Florida is known for many things, among them, hurricanes. Every year, Florida hospitals face devastating winds and storm surges, but these yearly disasters have helped them become some of the greatest experts on hospital emergency management.
"Hospitals have done a tremendous job hardening their facilities, implementing flood mitigation strategies and establishing clear protocols for evacuation and patient transfer," Mary Mayhew, president and CEO of the Florida Hospital Association, told Becker's. "The only positive to experiencing so many hurricanes is that our hospital emergency management staff continually analyze their plans. This ongoing testing creates opportunities to identify vulnerabilities."
Recently, these plans were put to the test during two large hurricanes: Helene and Milton. These hurricanes helped state hospitals identify new areas for improvement and strengthened their protocols.
Although not all hospitals experience hurricanes, many experience natural disasters. Becker's recently spoke with Ms. Mayhew and Tony Venezia, vice president of public safety at Tampa General Hospital, about the most important steps hospitals can take to mitigate natural disaster impacts and stay operational.
5 ideas to steal for your hospital
Ms. Mayhew and Mr. Venezia shared five steps every hospital should take to improve their emergency management response.
1. Develop a comprehensive emergency plan.
Florida hospitals have developed comprehensive emergency plans and checklists that are revised after each hurricane season. These plans ensure smoother operations during the next year's hurricanes and inform building projects. For example, many hospitals have moved electrical infrastructure higher in buildings to avoid flood-prone areas and staff are given satellite phones and two-way radios in the event cell service goes down.
2. Connect with community leaders before the emergency.
At the beginning of hurricane season, Tampa General leaders connect with staff to remind them of emergency procedures and reevaluate plans, Mr. Venezia told Becker's.
"The important piece is to have a strong, top-down emergency management platform," Mr. Venezia said. "Executives must be part of the planning and understand the potential issues we might face throughout the year."
3. Begin emergency procedures early.
Storms are closely monitored and about five days before a potential impact, the hospital begins implementing its mitigation efforts. This includes its aquafence, a waterproof barrier that holds back surge water. This year, the fence was truly tested, Mr. Venezia said. Four feet of storm water rose up on one side, but the other side was bone dry. The hospital is already working to build a taller fence.
4. Maintain communication throughout the emergency
When a storm is expected, the Florida Hospital Association holds meetings before and during the storm. These meetings include hospital executives, state officials and utility company executives, and allow everyone to receive real-time updates and ask questions.
"Constant communication and engagement from statewide to local levels are vital," Ms. Mayhew said.
5. Have your response team on site and at hand.
During an active storm, Tampa General calls its response team to the hospital to coordinate with vendors to ensure supplies are in place and patients do not experience a disruption to care. The system has a warehouse stocked with 10 semi-truck loaded with food, water, medical supplies and gasses that allow the hospital to sustain itself during a storm, and can be used to help the community post-storm.
"Never stop preparing," Mr. Venezia said. "Climate change is real, and mitigation planning takes time. Sharing knowledge and plans is crucial to improving resilience across communities."
Areas for improvement
The Florida Hospital Association holds yearly regional emergency management roundtables with hospital emergency staff and county officials to prepare for each hurricane season. This year, these sessions identified a few areas for improvement.
"One area of increasing focus is dependency on public infrastructure — water, sewer, etc.," Ms. Mayhew said. "Hospitals can control many things, but when access to public water and sewer systems is lost, they must find ways to adapt. In some cases, hospitals in Florida are installing wells on their campuses where possible."
These wells can be used in an emergency to provide water for fire suppression and cooling systems. WIthout these, hospitals may have to evacuate, she said. A full evacuation could mean moving thousands of patients.
"If patients can remain safely within the facility, it’s critical for them and for community members who might need hospital-level care during an emergency," she noted.
Hospitals also identified patient transport as a potential crisis area. There is an overlap dependency on EMS support that could lead to issues if multiple hospitals require EMS at the same time.
During Hurricane Milton, another transportation issue became apparent: fuel.
"During Milton, one of the largest evacuations from the Tampa Bay area, people filled their cars and left," Ms. Mayhew said. "The Port of Tampa shut down, cutting off fuel supplies, and power outages affected the port and gas stations. Some health systems managed to bring in fuel trucks to support employees, but others are still developing partnerships with retail fuel distributors to secure fuel access."
Another area of need is long-term care facilities and knowing which are open and operational.
"Many hospital patients come from or return to nursing homes and assisted living facilities," Ms. Mayhew said. "Large-scale evacuations or damage to these facilities can affect patient movement and care coordination."
The association is working on a way to more effectively share information about patient movement and support transportation back to skilled nursing facilities. This includes finding shelters that can support individuals with medical equipment needs. Not all shelters provide necessary power for equipment, which can leave some patients in limbo. The association is working with state officials to identify vacant buildings that could be converted into specialized shelters during emergencies. These buildings would be equipped with portable water, air filtration systems and sufficient power for everyone's medical equipment. However, "understanding how many of these shelters might be needed is still a work in progress," Ms. Mayhew said.
The future of hospital emergency management
Storms are expected to become more frequent and stronger as climate change progresses, and hospitals are rising to the challenge.
"The future will require robust community partnerships, involving county and state emergency management and federal infrastructure support," Mr. Venezia said. "We're seeing more extreme weather. Strong collaboration and actionable infrastructure protection plans are essential."
To prepare, Mr. Venezia suggests a comprehensive emergency management program that covers all departments and is drilled extensively until each system breaks.
"This ensures that when we activate the command center, we have a confident, result-driven team ready to address both immediate and long-term challenges," he said.