Special report: Planning for the unlikely

by Carol Ko, Staff Writer | August 28, 2013
NYU’s incident command center
during Hurricane Sandy
From the August 2013 issue of HealthCare Business News magazine

In the last year or so, it seems the nation’s hospitals were besieged by a variety of high-profile disasters, including Hurricanes Irene and Sandy and the Boston Marathon bombing. These events get at the primary challenge of emergency preparedness: trying to anticipate and prepare for the unknown.

Preparing for disasters is always a tricky balancing act — departments are often caught in the difficult position of being considered a resource drain when things are going smoothly, only to be raked over the coals when a disaster catches a hospital unprepared. They’re often required to stretch a limited (and shrinking) budget against a series of worst-case scenarios which they hope will never happen.

The art of risk management, in short, is always a gamble. Even the most well-intentioned plans to anticipate realistic natural disasters and risks can fall victim to unpredictability. For instance, in 2005 scientists determined there is a 90 percent probability of a 6 to 7 magnitude earthquake in the Chicago metropolitan area in the next 50 years — a contingency that hospitals in the area had to account for going forward. “If you asked me ten years ago about earthquake preparedness in Illinois, I’d say it was not on our list. Who would have thought we’d have earthquakes?” says George Mills, department director of the engineering department at The Joint Commission.

Still, planning for the worst requires planning for more than just looming earthquake threats. Hospitals are trying to push their doomsday scenario drills as far as they can. Though NYU has always had a robust exercise program, including multiple evacuation exercises that stretch from the unit all the way to the street, in the aftermath of Hurricane Sandy director of emergency management Kristin Stevens realized that these exercises needed to be escalated even further.

“There has been so much that surprised so many people across the city that I think when we’re planning exercises, you want to keep it realistic but stretch it as far as you can go get people to think about things they would consider unlikely to happen but are still possible in some capacity,” she says.

To guard against future hurricanes, NYU is building an exterior barrier system, made up of permanent and temporary barriers, to protect the perimeter of the medical Center’s main campus. Additional interior barriers are now being installed, designed to prevent the spread of water between buildings or to critical areas on lower levels. “By 2017, the perimeter of the main campus will be protected by walls and gates — both permanent and movable — that will guard against far higher surges than New York City has ever seen,” says Stevens.

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