Hurricane Andrew was, at the time, the costliest hurricane in U.S. history. The category 5 storm made landfall on August 24, 1992, in Elliott Key, Fla., and later in Homestead, Fla.
Wayne Brackin, who currently serves as COO and executive vice president of Coral Gables, Fla.-based Baptist Health South Florida, was the president of Homestead (Fla.) Hospital from 1990 to 1994 and experienced just how costly the storm was.
The hurricane caused about $5 million in damages to the hospital building, but the total financial loss was "through the roof," said Mr. Brackin. Many patients affected by the storm weren't able to pay, and less than 25 percent of the large amount of unpaid care provided to community residents was ever reimbursed by the state. Mr. Brackin estimates the hospital lost a total of $15 million as the hospital, and the community, was recovering.
The storm also cost the hospital a large percentage of its most valuable resource — staff. About half of the hospital's employees ended up leaving the storm-ravaged community, said Mr. Brackin, throwing the hospital into a staffing crisis during a period when demand for care had increased fourfold from pre-hurricane levels.
Despite all the obstacles, the hospital was only closed for a week (caused by the failure of the hospital's older backup generators). A $10 million construction project that was underway when the hurricane struck was eventually finished. In 2007, construction on a new, replacement facility for Homestead Hospital was completed, a state-of-the-art building designed to withstand strong storms.
Mr. Brackin's experience guiding Homestead Hospital through the recovery process offers five lessons for hospital administrators in planning their hospital's natural disaster response.
1. Earn staff loyalty now, not the day after the disaster. Hurricane Andrew caused damage and destruction across the community, affecting the homes and lives of the hospital's staff. Homestead's continued operations following the hurricane were dependant on hospital staff working "extraordinary hours with lots of personal sacrifice," said Mr. Brackin.
Mr. Brackin recommends letting hospital staff know now, before a disaster, how much their work and expertise is valued by the hospital. Surviving a disaster both in the short and long-term requires a staff dedicated not only to providing exemplary care, but dedicated to their current hospital (and community) as well.
2. Form assistance partnerships with hospitals (that are at least 75 miles away). Mr. Brackin admits that one element of the hospital's pre-Andrew hurricane plan was a reliance on neighboring hospitals for assistance during crises. After Andrew, neighboring hospitals had also been severely damaged, and were struggling with the same patient overload and staffing shortages that Homestead was. "Remember," said Mr. Brackin, "that in all likelihood, the next hospital over will be in the same situation you're in."
Following Hurricane Andrew, Homestead Hospital received assistance from hospitals in Miami and from Roper Hospital in Charleston, S.C., which Mr. Brackin cites as instrumental to allowing the hospital to continue to function and serve the community in the aftermath of the hurricane. He now advocates looking to hospitals at least 75 miles away as potential sources of assistance during and following natural disasters.
3. Have a disaster plan (or department). Before Hurricane Andrew, Florida had not seen a hurricane of that magnitude for 30 years. Homestead Hospital administrators "lacked a lot of institutional knowledge on how to manage a crisis like that," said Mr. Brackin.
Following Hurricane Andrew, the hospital instated an entire department focused on disaster preparation that works year-round to keep the hospital ready to weather another such storm. In the 20 years since Hurricane Andrew, the hospital has faced "four to five significant hurricanes," said Mr. Brackin, and the hospital's "orderly, calm approach" to preparation and response to these storms has been thanks to the hospital's disaster preparation team.
4. Coordinate with local disaster response teams. Mr. Brackin emphasized that Homestead Hospital during the hurricane wasn't a hospital in crisis, but "a community institution in crisis." Storms like Andrew "affect entire communities," he said, and response and recovery are community efforts.
Mr. Brackin advocates participating in community disaster planning, and cooperating with all local and regional response teams. He recalled that, following Hurricane Andrew, the military set up a field hospital in a park adjacent to Homestead, and worked closely with Homestead Hospital to provide care to the community. Working with the military, and civilian volunteers during the recovery process helped the hospital provide the best care possible to the community, he said.
5. Be ready to adapt to a changed community. Homestead, Fla., "never completely recovered from the hurricane," said Mr. Brackin. Jobs lost at the damaged Air Force base were never replaced, and, 21 years later, the community has still not fully recovered economically from the 1992 storm.
Today, Homestead Hospital is "the sole community hospital" in the area, said Mr. Brackin, and "serves the vast majority of patients." Despite this market share, the hospital continues to face operational losses due to a changed community. Baptist Health South Florida continues to operate the hospital as part of its broader mission, and losses are offset by the organization's other facilities.
"We're all still feeling the effects," said Mr. Brackin.
