Frontiers: Are Hospitals Disaster-Ready? Lessons from Katrina One Year Later

Features by Jack O. Bovender Jr., FACHE, and Bill Carey; and Havidán Rodríguez, Ph.D., and Benigno Aguirre, Ph.D.

Softbound, 40 pp, Fall 2006
ISSN 0748-8157
Order code: WWW1-J488
Price: $29.00

EDITORIAL

One year after the Gulf Coast hurricanes that caused what many have called the worst natural disaster in U.S. history, it seems appropriate to look at how the healthcare system responded—what went right and what went wrong. Although every disaster is different, basic lessons can be gleaned from each such event that can help in our preparation and response the next time. This country has experienced a number of major disasters over the past five years—one a result of terrorist attacks, the others from natural phenomenons. More threats will surely come.

In this issue of Frontiers, we focus on Hurricane Katrina and its impact on New Orleans. Was the healthcare system as prepared as it could have been? How did the hospitals respond? What have we learned, and what can we do differently in the future? In the first article, “A Week We Don’t Want to Forget: Lessons Learned from Tulane,” Jack Bovender, CEO of HCA, Inc., and Bill Carey, author of Leave No One Behind: Hurricane Katrina and the Rescue of Tulane Hospital, relate the experience of one hospital—Tulane—and how the hospital and the HCA system handled the event and the lessons learned from it. Bovender and Carey focus mainly on preparation, communication, airlift and transfer, and recovery. This is not only a story of the heart and soul of what healthcare is all about, but one of the courage and compassion of everyone involved. Their account of what Tulane was able to do and the lessons HCA learned should help us all in the future.

In the second article, “Hurricane Katrina and the Healthcare Infrastructure: A Focus on Disaster Preparedness, Response, and Resiliency,” professors Havidán Rodríguez and Benigno Aguirre from the Disaster Research Center at the University of Delaware take a look at the impact of this devastating event on the healthcare system and its infrastructure and talk about how hospitals prepared for, responded to, and coped with the disaster. The authors provide an overview of the current situation and the healthcare crisis confronting the hospitals and communities in the affected regions. They stress the impending need to develop disaster-resilient medical and health systems to prepare for future disasters, and share some recommended initiatives aimed at doing that.

The commentaries begin with “Perspectives,” by Dr. Patrick Quinlan, Warner Thomas, and Dr. Richard Guthrie of the Ochsner Health System in Jefferson, Louisiana. These authors add their experience to the discussion. The Ochsner Clinic stayed open throughout the crisis and was one of three hospitals receiving the brunt of patient needs. They describe the lessons learned from this ordeal and present a number of recommendations for future preparedness. We learn that their ability to sustain operations mainly resulted from the immediate and aggressive response from their business partners. They stress the importance of leveraging the strength of the private sector and formalizing that collaboration ahead of time. In “Can It Get Any Worse?,” Richard Boland from the Disaster Management Center at the University of Pittsburgh Medical Center reminds us that neither feature article speaks to the behavioral health needs of the people involved in these catastrophic events. He describes some of the behaviors that result from such disasters. Boland explains the disaster phases that affect the victims and suggests that mental and behavioral health specialists should be included in the response plan. Finally, in “Keeping Patients Safe When Disaster Strikes,” Dr. Robert Wise of the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) asks two questions: When a healthcare system experiences a disaster, what is required to maintain its operations, and how can the necessary resources be accessed? To answer these questions, JCAHO has, since 2001, been interviewing hospitals and their communities following natural and man-made disasters to understand the effectiveness of the hospital community planning required to maintain quality and safe medical care under disaster conditions. A number of patterns emerge from this research that are described in this article.

The underlying message in this issue is that our healthcare system needs to be made disaster resilient. Catastrophes of all shapes, sizes, and magnitudes will continue to happen, and we as healthcare providers are morally obligated to be prepared. No matter how “ready” we think we are, there is always room for improvement, always one thing we may not have thought about. That is why it is important to share our knowledge and experience, and that is precisely what the authors in this issue have done.

Audrey Kaufman, Editor