early to check in with the site coordinator and load baggage. Thank you for volunteering.”

In addition to sending volunteers to supplement staff in the Houston area, West Hospital was among the facilities preparing to provide care in the event of patient evacuations. Using a sidebar discussion on LiveProcess, West leadership worked to identify possible personnel, so their ability to provide support could be determined:

“We are expecting more than 250 transfers from the Houston area in the coming hours and days. Please reach out to staff to secure coverage.”

All West Hospital staff then received a mass notification:

“We are anticipating an influx of patients transferred from North Hospital and other hospitals in the Houston area. Please respond if you are available to cover shifts.”

Transferring care for evacuated patients

The severity of Harvey necessitated the evacuation of more than 1,500 patients from Houston-area hospitals. North Hospital first identified 10 patients who would need to be transferred to ensure continuity of care at the appropriate level. Under the guidance of FEMA, incident command notified West Hospital to be ready to receive some of their most vulnerable patients, using another sidebar conversation to target the appropriate recipients.

“Expect 10 CVICU patients to arrive later this evening from North Hospital. Please prepare for the incoming transfers.”

While preparations were underway, West Hospital received further instructions from FEMA that the first batch of expected Houston evacuees would be coming the next day, arriving first at the regional airport.

“We are expecting 150 of the Houston evacuees tomorrow morning. Regional airport will be the central point for evacuee coordination and transfer. Stand by for more information.”

Not all evacuees would be hospital bound. Triaging and relocating evacuees appropriately was a community effort that required collaboration with a coalition of healthcare providers, local officials and other emergency management resources.

“East College will host a clinic for incoming transfers at Regional Airport Hangar 5. Local fire and rescue will transport patients out as appropriate and necessary.”

As triaged evacuees traveled from the airport to West Hospital, West incident command sent out further instructions ensuring that patient records were maintained appropriately and any treatment was documented in accordance with emergency plans.

“West ED staff will need to keep a log of all patients that are Hurricane Harvey evacuees. Chart evacuees in Nursing Notes and put a sticker on the log. Documentation is critical; we are in Disaster Relief mode.”

Maintaining situational awareness during and after the storm.

Meanwhile, back in Houston, conditions worsened. The relentless rainfall continued to close roads and facilities. North Hospital had been sending notifications to all staff from the beginning.

“Harvey reached CAT 4. Winds 130 MPH. 35 miles east of North main campus.”   “Harvey expected to make landfall shortly. We’ve declared COR [Condition of Readiness] 1.”

Because of the continued heavy rain after the eye of the hurricane had passed, North also reported multiple site closures due to unsafe conditions.

“Flooding at Main Entrance to North Hospital. All essential personnel coming in to North should enter the building via the Ambulance Bay”

North Hospital incident command continued to remind staff to check current conditions and road closings before travel as water gradually receded.

Keeping hospital communication flowing

We’re happy to report that all of the hospitals represented in this composite account maintained staff and patient safety throughout Hurricane Harvey and its aftermath, and all patient transfers occurred without incident. We’re also proud that LiveProcess was a part of their hard work, keeping hospitals and emergency management officials connected without any network interruptions or loss of data. Giving healthcare providers the tools to carry out their mission every day—even during a Category 4 storm—is what we’re here for.

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terry-zysk-100x100Terry Zysk, CEO of LiveProcess, has more than two decades of experience in leading organizations that provide innovative solutions to the healthcare industry.