As the number of natural disasters grows in the U.S. and in the world, so must the readiness of hospitals and other healthcare facilities.
In 2023, the U.S. saw 28 billion-dollar natural disasters, surpassing the 2020 total. Worldwide, there was a fivefold increase in the number of weather-related disasters in the last 50 years.
Healthcare facilities must be diligent and prepared as the incidents of natural disasters are not expected to slow down. In fact, they are predicted to get worse. Recent events have underscored this necessity.
This week, Florida hospitals prepared for Hurricane Milton, a Category 5 storm expected to make landfall on the state's west coast as a Category 3 on October 10. If forecasts hold, it could be the most severe storm to strike Florida in a century.
Milton arrived about two weeks after Hurricane Helene, which wreaked havoc on hospitals in Florida, Tennessee and North Carolina and sent ripple effects throughout the system with supply chain disruptions. Unicoi County Hospital in Erwin, Tenn., took on so much water it evacuated patients to the roof, where many were rescued by helicopters.
Lessons from past disasters highlight the importance of preparedness. Hospitals learned from the infamous situation 20 years ago at Memorial Medical Center in New Orleans. The hospital encountered a perfect storm of hot weather, strong winds and rising floodwaters brought by Hurricane Katrina. Dozens of patients died, and some caregivers were accused of ethical misconduct.
These are extreme examples, but tornadoes, floods, storms, fires and earthquakes are on the rise and likely will challenge healthcare facilities for the foreseeable future. While hospitals quickly responded to and navigated the COVID-19 disaster, natural disasters are particularly daunting because the facilities themselves are typically compromised.
The top problems for health facilities in a disaster are:
1. Loss of power
2. Loss of water
3. Structural damage
4. Loss of staff
5. Loss of safety and security
Those five issues are overwhelming to handle — especially when a hospital is at capacity and they happen all at once. Experts say the time is now for hospitals and other patient care facilities to prepare. Here are five key actions they should take:
1. Planning. Healthcare organizations should have in place broad emergency preparedness plans that cover mitigation, preparedness, response and recovery — and cover them for different scenarios.
2. Command in leadership: Healthcare facilities must have already identified a management team to manage a crisis and lead employees. These staff members need to be selected in advance and trained.
Incident command, as highlighted in this study, is an often-practiced, proven structure hospitals should use during disasters. The command center's importance is to "accept the disaster's burden and survive it and remain afloat beyond the disaster," as the study found.
3. Training: All employees need to know what is expected of them in a disaster. Before disaster strikes, employees need to know what will be expected from a ride out and recovery, and hospitals must prioritize drills and practice.
4. Collaboration: Partnering with other healthcare organizations and with government entities before a crisis hits is critical, as this study in Cureus notes. Build these relationships proactively with regional emergency management agencies, health departments and other healthcare facilities to ensure a coordinated response when disaster strikes..
5. Communications: There must be transparent communication with stakeholders throughout a natural disaster, providing regular updates. Developing crisis communication plans in advance — including key messages, defined roles and protocols — ensures that everyone is informed during emergencies.
There are federal requirements for healthcare facilities to be ready for disasters. CMS' Emergency Preparedness Requirements mean all hospitals and healthcare facilities must develop emergency plans using an all-hazards approach in four areas: risk assessment and planning, policies and procedures, training and testing, and communication plans.
Much can be learned from hospitals that have experienced internal disasters, including Centura Health's Avista Adventist Hospital in Louisville, Colo., which evacuated a full neonatal intensive care unit due to wildfires in 2021 — at a time when it was short-staffed due to winter holidays. In the above debrief, the hospital credits repeated disaster and evacuation drills for the relatively calm and successful disaster response.
Hospitals are successful in handling disasters in part because employees are trained in what is expected of them during an emergency. Simulating emergencies and conducting regular drills are keys to better manage disaster response for all industries, not just healthcare.
It is impossible to prepare for all disasters because they vary greatly, ranging from cyberattacks, to pandemics to hurricanes, but a well-executed disaster plan has proven time and time again to be the best way to protect patients and employees in potentially dangerous situations. The role of hospitals in disasters is expanding and with the right planning and coordination, hospitals will be up to the challenge.