Quality & Patient Safety

Harvey, Irma, and Maria: Questions hospitals need to answer before a hurricane hits

Patient Safety Monitor, October 4, 2017

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Patient safety is difficult even when there isn't a hurricane raging outside

While the deadline to meet CMS's new emergency preparedness Conditions of Participation (CoP) is November 15, hurricanes this August and September have shown why these rules are needed in the first place.

In a mere six days, Hurricane Harvey dropped 27 trillion gallons of water on Texas and Louisiana, destroyed over 30,000 homes, displaced over 1 million people, and killed at least 82. Mercifully though, John Hellerstedt, commissioner of the Texas Department of State Health Services, told reporters on September 14 that “mass casualties have absolutely not happened.”

Then, before Harvey's floodwaters were drained, Hurricane Irma mowed through the Caribbean and into Florida. Irma broke several records and has already been named one of the strongest hurricanes to hit the U.S. mainland. The hurricane caused the entire island of Barbuda to evacuate, left nearly 2 million homes and businesses without power, and killed at least 31 in the U.S.

A mere 10 days later, Hurricane Maria struck Puerto Rico and left over 3.4 million Americans without power. As of October 1, only nine out of 69 Puerto Rican hospitals are back on regular power, with the rest either closed or operating on generator power. Meanwhile, half the island is without drinking water, and only 11% of cell towers and 5% of the electric grid are operational. Early estimates say it’ll take more than six months to restore the power grid.

Hospitals throughout the Gulf Coast had to react quickly to these storms. Some facilities became isolated or inundated with floodwaters, while others faced a surge in patient population.

With lots of shore-hugging cities and towns, Gulf Coast and East Coast states are extremely vulnerable to hurricanes and other large storms. And while these storms tend to hit the Southeast the hardest, they can still cause devastation up north, as seen with Hurricane Sandy in 2012.

Medical facilities that sit in hurricane-prone regions know to remain prepared before, during, and after the regular storm season, which extends from June 1 to December 1. But Harvey and Irma struck with surprising speed and strength, leaving many facilities with one question: How can a hospital possibly prepare for an event of such magnitude?

While it’s a bit too early to offer many critical lessons learned from these storms, the main advice is to pay attention now so you can plan for similar scenarios, says one disaster planning expert.

Do you evacuate?
Hurricanes always pose the biggest challenges because of their unpredictability, notes Howard Levitin, MD, FACEP, an emergency department physician and founder of DQE Inc., an Indianapolis-based disaster readiness training and consulting company.

The initial debate is always whether it's best to keep patients put or to evacuate. “These kinds of events are the classic damned if you do, damned if you don’t,” says Levitin.

 

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Patient Safety Monitor.

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