University Medical Center
When disaster strikes hospitals prepare for both internal and external challenges. External aspects such as severe weather and transportation issues pose one set of problems to healthcare providers. Internal issues such as flooding inside the facility affect the basic ability of the institution to function. Gulf Coast hospitals felt the worst of it, and in the aftermath of Hurricane Katrina, Metro Jackson area hospitals found themselves in crisis mode as well.
The University of Mississippi Medical Center (UMC) turned to its disaster preparedness plan and the resourcefulness of it staff to keep the UMC hospitals running, assist other area hospitals and help coordinate emergency medical care for South Mississippi.
As the storm approached, UMC accepted more than five times the normal number of daily transfer patients and cancelled elective surgeries. Following the storm, the Jackson area and nearly all of South Mississippi was without power and many basic services.
“In Jackson, 97 percent of the area was without power. Our internal disaster developed over several days, and our system worked perfectly,” said Dr. Robert Galli, professor and chair of the department of emergency medicine.
UMC established an internal emergency operations center to implement the institution’s disaster plan and meet challenges that arose. “Our CEO Frederick Woodrell was very instrumental in getting the emergency operations center up and running. We manned it 24/7 and a lot of decisions had to be made off the cuff. Our biggest challenge was getting people here because they had no fuel. We had administrators driving vans of patients. Everybody from the employees in the laundry to the vice chancellor worked long hours,” said David Putt, CEO of the University Hospitals and Clinics.
“We did not lose power. We have our own water system, so we were able to provide ice and water to nursing homes in the community and assist the Methodist Rehabilitation Center,” added Putt.
Access to fuel, a lack of water, power and communications and the availability of child care were just some of the challenges that had to be overcome so UMC staff could report to work.
“Preparation is a constant learning process. The unique thing about UMC is that we are not just a hospital, we are an academic institution. UMC is the size of a city in itself. We have to consider students, housing and fuel for essential personnel. This experience has shown that we have to take a step back and take a different look at how preparedness is instituted in a hospital,” said Pam Hemphill, disaster preparedness coordinator for UMC.
“We were able to have fuel hauled in from Texas and given a gas station to use for our own personnel and equipment and also to help Baptist Hospital, St. Dominic Hospital and Methodist Rehabilitation Center meet their needs. We established a day care center in a day’s time to provide for our employees,” said Hemphill. “It was amazing for me to see, not being a medical professional, all of the people who came together to make it work.”
“We have a telemedicine program to provide emergency care to rural hospitals. Our department of information systems is superb at maintaining that. We were considering expanding our ties with MEMA (Mississippi Emergency Management Agency) and the Department of Health to establish a video emergency operations center. We have been putting together a grant to facilitate that,” said Galli.
UMC received five pieces of equipment to test for the program – three tabletop video camera centers and two portable units to use in the field. The system was initially set up for video conferencing to facilitate transferring patients from the Gulf Coast to UMC.
“One of the hospitals that participates in the telemedicine program in Prentiss, had a patient with acute gastrointestinal bleeding, but they were able to stabilize him. Three days after the storm, he started bleeding again, but the telemedicine system was the only communication system that was working,” said Galli. UMC physicians were able to work with medical staff in Prentiss through the telemedicine connection to stabilize the patient and arrange his transfer to UMC.
The T-1 lines used to link UMC to rural hospitals for the telemedicine program also proved helpful in facilitating internal communication. The system was used to link command centers within the hospital to one another so staff could communicate between departments without leaving their posts.
“The T-1 connections to the telemedicine institutions worked perfectly except for one center. Many locations lost standard phone services, but the higher level technologies seemed to weather the storm better,” said Galli.
Hemphill added that the experience from Hurricane Katrina has lead UMC and other healthcare providers, as well as state officials, to examine how technology may be instituted to help respond to future disasters as well as what changes need to be made to existing facilities to mitigate those events.
As an example, UMC Associate Vice Chancellor for Administrative Affairs David Powe said, “A lot of medical centers will take note of flooded basements and assess where to locate back up power units.”
Dr. Galli added, that on one day following the storm, UMC had patients transported to the hospital in four different types of aircraft, some of them larger than the helicopters that normally land on the hospital’s rooftop landing pad. Future disaster planning will have to include identifying a place for large helicopters to land so patients can be moved safely and quickly into the hospital.
“As the Level 1 trauma center for Mississippi, we cannot simply board up and leave. We must be ready to deliver services 24/7,” said Hemphill. Thorough disaster planning is imperative.
Hemphill added that the disaster prompted a sense of togetherness in the state’s medical community.
“Territorialism went out the window. We did laundry for other facilities because we had the water capacity and generator power. Our three-tiered power system allowed us to be of assistance to other facilities. We were part of the disaster ourselves, and we had to step up to the plate no matter where assistance was needed,” said Hemphill.
“The governor provided tremendous leadership, as did other statewide officials and our congressional delegation,” said Powe. He added that cooperation from State Auditor Phil Bryant and Attorney General Jim Hood enabled UMC officials to move quickly to provide needed services in an extremely difficult time.
Galli believes a national incident management system that establishes a uniform disaster organizational structure would make it easier for communities to assist one another in times of crisis. Thousands of healthcare professionals from across the nation volunteered to travel to Mississippi to help victims of the storm. Galli said a uniform system for processing offers of help and verifying medical training and licenses could make it easier to deploy volunteers to affected areas.
The focus has shifted now from crisis management to lessons learned and preparing for the future. Galli credits staff in all departments for helping UMC weather the storm.
“Most people recognize that UMC has specialty doctors. This disaster overwhelmed most plans, but having a 24-hour emergency operations center with professionals and specialists in every field available to make decisions on the fly propelled UMC to the top in responding to Hurricane Katrina,” said Galli.
You may contact Kim at kgallaspy@technologyalliance.ms