Study Reports Critical Challenges Hospitals Faced During Sandy

WASHINGTON — When Hurricane Sandy hit the East Coast two years ago, hospitals were not ready to handle the problems that came with such a disaster and many were cited months earlier for the same problems they dealt with during the storm.
The Department of Health and Human Service’s Office of Inspector General (OIG) examined emergency preparedness and response at 172 hospitals in New York, Connecticut and New Jersey and released the study’s findings on Sept. 16.
The study found that 93 percent of hospitals sheltered in place during the storm, and most of those hospitals (65 percent) took in patients from other hospitals, forcing them to discharge patients who weren’t as sick.
All the hospitals reported that they participated in at least one emergency preparedness activity, and all but one hospital said written emergency plans were useful during Sandy. However, the report stated, one administrator expressed how hospitals can drill on a variety of emergency scenarios, but Sandy was a storm of such magnitude that all those scenarios happened at once.
Eighty-nine percent of hospitals reported experiencing critical challenges during the storm, whether they evacuated or sheltered in place. These challenges represented a range of interrelated problems from infrastructure breakdowns, such as electrical and communication failures, to community collaboration issues over resources, such as fuel, transportation, hospital beds and public shelters. The report did not specify which hospitals had which problems.
Two of the most severe infrastructure problems were flooding and power outages caused either by flooding or wind. Half of the hospitals in declared disaster areas reported challenges in their infrastructure. In one hospital, only an inch of water came inside, but it was enough to compromise the backup generator, forcing the facility to evacuate when it lost power. When 69 percent of hospitals experienced a power outage, more than two-thirds said backup generators were not a reliable power source.
Communication between staff, officials and other hospitals was another obstacle for one-third of the hospitals. Sandy destroyed cell phone towers and telephone poles, and flooded telephone switching stations. Subsequently, many hospitals developed multiple communication channels such as using multiple cell phone providers, using satellite telephones and installing a cell phone tower in the hospital that will be powered by a generator.
At 29 hospitals, fuel shortages substantially affected patient care. Fuel is needed to run backup generators, operate ambulances, ensure delivery of supplies through trucks and make sure staff is able to get to work. Although gasoline was often available, gas stations did not have backup generators to pump the gasoline when the main power went out.
After their findings, OIG recommended that the Office of the Assistant Secretary for Preparedness and Response (ASPR) continue to promote federal, state and community collaboration in major disasters. It recommended that the Centers for Medicare & Medicaid Services (CMS) examine existing policies and provide guidance regarding flexibility for reimbursement under disaster conditions.