When it comes to disaster preparedness one must hope for the best, but prepare for the worst.
Hospital personnel may not believe the “worst case scenario” would happen to their facility, but they need to have plans in place in case it does.

Leon Zebrick, director of molecular imaging at Ochsner Medical Center in New Orleans, and Donal Teahan, director of practice management at NYU Langone Medical Center in New York, shared recommendations on how to prepare for a disaster and how to get back up and running quickly after a disaster.

Ochsner and NYU Langone both experienced the destructive effects of a major hurricane. In 2005, Ochsner was hit with Hurricane Katrina, which was the costliest natural disaster in U.S. history, and in 2012, NYU Langone was struck with Hurricane Sandy. But thanks to both medical centers’ planning and preparation, they were well equipped to handle the disasters. We can only hope that disasters like those don’t happen to your hospitals, but in case they do, Zebrick and Teahan have some advice to share.

What advice would you give a hospital on how to prepare for a disaster?
Donal Teahan: While you never dream of the worst case scenario, you must prepare for it by putting together a response plan. In my opinion, the worst case would be loss of power because without power, everything else starts to break down. Almost all employees have to be familiar with an evacuation plan so when the time comes, they react instinctively. This is why dry runs of your plan are important. NYU Langone was able to evacuate 17 floors of our hospital during Hurricane Sandy in less than 12 hours, all without electricity. Leon Zebrick: Contact and coordinate with state and local officials. Make sure all employees know their designation (Team “A,” Team “B”) — Team A comes in during the disaster, Team B relieves Team A and so on. Have a means of communicating with all employees via “broadcast” texts to their mobile devices (software applications for this purpose are readily available).



How can you prepare the staff for a disaster?
DT: Our culture is all about taking care of the patient. This has to be the number one goal even during a disaster but the number two goal is getting the hospital up and running again. If your staff is well prepared and well trained then they are focused and know exactly what they have to do. If they are not, it breeds insecurity and that’s when you have problems. You need strong leadership and a strong focus. People have to understand what needs to be done and they must know that if they make decisions, those decisions are supported. The staff needs to know that they own it because then you will get back up more quickly. In addition, we made arrangements for some of our employees to work from home when they could. Because we knew the hurricane was coming, we made arrangements for lodging and we had food on hand to feed our staff.


What advice do you have for a facility that doesn’t have a disaster plan?
LZ: Get one, but don’t reinvent the wheel. Start by referencing FEMA material on the standardized “Incident Command System” and consider building your program around this proven framework. Get your top planners on board and require them to take and pass coursework from FEMA’s Emergency Management Institute. This is known as NIMS training. Details are easy to find on the Web.

Are paper records secure at your hospital and can they be accessed in a disaster?
LZ: Our paper records are stored off site by contract with a major records storage company. They generally would not be accessible during a major disaster. With the electronic medical record system now fully in place, and our IT redundancies, we fully expect to be able to access the electronic record during all anticipated stress conditions.

To what degree does your facility plan to depend on government resources in the event of a disaster? Can your facility function for an extended period of time without such resources?
LZ: Our plan is for minimal dependency. We have resources on hand to evacuate our own facilities if required (10 shallow draft power boats, 2.5-ton trucks with snorkel kits). We have standing agreements with suppliers for additional diesel pre-positioning as well as medical supplies. In our case, hurricanes are the largest concern. Fortunately, a critical few days notice is generally given and we can put our plan into action.

How can you keep your facility functioning in the event of system breakdown or destruction?
LZ: We have a water well, which is unusual for New Orleans, generators capable of operating all critical systems including chillers and heating, ventilating and air conditioning, satellite Internet, satellite telephone, amateur radio stations. Each hospital in our system has a ham station providing last resort facility-to-facility communications without dependencies on external infrastructure. It works.

DT: Generators should run on piped natural gas. During Hurricane Sandy, there were disruptions to the supply of gasoline and diesel fuel, but none to the supply of piped gas. One of the few potential disruptions to this supply may be in the event of ruptured supply piping during an earthquake but excluding that, natural is the way to go. In addition, we make sure to test our generators every month.

What should hospitals be thinking about immediately after a disaster?
DT: You must have a plan in place to get in touch with patients and their families If you are an inpatient facility, you should get in touch with the families of patients that have been evacuated. If you are an outpatient facility, you should get in touch with patients that have a procedure scheduled for the near future. You may want to send them to one of your remote locations or, at least let them know not to come in.

What steps must hospitals take in order to recover after a disaster as quickly as possible?
LZ: Ensure employee needs are met. Our facility actually arranged and paid for hotel rooms for employees whose homes were uninhabitable. Without your employees, recovery is a non-starter. Do not assume their availability. Be flexible and open to individual needs to help ensure their presence and loyalty in a post disaster environment.