Early Lessons from Hurricane Sandy

Dawn Holcombe, MBA, FACMPE, ACHE
Editor-in-Chief
President, DGH Consulting, South Windsor, CT

As practice administrators, we try to prepare for emergencies, but the unexpected always happens. Hurricane Sandy blew onto the East Coast and hit hard with rain, wind, and blizzard conditions. Many are still digging out; some are still without power more than a week later. It is not too early to see what we can apply from this storm to other storms that can hit here or anywhere else in the country.

Water
Many of the affected areas were in low-lying areas that were vulnerable to both storm surges and driving rain. Flooding into basements and lower floors was the culprit for many of the power failures, and even many generator failures, for major healthcare institutions. To the extent possible, putting vulnerable emergency equipment in higher elevations could provide protection.

The power outages in southern Connecticut would have been greater if one of the major electrical substations had been flooded. As it was, Connecticut Light & Power built the substation to be higher than the 100-year flood maximum plus 1 foot. Water rose to within inches of even that height. As we renovate offices, or build new buildings, many of us do not routinely check 100-year flood stages in our planning, but we have seen the relevance of that in­creasing in recent years.

Power
The question is not, “Where were you when the lights went out?” but rather, “How isolated are you when the lights go out?” Medical offices that rely on elevators for patient and staff access are severely affected when the building elevators stop working. Some healthcare facilities keep their emergency generators on upper floors to avoid flooding, but then find significant challenges in lugging the fuel needed to power the generators up several flights of stairs.

Communications
We all have disaster plans for communications, but when the power is out and when cell towers are out, even cell phones will not work. In our area, we have had lengthy power outages 3 times in the past 2 years, even before Hurricane Sandy. A part of the routine preparations we now make are building lists of “landlines.” Every home and office should have old-school phones that do not rely on electricity and that simply connect directly to the phone line, which can be done easily with a split adapter at the wall sending 1 wire to the nonelectric phone and 1 wire to the electrified base for the remote/answering machine.

I keep 2 landline phones permanently attached to the phone lines in my own office and in my house (in addition to the numerous remote phones), and before storms, I remind key contacts of that number as opposed to my cell number. Key personnel in medical offices would do well to have such landline connections set up in advance of disasters so communications can still occur. Do you ask your patients for their emergency numbers, and remind them of how useful landline phones can be?

Fuel
When the power is down, fuel often becomes in short supply, because it needs electricity to be pumped. If you have backup power planned, have you also made plans for sufficient fuel availability to keep that backup power working?

Do you know where your remote backup servers are? At least 1 remote backup service was badly affected by the power outages in New York, as were all of its clients. Even if you have not been affected by a storm, identifying the risk of your own backups and servers based on their locations can be useful.

Backing Up Your Backups
You may have a backup plan in your disaster preparedness, but have you gone 1 step further to identify what the backup may be to your backup plan failing? Hospitals prepare for natural disasters all of the time, and yet even major hospitals in New York had to punt when their safety net plans failed. Perhaps even with generators, oncology practices might find it useful to invest in simple large coolers and fill them with ice before an emergency. I myself (having lost 3 freezers full of food over the past 2 years) bought an oversized cooler for $50 and stuffed it with 7 large bags of ice (approximately 5 lbs each). It was warranted to keep ice frozen for at least 5 days. I did not lose power, but 8 days later, more than half of the ice in that cooler was still intact and frozen.

Our hearts go out to all of those who are still recovering and are facing not just getting power back but also the rebuilding process.

We are a close-knit community in oncology, and even if we were not directly affected, we are all touched by these events. It is interesting to note that even as we struggle for greater efficiency through the wonders of technology, there are simple, old-school solutions that we still need. Good luck to everyone touched by Hurricane Sandy. As you emerge from this, we look forward to hearing from you and learning from all that you have learned.

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