Saturday September 23, 2017
Healthcare in a Hurricane
It's a haunting photo - especially if you're a medical professional: elderly residents sitting in waist-deep floodwaters in a Texas nursing home after Hurricane Harvey hit last month.
They were eventually rescued and moved to drier locations, but the news was more grim in Florida where Hurricane Irma hit a short time later.
Ten nursing home patients died after being kept inside a facility where the air conditioning shut down after Irma struck. They were kept inside for three days even though there was a fully functioning and cooled hospital across the street.
Both incidents raise questions about what could have been done to spare them - and about how hospitals and other healthcare facilities prepare for, and cope with, natural disasters.
During Hurricane Harvey, Ben Taub Hospital in Houston was surrounded by floodwaters.
Dr. Ericka Brown is the hospital's Executive Vice President and Administrator. She tells White Coat, Black Art's Dr. Brian Goldman that they relied on lessons they'd learned during Tropical Storm Allison in 2011.
"You cannot wait until the crisis hits to decide what to do," Dr. Brown says.
The people of Houston got a two-day warning of Hurricane Harvey's impending arrival. Those 48 hours of preparation were crucial in determining how well the hospital and its patients would fare during the hurricane and the flooding that came with it.
Dr. Brown and her team discharged all patients who were well enough to leave and made sure there was enough food, water and essential supplies to keep the hospital running. The hospital called in its "ride out" team - two shifts of all essential staff needed to keep the hospital running through the storm. Then they locked down and waited.
But not everything went exactly as planned.
"One of the things I have learned very quickly is unfortunately you cannot keep water out... you can prepare as best as you can but at some point, if there is enough water, there is nothing you can do to keep it out."- - Dr. Ericka Brown, VP of Ben Taub Hospital in Houston
As the nearby bayous overflowed, the hospital basement flooded, destroying half of its dry food supply.
The loss of food meant they had to ration. Once the patients were fed, the staff was limited to two meals and a snack.
"At the height of the storm we were not sure we would be able to get additional food supplies," Dr. Brown says.
But there was a bigger problem: the rising water also threatened to short the switches for the generator. That would leave the hospital without an emergency electricity supply, endangering the lives of patients who use ventilators.
In the end they were only able to move one of the five patients at risk. Fortunately the generator continued to function through the entire storm.
Meanwhile, staff had to spend a lot of time reassuring anxious patients who could not reach their families or check on their homes.
"We spent a lot of time counselling - literally hand holding." - Dr. Ericka Brown, Ben Taub Hospital VP
In the aftermath of the storm, the hospital is seeing a surge in demand. As soon as the water receded, dialysis patients, cancer patients and others who had their treatment suspended during the storm returned for treatment.
Dr. Brown credits her staff for their success in surviving Hurricane Harvey without any losses.
"I can't tell you how much respect and admiration I have for them. We have staff that we know have been displaced from their homes but they are continuing to come to work everyday and provide exceptional care."