ASHE PDC: Disaster Readiness

It wasn’t that the Mercy Health Care Campus in Joplin, Missouri, hadn’t prepared for a disaster. It’s that no one was prepared for a total loss.

The story of the hospital that got hit by an F5 tornado on May 22, 2011, was shared during the plenary session “Disaster Readiness: Restoring the Joplin/Mercy Health Care Campus” during the ASHE PDC Summit in Phoenix.

Panelists were Dottie Bringle, RN, CNO/COO, Joplin/Mercy Hospital, and Kevin Wagner, regional manager-PDC, with moderator Ken Cates, SASHE, principal, Northstar Management.

The session opened with a haunting video showing footage of the damage from the tornado as well as interviews with hospital employees giving harrowing accounts of what they went through to not only save their own lives but those of patients as well.

The 600,000-square-foot hospital sat on 114 acres of land, and on that Sunday evening, it had 183 inpatients, including 25 from the emergency department, when the storm descended upon Joplin causing billions of dollars in damage across the small town.

Within just 45 seconds, water pipes had burst, power was lost, and natural gas was leaking throughout the facility, says Bringle. It became immediately clear to the hospital’s staff that everyone had to be evacuated.

The only silver lining to the situation that unfolded was that due to a recent transition to electronic medical records, the hospital had intentionally kept its occupancy down to smooth the process and had only those 183 patients to tend to. As patients were moved with help from local residents’ pick-up trucks and vans and staff members walked three miles to set up a triage area, tactics for how best to handle a disaster of this scale began to emerge.

Bringle says a primary issue was communications, which the facility first relied upon by a “code gray” being called due to the storm warnings. Staff stayed calm and moved patients to safe ground due to well-practiced drills being relied upon. However, failures were seen in the loss of radio and phone systems that prevented the facility from communicating with the outside world and internally, as well.

Having a disaster plan in place also proved to be vital, Bringle says. Again, staff members had been trained and knew what to do. She adds that it’s important to designate an off-site command center as well as who runs it, while also identifying alternate sites for care and alternate communications methods.

As the hospital staff jumped into action, Wagner and his team on the management side for Mercy put together a caravan of support which quickly worked to get to the site by daybreak of the following morning. The team performed a search and rescue of the facility, established security, did a risk assessment and mitigation, and performed an urgent recovery for important items left behind.

Once the site was stabilized, Mercy next had to shift toward the rebuilding process, first deciding upon the creation of a tented field hospital, where a mobile medical unit offered 60 beds—20 ED beds and 40 ICU med-surg beds, in addition to specialized tends for a cath lab, MRI, etc.

However, winter was on its way and the hospital knew it would need a more solid location to serve patients, and the next stage of a portable building model was pursued. In April 2012, a 110-bed facility with an expanded OR was completed and is where the facility operates out of today.

In 2015, Mercy will finally see the doors of its new replacement hospital open.

As for lessons learned throughout the process, there were many. But Bringle and Wagner identified a few core takeaways:

• Decide if a building is off limits, and keep it that way—if the people are out, there isn’t much of importance left inside to risk going back in.
• Use local trusted, contractors—companies will emerge out of nowhere following disasters, and trusting long-time community partners or others already close to the facility is best.
• Establish on-site command and maintain communications as best as possible.
• Ensure proper safety gear is available for those who do have to access the building.

With Mercy in its second building and working toward a third in less than a year, Bringle says she’s thankful for the team that has helped make that a reality. “It’s done with teamwork and with people who trust and believe in each other,” she says.

Plans for the future building include having “bunker-like” storage units, glass windows that won’t break into shards, and an envelope that can withstand high winds. And also key is thinking not only about protocols but systems and building designs that play a significant role in disaster preparedness, as well.

Bringle reminded the audience of PDC members to remember their role in the overall process.

“Please never underestimate what you do, because you make a huge difference in people’s lives,” she says.