When Hurricane Irma hit Florida last September, five Schumacher Clinical Partners’ client hospitals lay in its path: two in Broward County and three in the central part of the state.
Preparing for the storm became the responsibility of Dean Dalili, MD, MHCM, senior vice president and group medical director for Schumacher, who oversees several hospital groups on Florida's east coast.
In an article in Today's Hospitalist — When the Hurricanes Hit — Dr. Dalili, along with several other HM physicians, shared the following six steps any hospital can take to prepare for when natural disasters strike.
1. Prepare for Power Loss
One event that almost always accompanies a hurricane is loss of electrical power. The certainty of such an occurrence requires that hospital personnel make preparations ahead of time.
"Before a storm hits, think through how you identify patients, bill, create rounding lists, and communicate with nurses," Dr. Dalili advised. "Then, think about how to do all that with only paper, and print all those forms in advance."
Since gas pumps run on electricity, the article recommended that physicians make sure their vehicles are fueled in advance. It also suggested that hospitals have a van that could be used to ferry staff members to and from their homes.
2. Urge Self-sufficiency
"Doctors covering storms need to bring seven days’ worth of clothes, personal medications, and toiletries," the article said, as well as "pillows, nonperishable food, and an air mattress if the hospital can’t provide cots or beds."
Today’s Hospitalist also recommended bringing such items as a headlamp, hand-cranked radio, and a flashlight that does not require batteries. Other essentials include a remote phone charger and cash.
3. Plan for a Post-storm Patient Surge
“For hospitals in Florida the day after a storm is the busiest of the year, with a census running at least 20 percent higher than normal," Dr. Dalili said.
The physical event that created the spike in demand not only affects facilities and patients but also providers who live in the area.
"The real strategy is how you get people to come in and help with the increase," Dr. Dalili said in an interview with SCP. "Accommodating for staffing under these circumstances requires much more creativity."
As Irma approached the Florida coastline, "once meteorologists clarified the forecast and we knew where Irma was likely to hit, we began preparations," he said.
"We engaged all the providers, medical directors, and operational teams in each of the facilities starting with daily calls three or four days before the storm made landfall, then every day during, and two days after to ensure we were back to the normal operational mode and to prepare for a spike in volume."
One advantage Schumacher has is our sizeable regional presence, particularly in the southeast, an area prone to hurricanes.
"When disasters occur, and there is a surge in demand, you have a lot of regional resources at your disposal to draw upon for help," Dr. Dalili told SCP. "If you were just one hospital, you’d sink or swim based on your ability to mobilize. But when you are a large company, you can pull providers from multiple states into an affected area.”
Another advantage is our resourcefulness. To demonstrate, during Irma, when the Orlando airport closed for two days, SCP offered its private plane to shuttle providers from other parts of the country, a feat that would have been impossible had we been forced to rely on commercial transportation.
4. Guard against Fatigue
According to Dr. Dalili, physicians coming in to relieve those who staff a storm are often as exhausted as the people they are relieving.
To guard against that, leaders must stress the need for sleep, both for those working in the hospital and those at home. During Irma and its immediate aftermath, Dr. Dalili made a point of asking every program leader how much sleep he or she received the night before.
“It was important for me that doctors were sleeping, and it’s important for leaders to model that for their team,” he said. “We need to role model how important it is to take care of ourselves.”
5. Manage Fear, Anxiety, and Stress
Another area of concern that demands preparation is how to effectively communicate with people in the context of fear or danger.
"A storm is an emotional event as much as a physical one," Dr. Dalili told Today's Hospitalist. "You can manage people’s emotions by being as prepared ... and by talking prospectively about stress, the importance of teamwork, and taking care of yourself. Those are critical management skills.”
6. Demonstrate Leadership
During a storm and its aftermath, program directors need time to check in with group members and administrators, the article said. To that end, Dr. Dalili stressed that program directors not take an equal share of patients.
"Your primary role as a director is to communicate, and you have to free yourself up for management meetings," he said.
Teaching crisis management leadership skills is another area SCP emphasizes.
"Being proactive about teaching leadership skills and crisis management is something we take seriously at Schumacher," Dr. Dalili said when speaking with SCP. "Every year, during our annual leadership conference, we teach capacity-demand matching and principles of disaster management response."
It's a given: Natural disasters will occur sooner or later. Hospitals located in disaster-prone areas would do well to have preparedness protocols firmly in place. The six steps listed here — preparing for power loss, urging self-sufficiency, planning for a patient surge, guarding against fatigue, managing fear, and demonstrating leadership — are foundational to effective crisis planning. Consider your partnerships, take advantage of resources, and look for those who can provide crisis management leadership so you can be better prepared for sudden disasters.