Weathering the storm: Maintaining imaging in the face of disaster

Hospital administrators and leaders can ensure their imaging services remain operational during a disaster scenario with careful planning and management.

Hurricane Matthew was the longest-lasting major October hurricane since record keeping began in the 1960s, according to CNN meteorologists. While the U.S. death toll topped 30 this week and damages are estimated at $10 billion, major loss of life was averted due to timely evacuation and disaster preparedness.

Having a concrete yet flexible disaster preparedness plan is a must for any hospital—not just those on the coasts. Some 87 percent of hospitals faced a scenario that required implementation of an emergency preparedness plan in the past five years, according to a 2014 joint survey conducted by Health Facilities Management (HFM), the American Society for Healthcare Engineering, the Association for the Healthcare Environment and the Association for Healthcare Resource & Materials Management.

You may not think of it as a “disaster” scenario, but winter storms were cited as the number one reason for entering emergency protocol, affecting half of all respondents. Hurricanes and tornados were each reported by 20 percent of surveyed hospitals—and the prevalence of extreme weather is likely to increase. Climate change is wreaking havoc on weather systems, causing an increase in events such as drought, flooding and hurricanes.

In addition, it’s not just weather. In 2014, a chemical spill into a West Virginia river sent 30 people to the hospital and led state authorities to declare the water undrinkable—making it unusable for medical procedures. Charleston Area Medical Center required 7,200 gallons of water per weekend, stretching the area thin.

Hunkering down

Successfully weathering a disaster scenario takes level heads and comprehensive planning, according to New Jersey-based AtlantiCare Assistant Vice President James Kilmer Jr., who was in charge of emergency management at the AtlantiCare Regional Medical Center's City Campus during Hurricane Sandy. 

“We had tidal flooding, high winds, all that stuff,” said Kilmer. “For hurricanes, we have what is called a ’96 hour plan.’”

At 96 hours out, AtlantiCare’s emergency management team begins to monitor the storm. Depending on the strength of the storm, certain policies kick in at 72 hours til landfall, 48 hours til landfall, etc. One such policy is to ensure shelves are stocked with seven days of medical supplies, in addition to topping off generators with fuel.

“There’s key pieces of equipment that need to be on backup generators, and we know which equipment is marked for backup power, in case we lose power,” said Kilmer.

Hospitals should take a Noah’s Ark-like approach to prioritizing scanners for backup power, aiming to have at least one of each modality.

“There’s an MRI and a CAT scan in each department, in addition to x-rays and ultrasound. We can do anything from nuclear medicine to interventional radiology,” said Kilmer. “Fortunately, nowadays, the imaging is digital—PACS is on backup generators—so you don’t have to worry about film.”

The human element

Planning for equipment and supplies will only take you so far—management of hospital staff can make the difference between merely withstanding a disaster or triumphing over it. All hospital staff are considered essential, so they can travel to and from work on roads that could be closed. In addition, the hospital is connected to several Atlantic City casinos by parking garages and they have agreements to offer discounted rates for staff who may not live in the area.

“Our staff follow the 96 hour plan, so we’ve got pre-landfall and storm shifts, and relief shifts once the area has been cleared,” said Kilmer.

However, the greatest cost of Hurricane Sandy wasn’t damage to the hospital or injury to patients; it was the loss experienced by many hospital staff.

“We never realized until afterwards just how many of our employees were personally affected by the storm, losing houses or personal belongings,” said Kilmer. “We’ve put a lot of mechanisms in place to help those families in the future, such as a catastrophic assistance fund.”

Prepping for the next one

AtlantiCare uses a “hazard vulnerability assessment,” a tool used to score the probability and severity of an adverse event, weather or otherwise. To evaluate their preparedness, they practice disaster response drills—or in the case of a real event—document and asses their performance.

“We do an annual hazard vulnerability assessment and review programs and make adjustments,” said Kilmer. “We actually just implemented a new mass communication system because our previous one was antiquated.”

The new system gives the emergency management team the ability to send out text, phone calls, and emails to all 5500 employees at once. It doesn’t rely entirely on mobile phones, which may be unreliable in an emergency. However, the most valuable communication was between the hospital and the community, according to Jennifer Tornetta, also of AtlantiCare.

“We had other organizations and agencies come to the hospital to ask us for supplies, staffing or medical assistance,” said Tornetta. “The hospital was a real resource for the entire community,”