Hospital Evacuations During a Disaster: a Model of the Future

When Hurricane Irene threatened Brooklyn in August of 2011, the Coney Island Hospital was well prepared for an evacuation. Armed with a robust emergency management system and the experience of 20 disaster drills per year, the hospital had a full three days to prepare for an evacuation in the face of a large coastal storm. On Friday, August 26th at 8am, personnel began evacuating 280 patients to nearby medical facilities; the operation took 12 hours to complete. Despite being considered a highly successful evacuation, the Coney Island Hospital evacuation lasted a full day and necessitated patients being transported without their medical records to save time.

At best, even the most successful hospital evacuations take a day or two to transport patients to safety. At worst, a poor evacuation plan can jeopardize the lives of hundreds of patients. When Hurricane Katrina left 11 hospitals surrounded by floodwater in August of 2005, emergency preparedness plans floundered. The city had no plans for moving hundreds of patients at once, and lost telephone communications systems made it almost impossible to contact available ambulance companies. When help did come, hospital personnel found it difficult in the moment to separate patients by type, destination, and mode of transportation.

While waiting for rescue, an estimated 215 patients died in New Orleans nursing homes and hospitals. Doctors at Memorial Medical Center even found it necessary to euthanize some patients they felt were beyond safety, resulting in a highly controversial court case brought to the Louisiana Supreme court. The effects of a inefficient hospital evacuation can often be disastrous and fatal.

Though no crisis can be fully prepared for, hospitals often encounter the same problems in an evacuation. Most notably, communications systems are fundamentally unreliable in a crisis. To quote a study from the Eurasian Journal of Medicine:

“Although communication and coordination are critical in disasters, the communication systems usually do not function properly during a catastrophe. This situation is one of the most significant problems concerning disasters. It becomes even a greater problem if communication and coordination with necessary institutions have not been established ahead of a catastrophe.”

Hospitals generally rely on telephone communication to reach emergency transport services, and are left in the dark when phone networks often fail during emergencies. Though hospitals can call on the National Disaster Medical System(NDMS) for transportation help in the events of a major disaster, the request requires a presidential declaration and can take days for help to arrive. When hospitals are finally able to secure transport, patients often travel without valuable medical records or care information.

VectorCare, an SF based healthcare logistics company, has been re-imagining what Healthcare Logistics looks like in the face of an evacuation. Using VectorCare’s broadcast tools, any Department Head can send a message to hundreds of local transportation vendors requesting their services to help move patients to safety. vendors can then confirm that they can help, how many vehicles they have available, and continue to communicate with the messaging tools built into the platform. VectorCare’s platform, accessible directly from any web browser, dramatically reduces the calls made and time on task for facilitating evacuation during a major event like a fire. This technology can be crucial during disasters when phone systems and other traditional modes of contact are otherwise unreliable

To learn more about VectorCare’s initiative to donate a free evacuation module to all California hospitals, visit their evacuation page.


Sources:

Graff, Amy. “130 patients evacuated from Kaiser hospital in Santa Rosa”, SF Gate, 9 October 2017.

Gray, Brad H, and Kathy Hebert. “Hospitals in Hurricane Katrina: Challenges Facing Custodial Institutions in a Disaster.” Urban, July 2006.

“Hurricane Irene: Evacuation of Coney Island Hospital.” Case Studies in Public Health Preparedness and Response to Disasters, by Linda Young Landesman and Isaac B. Weisfuse, Jones & Bartlett Learning, 2014.

LaFrank, Glenn. “Calling all Transports”. kp.org, 31 January 2018. Web.

“Statement from Sutter Santa Rosa Regional Hospital regarding Wildfires”. sutterhealth.org, 10 October 2017. Web.

Tekin, Erdal et al. “Evacuation of Hospitals during Disaster, Establishment of a Field Hospital, and Communication.” The Eurasian Journal of Medicine 49.2 (2017): 137–141. PMC. Web. 9 Mar. 2018.

Wildland Fire Management Program, 2018, www.predictiveservices.nifc.gov/outlooks/monthly_seasonal_outlook.pdf.