Homestead Hospital's experience following Hurricane Andrew demonstrates both the need for disaster preparation, and an organization — and administration — flexible enough to adapt to a community fundamentally changed after a natural disaster.
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Wayne Brackin, who currently serves as COO and executive vice president of Coral Gables, Fla.-based Baptist Health South Florida, was the president of Homestead (Fla.) Hospital from 1990 to 1994 and experienced just how costly the storm was.
The hurricane caused about $5 million in damages to the hospital building, but the total financial loss was "through the roof," said Mr. Brackin. Many patients affected by the storm weren't able to pay, and less than 25 percent of the large amount of unpaid care provided to community residents was ever reimbursed by the state. Mr. Brackin estimates the hospital lost a total of $15 million as the hospital, and the community, was recovering.
The storm also cost the hospital a large percentage of its most valuable resource — staff. About half of the hospital's employees ended up leaving the storm-ravaged community, said Mr. Brackin, throwing the hospital into a staffing crisis during a period when demand for care had increased fourfold from pre-hurricane levels.
Despite all the obstacles, the hospital was only closed for a week (caused by the failure of the hospital's older backup generators). A $10 million construction project that was underway when the hurricane struck was eventually finished. In 2007, construction on a new, replacement facility for Homestead Hospital was completed, a state-of-the-art building designed to withstand strong storms.
Mr. Brackin's experience guiding Homestead Hospital through the recovery process offers five lessons for hospital administrators in planning their hospital's natural disaster response.
1. Earn staff loyalty now, not the day after the disaster. Hurricane Andrew caused damage and destruction across the community, affecting the homes and lives of the hospital's staff. Homestead's continued operations following the hurricane were dependant on hospital staff working "extraordinary hours with lots of personal sacrifice," said Mr. Brackin.
Mr. Brackin recommends letting hospital staff know now, before a disaster, how much their work and expertise is valued by the hospital. Surviving a disaster both in the short and long-term requires a staff dedicated not only to providing exemplary care, but dedicated to their current hospital (and community) as well.
2. Form assistance partnerships with hospitals (that are at least 75 miles away). Mr. Brackin admits that one element of the hospital's pre-Andrew hurricane plan was a reliance on neighboring hospitals for assistance during crises. After Andrew, neighboring hospitals had also been severely damaged, and were struggling with the same patient overload and staffing shortages that Homestead was. "Remember," said Mr. Brackin, "that in all likelihood, the next hospital over will be in the same situation you're in."
Following Hurricane Andrew, Homestead Hospital received assistance from hospitals in Miami and from Roper Hospital in Charleston, S.C., which Mr. Brackin cites as instrumental to allowing the hospital to continue to function and serve the community in the aftermath of the hurricane. He now advocates looking to hospitals at least 75 miles away as potential sources of assistance during and following natural disasters.
3. Have a disaster plan (or department). Before Hurricane Andrew, Florida had not seen a hurricane of that magnitude for 30 years. Homestead Hospital administrators "lacked a lot of institutional knowledge on how to manage a crisis like that," said Mr. Brackin.
Following Hurricane Andrew, the hospital instated an entire department focused on disaster preparation that works year-round to keep the hospital ready to weather another such storm. In the 20 years since Hurricane Andrew, the hospital has faced "four to five significant hurricanes," said Mr. Brackin, and the hospital's "orderly, calm approach" to preparation and response to these storms has been thanks to the hospital's disaster preparation team.
4. Coordinate with local disaster response teams. Mr. Brackin emphasized that Homestead Hospital during the hurricane wasn't a hospital in crisis, but "a community institution in crisis." Storms like Andrew "affect entire communities," he said, and response and recovery are community efforts.
Mr. Brackin advocates participating in community disaster planning, and cooperating with all local and regional response teams. He recalled that, following Hurricane Andrew, the military set up a field hospital in a park adjacent to Homestead, and worked closely with Homestead Hospital to provide care to the community. Working with the military, and civilian volunteers during the recovery process helped the hospital provide the best care possible to the community, he said.
5. Be ready to adapt to a changed community. Homestead, Fla., "never completely recovered from the hurricane," said Mr. Brackin. Jobs lost at the damaged Air Force base were never replaced, and, 21 years later, the community has still not fully recovered economically from the 1992 storm.
Today, Homestead Hospital is "the sole community hospital" in the area, said Mr. Brackin, and "serves the vast majority of patients." Despite this market share, the hospital continues to face operational losses due to a changed community. Baptist Health South Florida continues to operate the hospital as part of its broader mission, and losses are offset by the organization's other facilities.
"We're all still feeling the effects," said Mr. Brackin.
Homestead Hospital's experience following Hurricane Andrew demonstrates both the need for disaster preparation, and an organization — and administration — flexible enough to adapt to a community fundamentally changed after a natural disaster.
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