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NLM Director’s Comments Transcript
Hospital Readiness for Hurricane Sandy: 01/07/2013

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

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The readiness of New York City hospitals for hurricane Sandy -- compared to the preparedness of New Orleans’ medical centers for hurricane Katrina in 2005 – reveals both progress and remaining challenges, finds an interesting viewpoint recently published in the Journal of the American Medical Association.

The viewpoint’s authors note New York City hospitals comparatively had more detailed emergency plans and better positioned emergency electricity generators. Similar to New Orleans, the fuel pumps for New York hospitals were in the basement because of building codes. However, the authors explain the fuel pumps in some New York City hospitals wisely were encased in concrete to prevent damage from hurricane Sandy’s 14-feet storm surge.

The viewpoint’s three authors find New York City hospitals developed and implemented some plans to better manage patient evacuations as a result of some lessons learned from the experiences of New Orleans’ medical centers in 2005.

For example, the authors explain some of the New York City hospitals that received evacuated patients resumed close to normal operating conditions via the innovative use of interior space. The authors find some hospitals turned lobbies into patient receiving areas, some hallways accommodated patient beds, and clinical documentation operations eased to lighten the burdens on some medical providers.

The authors imply most New Orleans hospitals did not have a surge plan to prepare to evacuate or receive patients after hurricane Katrina.

Conversely, the authors note (and we quote) ‘In the aftermath of Sandy, [some New York City] hospitals were unable to ensure continuity of operations, which is a hallmark of successful disaster plans’ (end of quote).

In his blog (directorsblog.nih.gov) NIH’s director Francis Collins M.D. recently described the post-Sandy damage at one of the New York City medical centers that evacuated patients, and lost years of clinical research.

The viewpoint’s authors encourage New York City hospitals (and by implication other urban medical centers) to invest in infrastructure improvements to augment their individual and collective capacity to reopen after a disaster. The authors write (and we quote): ‘Delayed reoccupancy… has major public health implications, including limited access to care, financial strain on local facilities, and stress on regional health care systems that must accommodate the loss of medical capacity’ (end of quote).  

The authors note at least one New York City hospital did not have a plan to transport disabled or obese patients, which was one of the vexing challenges that New Orleans’ medical centers experienced seven years ago. Similarly, the authors add some New York City hospitals needed (but did not have) clear and consistent criteria to guide an array of patient evacuation decisions.

The authors suggest public health and emergency management agencies should develop new protocols and help medical centers improve their collective situational awareness so hospitals can boost their response to natural disasters.

In two interesting suggestions, the authors write (and we quote): ‘The secretary of Health and Human Services should consider issuing an early public health emergency declaration to reduce legal concerns and regulatory constraints’ (end of quote). The authors add there should be more capacity for hospitals to share supplies, equipment, infrastructure, and training to improve both the hand off and responsiveness among medical centers during a disaster.

The authors write (and we quote): ‘Leaving critical decisions to (individual) health care facilities results in inconsistent action, potentially adverse to patient and public interests’ (end of quote).

Overall, while the authors believe the readiness of New York City hospitals showed improvement, they emphasize (and we quote) ‘Federal, state, and municipal authorities can better prepare for the next disaster and have a duty to do so’ (end of quote).

In the interim, MedlinePlus.gov’s hurricanes health topic page provides tips to help you better prepare for the next storm. A hurricane safety checklist (provided by the American Red Cross) is available in the ‘related issues’ section of MedlinePlus.gov’s hurricanes health topic page.

A helpful guide to strengthen your emotional preparation for a hurricane (provided by the American Psychological Association) is within with the ‘coping’ section of MedlinePlus.gov’s hurricanes health topic page.

A guide to prevent injuries and treat personal and family injuries caused by a hurricane and floods (from the Centers for Disease Controls and Prevention) is available in the ‘related issues’ section of MedlinePlus.gov’s hurricanes health topic page.

MedlinePlus.gov also has a health topic page devoted to disaster preparation and recovery that is written for patients and the public. To help medical centers of all sizes, NLM has a website called the Disaster Information Management Research Center that provides comprehensive information about responsiveness to natural and human disasters. This website can be found at: disaster.nlm.nih.gov.

To find MedlinePlus’ hurricanes health topic page, type ‘hurricane’ in the search box on MedlinePlus.gov’s home page. Then, click on ‘hurricane (National Library of Medicine).’ To find MedlinePlus’ disaster preparation and recovery health topic page, type ‘disaster preparation’ in the search box on MedlinePlus.gov’s home page. Then, click on ‘disaster preparation and recovery (National Library of Medicine).’

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I want to take the opportunity to wish you a very happy holiday season and a healthy New Year. The National Library of Medicine and the ‘Director’s Comments’ podcast staff, including Dr. Lindberg, appreciate your interest and company -- and we hope to find new ways to serve you in 2013.