After tornado, hospital able to place all in need
After tornado, hospital able to place all in need
One hospital destroyed; another took up the slack
In the first weeks after a tornado destroyed Sumter Regional Hospital in Americus, GA, the case management staff was at loose ends.
"Our patients are being cared for by hospitals in the surrounding area. There's not much we can do in our ordinary role. We pitch in and do what we can to get the hospital services back on track," says Rebecca Smith, RN, BSN, director of outcomes manager/patient safety for the 143-bed hospital.
In the days following the tornado, the case managers were instrumental in arranging for the Red Cross and FEMA to provide disaster counseling for the hospital staff.
As soon as the hospital building was judged safe enough for people to enter, the case managers went room to room, gathering up whatever personal effects of patients that could be salvaged.
"We organized home visits to these patients to give back the personal belongings that we could salvage," she says.
During the home visits, the case managers interviewed the patients to find out what their needs were and helped them access whatever community services still were available, she adds.
When the tornado roared through South Georgia about 9 p.m. on March 1, hitting the hospital directly, the staff already had moved their patients away from the window and into the halls, away from flying debris.
When word got out that the tornado had hit the hospital, nurses, physicians, and other people in the community poured into the hospital to do what they could to help, some walking for miles to get there.
Sumter Regional had to hold the patients for two or more hours after the tornado hit because the roads surrounding the hospital were blocked by fallen trees. It gave the staff the advantage of being able to gather patient records and allowed the receiving hospitals time to prepare for an influx of patients.
While the nurses gathered the patient information, the emergency department physicians worked to triage the patients to surrounding hospitals.
Throughout the night, the emergency room at Sumter Memorial also was dealing with an influx of patients who had been injured in the tornado. Some walked to the hospital from their homes, which had been destroyed.
"Unless they needed to be stabilized, we transported them to other facilities," Smith says.
Some patients, who were stable, were transported by bus. Others went in ambulances provided by ambulance companies from existing communities that came to the scene.
As people from the community brought their chain saws and joined crews from Georgia Power to help clear the roads around the hospital, the staff at Phoebe Putney Memorial Hospital, 40 miles away, put its disaster plan into effect.
The 443-bed hospital called in personnel from each unit to handle patients who were being transferred from Sumter Regional as well as people injured in the storm who were coming in to the emergency department, says Lynda Hammond, MBA, FACHE, vice president of operations at Phoebe Putney.
"It was to our advantage that the tornado occurred when it did because our central intake and assessment office, which includes bed placement functions, was still staffed," Hammond says. That office, which typically closes at 11 p.m., stayed open until the wee hours of the morning placing patients, she adds.
The hospital opened up its short-stay area to use as a triage and evaluation area for the incoming patients.
When Jeanette McDowell, RNC, MSN, manager of the central intake and assessment center, arrived at the hospital at about 11:30 p.m., she immediately checked the hospital census to determine what beds were available.
"I wanted to determine how many patients we could safely accommodate, and whether the beds available in semi-private rooms were male or female beds," she says. McDowell also looked at semi-private rooms that had been "blocked," designated as private rooms because of patient preference.
"In a disaster, patient preference doesn't count. We ended up unblocking some of those rooms to free up beds for the incoming patients," she says.
In addition to the patients being transferred from Americus, the hospital's emergency department had a steady stream of other patients who came on their own.
"We were treating the people who came into our emergency center with other illnesses and injuries, in addition to those transported from Sumter Regional. Americus was not the only place impacted. Newton, GA, just 18 miles away, had six deaths from the tornado," McDowell says.
Every patient who needed a bed was placed, Hammond says.
"We tightened up and put them where we could. I was amazed that we were able to find beds for that many patients. Our central intake department did an awesome job on throughput," Hammond says.
The Phoebe Putney medical records department is cataloging and holding the medical records of patients from Sumter Regional until the hospital is back in service.
"Not all of the patients were admitted. Some were evaluated and were able to go back to Americus," McDowell says.
CM called to handle communication
The hospital called in a case manager about 1:30 a.m. to arrange transportation for injured patients who were being treated and released, Hammond adds.
"Some people were brought in by bus and they had no way to get home. Because of the tornado, communications were difficult. The case managers arranged for taxis to take the patients back to their homes," she says.
The case manager also provided clean, dry clothing, food, and other necessities to discharged patients who needed them, McDowell says.
The weekend on-call case managers came in on Saturday and Sunday to facilitate the discharge of appropriate patients and free up those beds, Hammond adds.
The central intake and assessment office became a part of the care management department, under Hammond's supervision, just a few weeks before the tornado.
"We were still working out the kinks but the arrangement worked very well in a difficult situation," Hammond says.
Several weeks after the tornado, some areas of Sumter County were still without telephone service. Some case managers and other hospital staff still were coping with the loss of their homes and other belongings. An estimated 400 homes in Sumter County were destroyed or heavily damaged by the tornado.
Soon after the tornado, Sumter Memorial set up an urgent care facility, staffed around the clock, in a huge tent provided by the Georgia Emergency Management Agency.
"We are only taking care of the things we can manage within four hours. Everyone with more intense needs is transferred to other hospitals," Smith says.
Maternity patients were being transported to other hospitals. Oncology patients were transported by bus for treatment at Phoebe Putney.
The hospital administration was looking for alternative sites for services and to bring the hospital back on line at temporary sites until the facility could be rebuilt.
"The case managers are out of the loop right now. We're looking forward to the time the hospital reopens in a temporary building, so we can be able to care for our patients again," Smith says.
In the first weeks after a tornado destroyed Sumter Regional Hospital in Americus, GA, the case management staff was at loose ends.Subscribe Now for Access
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