Lessons learned from Florida hurricanes informed HCA's response to Katrina
Lessons learned from Florida hurricanes informed HCA's response to Katrina
Having resources in place early made the difference
Experience gained when hurricanes hit the coast of Florida in August and September 2004 served the Hospital Corporation of America (HCA) well when it came time to respond to the threat of Hurricane Katrina, which devastated the Louisiana and Mississippi coasts in September 2005.
"The lessons learned [in Florida] taught us what to do better in the future," says Jeff Prescott, a spokesman for the Nashville, TN-based company, which includes some 190 hospitals worldwide. "A lot of those things we were able to put in place just before Katrina hit."
HCA leadership followed up on several recommendations outlined in an earlier briefing by the company's eastern group president, who had overseen the response to the hurricanes that hit Florida on two coasts, says Prescott, including the following:
• Pre-position food, water, equipment, and supplies.
This piece of advice proved invaluable, he notes, and helped put HCA in the position to not only evacuate its own Tulane University Hospital and Clinic, but help to evacuate nearby Charity Hospital's two facilities.
As a large company "with lots of infrastructure and a robust supply chain," Prescott says, "we were able to move a lot of stuff quickly. Not every parent company is able to hire 20 helicopters.
"By virtue of that," he adds, "we were able to [get out] 60 or 70 people from the hospital across the street from our facility when local authorities didn't have enough resources to do it."
The heads-up on arranging the helicopters in advance, Prescott says, was provided by HCA's Florida division president based in Tallahassee, one of the company executives most experienced in dealing with hurricanes.
"He said, ‘You will need helicopters — start finding them and getting them under leases,'" Prescott recalls. "We did that a day or so ahead (of the storm)."
• You'll need extra linens.
Staff handling the aftermath of the Florida hurricanes, he says, discovered that when there is wind damage and rain, people will use linens to mop up water. "Then you won't have enough linens."
• Have the ability to switch electrical sources quickly.
"You have to have additional generators and have the ability to connect them to outlets and equipment in the hospitals," he says. "If it's a long time [before power is restored] the regular generator doesn't run everything. You might need more."
It's also important to remember that special connections are necessary to put the generators in place, Prescott adds. "You can't just plop them in the back yard and hook up."
• Get satellite telephones.
In anticipation of the likelihood that cell phones, which require a tower, won't work during a hurricane, HCA bought a large number of satellite phones and put them in hospitals before the storm hit, Prescott notes. "They're still not infallible, but when land lines don't work, we did have some in place and were able to use them."
Hospital officials found out early in the evacuation process, however, that even with satellite telephones, they couldn't communicate with people in helicopters.
"By this time, we had helicopters coming in with supplies, dropping those off, and picking up patients," Prescott explains. With the normal takeoff/landing area under water, he says, helicopters took off from a parking garage roof from which the light poles had been removed.
"The patients initially were taken to hospitals an hour and a half away, but then, in the case of less critical patients, they started taking them to a staging area at the New Orleans airport," Prescott continues. After dropping off those patients at the airport — where they were triaged by nurses and then taken on buses to other facilities — the helicopter could make a quick hop back for more passengers, he says.
"So now we've got a helicopter flying back and forth, but no way to [communicate]," Prescott says. The solution came when someone suggested using ham radios, he adds. "We put one at the parking garage, one at the airport, one at the division office in North Florida, which could call us because they're fine there."
The questions going back and forth, he notes, were things like, "How many helicopters are at the airport? How many are in the air? How many patients are left?"
When the pilot was ready to bring the helicopter back for the next group of patients, Prescott adds, he could ask, "What supplies do you need at the hospital? Do you need water, diesel fuel? What's the priority right now?"
Staffing, family concerns addressed
To move employees to different facilities as needed in the hurricane's aftermath, HCA made use of All About Staffing, its internally run temporary nurse staffing organization, he says. "We have hundreds of nurses all over the country on stand-by that we were able to access."
The agency also was used to help patients and employees displaced by the storm, Prescott adds, noting that HCA was committed to keeping every employee whose job was impacted by Katrina on the payroll until he or she found another job in the company.
To ensure that Health Insurance Portability and Accountability Act (HIPAA) requirements were followed precisely, he says, HCA ended up giving patient names to the Louisiana Hospital Association to post on its web site for the benefit of family members who might be looking for them.
Patients who were evacuated from hospitals, Prescott notes, were accompanied by a "standard transfer record" that would be used in any patient transfer. At HCA hospitals, he says, 60% to 80% of the patient record is electronic. "We are able to access the vast majority of records because [individual hospitals' data are] networked to a regional data center."
Experience gained when hurricanes hit the coast of Florida in August and September 2004 served the Hospital Corporation of America (HCA) well when it came time to respond to the threat of Hurricane Katrina, which devastated the Louisiana and Mississippi coasts in September 2005.Subscribe Now for Access
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