ICE STORM TESTS KY HOSPITALS’ METTLE
by John Commins, HealthLeaders Media, March 11, 2009
If you weren’t living in Kentucky in the last week of January, the ice storm that crippled the Bluegrass State wasn’t much more than a lead item on CNN – something regrettable that happened to somebody else. You watched the coverage. You felt bad for them, but you probably forgot about it when CNN moves to the sports segment. After all, there is nothing more local than weather.
The news that wasn’t reported, however, was the widespread closure of rural hospitals, and hospitals running out of supplies and food, and leaving desperate, freezing patients to fend for themselves. That wasn’t reported because it didn’t happen. And that didn’t happen because of the remarkable efforts by some of those small, isolated community hospitals in the path of the storm.
Methodist Hospital, a 205-licensed bed community hospital in Henderson, on the Ohio River about 15 miles south of Evansville, Indiana, not only kept the lights on when a lot of the region was in the dark, but seved as a shelter for townspeople who’d lost power, needed a warm place to sleep and a hot meal, and had nowhere else to turn. The hospital lost land-line and most of its cellular telephone services and the icy roads cluttered with downed tree limbs limited access, but Methodist continued to provide care because of dedicated employees, a solid emergency management plan, and the help of suppliers.
Don Nauser, director of materials management at Methodist, says the hospital was ready when the storm hit due to disaster preparedness training that several dozen employees at the hospital had taken at the Emergency Management Institute in Anniston, Al. The hospital set up its command center that spelled out each operational task and the personnel assigned to that task.
“One of the things they teach you at Anniston is the first 72 hours you are on your own,” Nauser says. “The National Guard didn’t show up with MREs and cots until the Monday or Tuesday of the next week. They were affected as much as anybody.”
In the initial hours after the storm hit, when electric power for much of the area was cut by falling tree limbs and temperatures plunged, “everybody knew the place to go was the hospital because everyday assumed the hospital would have power,” he ways.
The biggest obstacles for Methodist were the ones they didn’t foresee. For example, when the land line went down, the local cellular telephone service that almost everyone at Methodist used also experienced weather-related problems and was all but inoperable. Nauser says they had to rely heavily on his personal cell phone, which was based in southeastern Missouri.
“Don’t assume that one vendor, in terms of cellular service, is going to be reliable,” Nauser says. “I would recommend having a backup. Ours here was completely off line.” He said his cellular service was one of the few links that Methodist had to a smaller, remote sister critical-access hospital in Morganfield, 30 miles away. Methodist also relied on sporadic Internet service, so employees could update the hospital on their availability, and the hospital could update employees about heir staffing needs.
Methodist was also able to use the Internet, satellite phones (“they work a lot better when there isn’t ice on the antenna,” Nauser says), and cellular phones to communicate with vendors who kept the hospital well-stocked, despite the nearly impassible roads. The main supply point in Paducah, KY had been hit hard by the ice storm. So, Methodist’s vendors which include U.S. Foods, Cardinal Health, and Premier Inc., went north of the storm’s wake and routed supplies through Indianapolis. “We did not miss a deliver,” he says. “It may have meant bringing trucks in at 10 at night or later, but the basic supplies that you need was almost uninterrupted.”
There was a huge – and unanticipated – demand for oxygen canisters for home-bound patients nearby. Methodist found itself cast into the role of chief oxygen supplier for the area after local durable medical equipment suppliers and retail pharmacies that normally sell oxygen told their patients they’d either run out of oxygen or couldn’t get the product to patients.
“They were telling people ‘go to the hospital because we can’t take care of you’,” Nauser says. “Every other problem paled in comparison to the demand for home oxygen. Smaller hospitals, know where your DME is coming from.” The ice storm and its fallout prompted Methodist to reconsider whether it will expand its role as oxygen supplier for the area in the future.
As they struggled during the week-long emergency to provide care and shelter, Methodist officials didn’t have much time to reflect on their reaction to the weather disaster. “You get to the point where you’re running on adrenaline,” Nauser says. But during that frenetic week, no patients were denied care or shelter and services continued in an orderly way. “When it was over I wandered back to the apartment and started to reflect that this worked smoothly,” Nauser says. “It wasn’t perfect. We learned lessons for the next time. But our level of preparedness helped prevent a whole lot of problems. It was as close to business as usual as we could get under the circumstances.”