Written by Wendy Lyons Sunshine
During the last week of August, hospitals along the Gulf Coast of Texas braced for the worst. They activated emergency response teams, set up command centers, huddled with vendors, positioned truckloads of supplies and fuel, and set out cots for personnel who would shelter in place. Then they waited, tracking weather reports to see where the eye of Hurricane Harvey might make landfall.
As the storm began its rage, news commentators and reporters seemed to be preparing for the worst. After all, storms like Hurricanes Katrina, Rita and Ike wreaked havoc that resonates with hospital leaders to this day. And certainly, Harvey hit hard, wielding high winds and unprecedented rain. Close to 50 inches of rain fell across the region, overflowing rivers, bayous and gullies, which backed up onto roads and into homes. Interstates were impassable. Key utilities were jeopardized.
Texas hospitals in the storm’s path sustained more than a week of torment from a downpour that refused to subside. Considering the extent of the storm’s reach and its seemingly unrelenting will to inflict a kind of damage that would be difficult to imagine, providers in the region’s hospitals stood amazingly stalwart in their delivery of care to thousands of patients. How they managed to endure amid challenges from supply chain disruptions, flooding and utility damage is difficult to imagine.
Tom Flanagan, vice president of trauma and disaster preparedness of Memorial Hermann Health System, credits preparation, including an annual disaster planning drill that simulates a category 4 or 5 hurricane making landfall in their region, for keeping them functional during Harvey. About four days prior to the storm, Memorial Hermann’s emergency preparedness officers, known as EPOs, began formal assessments of infrastructure and logistics of food supply, pharmaceutical supply and staffing capabilities for nursing, physician and support areas. “They were looking at all of those elements if we were to be sheltered in place for up to 96 hours,” said Flanagan. “Thursday before the hurricane, we started setting up our incident command centers across each of our campuses, including our corporate office.”
Along the coast, similar preparations were underway. “We made sure that one week out, we had food, fuel, medical supplies, linens and pharmaceutical supplies for five days.” said Mary Poole, director of public relations at Baptist Hospitals of Southeast Texas, located in Beaumont. “On a given day, everybody in this organization knows if they’re on the A, B or C team. When we know a storm is coming, the A-team goes home, and prepares their home, while the B and the C team are here. Then once the storm gets within 72 hours, they go home, and the A team takes over. That gives everybody time to prepare for their homes to be ready.”
Riding Out the Worst
“We had absolutely no idea when we went to bed August 31 that we would get a call at 1 a.m. from the City of Beaumont stating that they had lost their water source,” said Poole. “That was not anything that anyone in this entire community of 124,000 people ever dreamed would happen. That information was a game-changer for us. We decided within an hour and a half that we needed to transfer our patients. Our dialysis patients, our heart patients and our neonatal intensive care babies were the first to go and went by helicopter.”
Throughout the night, the U.S. Coast Guard performed high-water rescues, shuttling patients into the hospital despite limited bed capacity. “They were bringing patients in to us faster than we could find places to take the ones that were already in our facility. Those people weren’t necessarily needing medical care; but they had no place to take them. We placed them in our Pediatric ED, made sure they had dry clothes and were warm and fed.” Ultimately, Baptist transferred 299 people from the facility. By Sept. 2, the military had set up in the parking lot next door to treat people and refill prescriptions.
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Medical organizations and neighbors offered assistance. For example, a company from Branson, Mo., supplied “duck trucks,” a type of amphibious tourist bus, to help waterlogged employees traverse flooded roads that would have otherwise kept them from the hospital.
“Every storm event is different, so you’re solving for a particular variable. Maybe it’s a loss of power, or maybe it’s damage to your facility. In this case, it was all about water,” said Paul Trevino, president of CHRISTUS Southeast Texas Health System in Beaumont.
CHRISTUS previously made strategic investments to protect their electric generators and to secure non-potable water sources. In addition, the city of Beaumont recently upgraded drainage systems around the hospital. Collectively, those investments provided a foundation for weathering the storm.
Trevino said, “We were able to work with the city of Nederland, and literally had tanker trucks going every hour on the hour, for four days, sourcing potable, clean water that we were able to then inject into the water system at CHRISTUS Southeast Texas - St. Elizabeth. We also had partnered, as a backup, with the city of Port Arthur, which did not have the water issues that Beaumont had, as a backup in the event something happened with our source with Nederland.”
Trevino said staff maintained services throughout the storm at their CHRISTUS facility in Beaumont with a census of approximately 200 patients. He said the hospital saw more than 2,500 emergency room patients throughout the storm.
Cris Daskevich, senior vice president for Texas Children’s Hospital, Houston, led centralized, daily updates using a formal checklist across all locations to help teams identify and address problems system-wide. “Across all three campuses, I believe we housed about 2,500 employees,” said Daskevich, who served as an incident commander during Hurricane Harvey. The organization spans more than 70 locations across the greater Houston area and includes hospitals, pediatric practices, maternal-fetal medicine practices, specialty clinics and urgent care. “That takes a lot of cots, a lot of logistics, food service, facilities management—and focusing on how we would sleep people in rotation,” she said. “We also had people from support areas, such as finance, human resources and legal teams here. If you weren’t doing direct patient care, you might be helping on the food service line, handing out cots, checking in people, assisting with supplies or you might have the coffee cart.”
Other Texas Children’s efforts included accepting patients and helping others evacuate from impacted areas along the Gulf Coast.
“As soon as the water receded enough for us to get up the street or to get a helicopter, we were accepting transfers. Not only did we receive more than 140 transfer requests, but our Kangaroo Crew transport team worked with other children’s hospitals across Texas to help evauate those in need. This included sending our transport crews to evacuate quite a few babies by air out of Driscoll Children’s Hospital in Corpus Christi to the Dallas/Fort Worth area,” Daskevich said. “It’s just an example of how collaborative we are across (hospitals in Texas)… helping one another move patients to the right location for the safest option throughout the storm.”
Challenges After the Storm
After the worst of the storm and flooding, emergency rooms began another robust round of patient influx. Treating bites, lacerations, infections and head trauma, hospital personnel faced a variety of challenges.
“A lot of (Memorial Hermann) employees lost their homes and their vehicles, so that in itself was a problem,” said Flanagan, noting adjustments in their own operations to help assist employees. “The system advanced pay schedules for some folks. We’ve also developed a relief fund for our employees. A lot of our campuses were able to secure hotel rooms for their employees, because employees want to get back to work, but they’ve got to take care of their homes.”
In Harvey’s aftermath, some healthcare facilities are still struggling to reopen. All the hospitals are currently debriefing with their teams, looking for strategies that will improve their defenses for the next hurricane. “Your community is counting on you when things like this happen,” said Trevino. “So, it’s really incumbent on us to be prepared, and give yourself the best chance of being there for the community when they need us.”