Irene as teacher
Lessons learned combating East Coast hurricane apply elsewhere
Near midnight on Friday, Aug. 26, as Hurricane Irene menaced North Carolina on its way to New York City, NYU Langone Medical Center made an urgent call to the Greater New York Hospital Association’s desk at the city’s Office of Emergency Management. One of seven hospitals ordered evacuation in advance of the hurricane, NYU Langone desperately needed to locate beds for three extremely ill intensive-care unit patients.
Lacking nearby options—hospitals across the region had been taking in evacuated patients and were at capacity—GNYHA called Hartford Hospital CEO Jeffrey Flaks at home, and the former New York hospital executive arranged for a helicopter to transport the patients. When the weather grounded that plan, ambulances traveled the 125 miles to Manhattan, and by Saturday morning, all three patients were in Connecticut.
Hartford’s no-questions-asked response mirrored the heroic efforts of hospitals and health systems that enabled New York’s healthcare community to overcome immense logistical challenges and safely evacuate thousands of hospital and nursing home patients.
To be sure, the going wasn’t always smooth. New York City had not ordered hospital evacuations in anyone’s memory, and as travel became more dangerous, it looked as if some evacuations would not be completed. But a relentless “can do” attitude, problem solving, tremendous communication and cooperation between hospitals and government agencies, timely leadership and a strong emergency preparedness infrastructure proved decisive.
Perhaps most important, we learned. We worked around the clock for nearly six days and took away lessons that can be applied elsewhere.
While 9/11 redefined hospital emergency preparedness across the nation, GNYHA has always devoted significant resources to our hospitals’ preparedness infrastructure and to ensuring that an “all hazards” approach enables them to respond to a wide range of emergencies. So when Irene emerged as a threat, we were ready.
Days before Irene’s arrival—and before Mayor Michael Bloomberg issued his “Zone A” evacuation covering five hospital sites and nearly a dozen nursing homes (several facilities on the Rockaway Peninsula were later ordered to evacuate as well)—hospitals were already reviewing their internal emergency preparedness checklists for staffing plans, communications systems, power systems, supply and other resource needs, and evacuation and sheltering plans. GNYHA helped several hospitals fulfill needs they identified before Irene’s arrival, such as sandbags, cots, a back-up generator, emergency lighting, sheets, towels and blankets.
We were reminded of the tremendous value of easy-to-read checklists, and that there’s no such thing as too much preparation.
No emergency follows a script. The evacuation order forced GNYHA and its member hospitals to adjust on the fly to facilitate the safe and timely transport of thousands of vulnerable hospital patients and nursing home residents. From the GNYHA desk at OEM, we were in touch with our members around the clock and could help locate beds for evacuees.
While New York’s clustered hospitals are usually regarded as competitors, it was in the spirit of collaboration that hospitals such as the bustling Kingsbrook Jewish Medical Center in Brooklyn boldly took in more than 200 evacuated patients, and the North Shore-Long Island Jewish Health System did the same for Staten Island University Hospital and several others. In the process, we learned that hospitals must be open to using nontraditional space for evacuees and must have plans for their caregivers to accompany patients when they are evacuated.
True leaders “lead from the front,” as demonstrated by state health Commissioner Dr. Nirav Shah, city health Commissioner Dr. Thomas Farley and OEM Commissioner Joseph Bruno. Their hands-on leadership at OEM headquarters set an example that GNYHA, and the hospital community followed. Shah called hospitals at the height of the evacuations to encourage their tired, anxious staffs to keep up their great work. He also gave hospitals the authority to exceed their operating certificate capacity and take on more evacuees.
Like the urgent call to Hartford, the power of relationships paid immense dividends. In just one of many examples, when OEM needed food for an evacuation shelter, GNYHA’s business subsidiary, GNYHA Ventures, called its longtime business partner U.S. Foodservice, which supplied to the shelters in less than eight hours.
In an uncertain world, we can be certain there will always be a “next time” for hospitals to prepare for, and respond to, an emergency. When that time comes, we hope the lessons learned from Hurricane Irene help our fellow hospitals to meet the challenge.
GNYHA staff, with local and state health officials, work at New York City’s Office of Emergency Management during Hurricane Irene.
Lee Perlman and Susan Waltman are executive vice presidents of the Greater New York Hospital Association.