Medxcel’s Scott Cormier tells us how to prepare medical facilities for disaster
When disaster strikes, the most essential business you can imagine is a healthcare facility. All eyes immediately turn to the hospitals and clinics trusted to provide emergency care. So, if you run one of those, you need to be prepared.
“During a disaster, one of our public’s greatest times of need, we have to be open and functional for them,” Scott Cormier, Vice President of Emergency Management, EC, & Safety for healthcare facility service provider Medxcel, told BOSS. “… If we have to close our doors because we weren’t well-prepared, or we didn’t attempt to put mitigation strategies in place, then we’re just now one of the other people that needs help in that community rather than the beacon of light for help.”
Medxcel services more than 160 hospitals nationwide with a total of about 200 incident activations yearly, so Cormier has a lot of experience determining best practices and bad practices.
The first step in preparing for disaster, Cormier says, is recognizing what constitutes disaster. Medxcel typically categorizes them as natural (hurricanes, floods, etc.), technological (IT or phone systems crashing), and manmade disasters (active shooter, bombing, etc.). To get ready, facilities and leaders need to assess the risk of each, determining the probability of each potential disaster and how each could affect operations. For example, ambulance entrances in Kansas and Oklahoma, areas prone to tornadoes, have garages with rolldown doors.
Once you’ve assessed the risk, you can go about designing and implementing a mitigation plan. As we’ve seen in recent years, hurricane seasons are becoming more active and intense on the Gulf Coast, as are fire seasons in the West, so risk assessment should be revisited regularly as probabilities can change.
“Normally, we’ll grade our risks based on the top factor of probability and impact,” Cormier said. “We’ll take the top five risks and create some very specific plans for them, and we’ll put some of our mitigation dollars into that.”
It’s also important to have a general operations plan for internal disasters such as power failure or external disasters such as a mass transit accident with the goal of caring for the greatest number of patients and protecting the people inside the hospital.
Facilities can take advantage of the FEMA Hazard Mitigation Grant Program, which provides federal funding for prevention measures such as floodwalls or hurricane-proof windows.
“Normally, FEMA will pick up 75% of the improvement costs and the facility itself will pick up 25% of the cost, which is great.”
These projects can be expensive. Cormier mentioned one facility Medxcel is working on in Florida to mitigate hurricane and flood damage that includes $78 million in FEMA funding. While that’s a big investment, it’s much better and less expensive than having medical facilities be inoperable in an emergency and rebuilding from scratch after a disaster.
When Disaster Strikes
You’ve put in all the prep work. Now, what do you do when disaster is at your door? Here again, planning as much as you can in advance is invaluable. There are disasters with notice, Cormier notes, events such as hurricanes and snowstorms that you can see coming.
“For a hurricane, for example, we know that four days before landfall we have to make decisions about bringing in extra equipment and supplies like remediation teams and generators,” he said. “Three days before landfall we have to make a decision about if we’re going to evacuate patients. Are we going to completely evacuate? Are we going to partially evacuate, which typically means those people on life-support systems, our critical-care patients?”
That far out, though, hurricanes can shift course dramatically, which is why Medxcel partners with a private meteorological service that provides specific forecasts based on the GPS coordinates of a particular facility. The two days before landfall, they bring in supplies and shore up staffing, evacuating patients if necessary.
Unknown events such as tornadoes, flash floods, or earthquakes leave less prep time, but facilities can still plan for an immediate response.
“In the first hour, all we’re going to be able to do is work with the supplies and resources we have in place. What you have in your building is what you have to work with,” he said. “But at hours 2 through 12, that’s when we’re going to be able to bring in extra equipment, people, and supplies.”
Call lists of vendors are drawn up beforehand so the process of resupplying can begin as quickly as possible in those critical hours.
“After that first 12 hours, we gauge how much more equipment and supplies we need until we can return to normal operations.”
Considering, for example, that caring for each patient in a hospital requires about 60 gallons of water per day, that can be a daunting task.
No matter how well your facilities did during and immediately after a disaster — and one will definitely come — you can always do better the next time around.
“After every disaster, and even after a disaster exercise, we bring a group of people together, including people that were boots on the ground in the front lines responding, and we do an after-action review,” Cormier said. “We talk about, ‘How did we respond? Did we use our plan? Was the plan appropriate? Were the steps that we outlined appropriate? If not, what changes do we need to our plan to improve it?’”
Medxcel then shares that information broadly throughout its national network. That’s, among other things, helped streamline the process of getting quick disaster reimbursement from FEMA. Responders across the board know to document and photograph every repair and every expense, putting receipts in a shared database so an accurate and thorough accounting can go to FEMA and medical facilities can recoup expenses from tree removal to overtime pay for staff, even the cost of project managers tallying everything up.
Often emergency management programs in healthcare are viewed as revenue-depleting, primarily regulatory, and not difficult to handle, Cormier said. COVID has taught everyone that’s not the case.
“We’ve determined that an emergency management program is actually revenue-generating,” he said. “When you stay open and you’re caring for your community during their greatest time of need, you’re seeing patients, and you’re able to bill for the services you offer, that’s an important part of being able to stay open in the community.”
That doesn’t mean emergency management departments need to be bloated, but they should probably be under the supervision of someone who isn’t also juggling other responsibilities.
“COVID taught us that some emergencies aren’t over after one, two, or three days,” he said.
Medxcel has been dealing with COVID since one of its facilities treated the second patient diagnosed in the U.S. in January 2020.
“You have to have a way of sustaining that response and not letting your guard down as well as dealing with all the other disasters that can occur.”
Being open and providing care amid a disaster is the best way medical facilities can serve their communities.