Sandy’s Wake: Disaster Planning Re-visited

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nyu-langone-mc-sandy.jpg - NYU Langone MC - Sandy
As NYU Langone Medical Center prepared to open many inpatient services that closed following Hurricane Sandy, the radiology department secured a mobile MRI system from Medical Imaging Resources. The company delivered the MRI system from Michigan to the courtyard of the medical center, driving an 18 wheeler through a 9-foot opening in the main lobby.
Source: John Abbott

Hurricane Katrina in New Orleans. An F5 tornado in Joplin, Mo. Blizzard Nemo in the Northeast. The earthquake and resulting tsunami in Japan. Nature has unleashed some devastating forces in recent years and these disasters have healthcare providers scrambling to re-visit their disaster plans. As the unscathed focus on preparation, the experienced share lessons learned.

Before the storm

In the middle of the Atlantic Ocean, nine days before Halloween 2012, Hurricane Sandy began to swirl toward the U.S. By Oct. 25, the storm had danced across the Caribbean, already responsible for dozens of deaths in Haiti, the Dominican Republic, Cuba and more.

Sandy was projected to hit the U.S. somewhere in the Northeast, sending healthcare providers in the storm’s path into preparation mode. For Tobias Gilk, MArch, senior vice president at RAD-Planning in Kansas City, Mo., however, disaster planning happens well before storm clouds appear on the horizon.

“The more thought that can be paid in advance of a capital project—whether  buying a new piece of equipment or building a new wing or renovating a suite—the better prepared you’ll be to respond to emergencies and mitigate the damage that comes from emergencies,” says Gilk.

Standing behind the notion that an ounce of prevention is worth a pound of cure, Gilk says providers can use facility assessments to detect weaknesses before a problem strikes. Even if there are issues identified that can’t be immediately addressed, considering possible scenarios can help in the development of contingency plans. For example, a rural hospital with limited access to power should identify its critical needs and design a backup generator strategy to maintain those services in the event that additional power supplies may not be accessible during a major storm. Equipment that isn’t an essential need should be removed from automatically receiving emergency power.

Radiology departments should have a criticality list in terms of imaging resources, says Gilk. Plain film radiography may be considered more essential than ultrasound or a department may choose to maintain CT service over MRI. If only one modality can be brought online, Gilk says providers should identify which one it should be and which can wait a few days.

Natural disaster profiles available through the Federal Emergency Management Agency (FEMA) and state-level FEMA offices can help facilities with these priorities. The upside of contingency planning is that the first plan will have cascading benefits and responses translate over various scenarios, says Gilk. A blizzard or a hurricane could knock out power, but some aspects of the response will be similar for either event.

Plans also may help with unforeseen events. Gilk described a situation at one hospital that was built on high ground nowhere near a body of water. A natural flood would have been nearly impossible, but a pipefitter who broke a water pipe servicing a wing of the hospital managed to flood the ground level of the facility, demonstrating why all facilities should have a flood plan to protect vital equipment.

Another benefit of disaster preparation is its value in non-disaster scenarios. A trailer dock designed to deliver a CT unit in the event that one is damaged during a storm also could provide easy access during a scheduled servicing event when a department may need to use trailer-based service.

“This doesn’t have to be money sunk into the event we hope will never happen,” says Gilk.

Imminent disaster

Once in the path of a major storm, the next phase of disaster planning begins. At NYU Langone Medical Center in New York City, the radiology department asks its vendors to assess equipment as standard practice when there is potential for normal power to be lost, says Donal Teahan, director of radiology practice development. The department made sure that MR scanners were full of helium, so they would stay cool if recovery took more than a couple of days. The facility looked at chill water and backup parts in the event of a damaging power surge.

“You shut down all systems prior to the storm with the exception of MRI coldhead compressors,” says Teahan. “You shut down all power breakers just to make sure you don’t get a power surge, because a power surge is usually the biggest problem.”

Beyond these steps, there aren’t many technical issues that need immediate preparation before a hurricane, he says. “There’s little you can do until after the storm, because you don’t know what you’re