In September of 2018, Hurricane Florence hit land and forced hospitals, nursing homes, and other medical facilities in the Carolinas and Virginia to either prepare resources needed to stay open or begin preparations to close, as per CNN. Each individual facility had to make decisions based on storm predictions and resources.
In Charleston, South Carolina, location determined whether or not a hospital closed, canceled elective procedures or appointments, or resumed operations as normal during the storm. East Cooper Regional Medical Center, for example, had to cancel elective surgeries, but kept emergency rooms open to accept emergency patients. Roper St. Francis Hospital kept a main facility open, but closed express care and physician partner facilities because they were unable to meet the state’s “shelter in place” requirements.
During a major storm or severe weather event, hospitals must decide between conducting an emergency evacuation or opting to shelter-in-place. According to OSHA, the decision is among the most important safety managers will make during an emergency. The organization defines evacuation as the immediate and urgent movement of people away from the threat or hazard. Shelter in-place requires taking refuge within a facility, waiting for instruction that the severe weather event passed or an evacuation order is placed instead. This poses a difficult question for hospitals in the direct path of severe weather threats, as not only are emergency rooms meant to provide ongoing care regardless of time or circumstance, evacuating patients can pose significant health risks.
So, what do hospitals do during severe weather event closings? Procedure may vary between states, and in many instances, hospitals opt to simplify operations down to the essentials, remaining open in case of emergencies or injuries sustained during the severe weather event. Medical facilities in the direct path of a storm may be required by the state to close, and should implement evacuation procedure. In order to ensure a smooth transition, an evacuation and closure plan should be in place ahead of time, and safety managers should be sure to communicate with physicians and staff throughout the process.
What Is Severe Weather Event Closing Protocol In Healthcare?
In order to manage the risks of closing a hospital during a severe weather event, communication is critical. When Hurricane Dorian hit North Carolina, residents at Ansonborough House in Charleston, which was built to provide affordable housing to seniors, were forced to evacuate, according to NPR. This example of a facility represents many of the challenges hospitals or healthcare organizations face during emergency closures, including logistical challenges such as managing individuals healthcare needs and financial issues, as providing reliable transportation for patients can be costly. Some of the residents at Ansonborough House struggled with a variety of chronic medical conditions requiring routine care, including people who need dialysis or chemotherapy, as well as medication to treat cardiovascular disease.
For this reason, a major concern during a closure or evacuation should be vulnerable residents who cannot be relocated to natural disaster shelters. In 2017, a study titled “Mortality in Nursing Homes Following Emergency Evacuation” found that moving older, frail patients can be bad for health, and safety managers should take medical conditions into transportation and shelter preparations.
During Hurricane Florence, patients at Tidelands Waccamaw, Tidelands Georgetown, and Tidelands Health Rehabilitation Hospital were forced to evacuate. Patients moved to other hospitals in the area via ambulance, medical bus, or by helicopter, as per CNN. Physicians accompanied patients to ensure they received appropriate care, while a “skeleton crew” rode out the storm at two locations along with patients too sick to evacuate.
If safe, a small crew at a hospital location during a closure can monitor patients unable to make the move. If possible, these patients and physicians will move to an area of the facility that is storm-proof. After a storm passes, the physicians and staff managing operations can help the facility resume operations as swiftly as possible. Physicians should collaborate with safety managers to make the best judgement about who is capable of moving to another facility, which mode of transport is most appropriate, and whether or not staff can shelter-in-place throughout the storm.
Unfortunately, many of the regions susceptible to Atlantic hurricanes are also popular retirement locations, meaning there’s a large population of older adults. Even more troubling, slow-moving, wet storms are becoming more common amid climate change, which can be particularly frustrating for hospitals, as they linger for days increasing financial, physical, and emotional tax, according to NPR.
Provide advance warning if a hospital or healthcare closure seems likely. If residents need to set up an appointment, seek care ahead of a storm or before an evacuation order is issued is ideal. Make sure residents understand how to check the website for the facility they're going to first, or call ahead, as circumstances can change quickly during a severe weather emergency and it may not be possible to seek care at certain locations. If safety managers communicate closures and evacuations to residents as quickly as possible, they will be able to prepare if they need to be admitted to a hospital or other healthcare facility.
How To Communicate Hospital Closure Protocol
During Hurricane Florence, Medical University of South Carolina used a mass notification system to communicate with over 23.000 community members as the severe weather event developed. During the severe weather event, which eventually became a tropical storm, all members of the community, including students, faculty, hospital officials, doctors, nurses, students on hospital rotation, employees working at the campuses’ various clinics or practices, and contracted employees, received updates throughout the storm. The campus focused on transportation - since the main campus was on the Charleston Peninsula, the community was able to find out which buses or shuttles were running or delayed due to flooding, which further helped the hospital and university continue to provide service throughout the severe weather event.
During a storm, wildfire, or other severe weather event, safety managers should communicate to residents any changes in healthcare availability. Often, traveling to seek care may be risky and it is critical people only seek hospital care during a storm in true emergencies. It’s also important for health care providers to plan ahead with patients, physicians, and staff to keep monitoring the right. A mass notification system can be a powerful tool for hospitals to manage both internal and external emergency communications, as demonstrated by MUSC during Hurricane Florence.