Tangney, a senior vice president, already had plenty to worry about -- 16 North Shore-LIJ hospitals spread across New York and Long Island. New York City hospital and nursing home patients and their loved ones might reasonably have believed they were safe as Hurricane Sandy approached. Over the past five years, I've reported on the impact of disasters on hospitals and medical systems, from Hurricanes Katrina, Gustav and Isaac in New Orleans to Hurricane Irene in New York. Both men speak passionately about preparedness and have worked as an effective duo dealing with recent hurricanes. As the hours passed, backup power kept functioning at all of North Shore-LIJ's hospitals. That same day, National Guard troops and staff members began ferrying patients out of Bellevue Hospital just blocks away. Minutes later, a member of the team delivered an alarming report about a community hospital in Bay Shore, N.Y.
A day later, still awaiting rescue in intense summer heat, doctors at Memorial Medical Center were so desperate, they intentionally hastened the deaths of some patients by injecting them with morphine and sedatives, and ultimately 45 bodies were found at the hospital. It kept a full complement of staff on duty to care for them and respond to storm-related emergencies. 28, was strikingly different from the chaotic scramble some have described at NYU hospital after the storm hit. The director of the hospital based her decision on geography, according to Jennifer Sammartino, public affairs officer for the VA New York Harbor Health Care System.
A bus carrying nursing home residents away from Houston in advance of Hurricane Rita in 2005 overheated and burst into flames, igniting oxygen tanks and killing about two dozen people. Others argue it is unreasonable to expect hospitals to gird against all foreseeable, but unlikely, catastrophes. Currently, hospital backup generator system codes and standards are more oriented to short-term power losses like those that might occur when a tree branch falls and cuts off city power for a few hours. As of Wednesday evening, there was no central place for relatives of hospital patients and nursing home residents to find out where their loved ones were or whether they were safe. Navy helicopter pilots reveals what really happened during Hurricane Katrina, and yet they got reprimanded and their story got buried, with hardly anyone grasping that arch-conservative Republicans Bush, Cheney, Rove, Rumsfeld, etal., got people killed because of what they deliberately did. So when Hurricane Sandy approached, I interviewed city and state health and emergency commissioners about their plans and the reasons for their decision this time not to mandate hospital and nursing home evacuations in the city's most vulnerable areas.
EMTs told me they had been waiting hours to carry out what they expected would be a pre-storm evacuation of the hospital. She said that after Irene, the hospital had invested in raising generators above ground level.
When New Orleans implemented city-wide hospital and nursing home evacuations prior to Hurricane Gustav in 2008, many patients were transferred to Baton Rouge, which was harder hit by power outages from the storm, necessitating the re-transfer of a number of patients. According to a sign posted in the hospital, Bellevue's largest generator, its sixth, was in the basement. Often it takes a real crisis for hospital engineers to discover pre-existing problems -- for example problems switching back from generator load to city electricity. Navy hospital ship probably could have landed near or on top of any distressed New Orleans hospital, saving lives, giving hospital caregivers an option. NYC hospitals that were flooded were very lucky no one was killed as a result of the decision to hunker down instead of evacuate. After the patients were evacuated, the hospital's maintenance staff and contractors continued to work on the building, keeping water out of key areas. The graphic shows the area under immediate threat from severe weather, at the top, the odds of which areas will be affected in the coming half hour and the next hour, and the estimated time the tornado or severe thunderstorm should arrive.The AMS Policy Program is focusing on hospital protection, because hospitals are not only centers of emergency and ongoing medical care, but also economic engines in their communities. One of the most important benefits of our warning service for hospitals is to give them a null warning, to let them know that even though a NWS tornado warning is in effect in their area, the hospital itself will not be hit.One of WeatherData's clients is the University of Kansas Medical Center in Kansas City, Kansas, where Rick Johnson is Director of Public Safety and Chief of Police.
Here, members of the Iowa-1 Disaster Medical Assistance Team move a patient with the help of flight nurses and medics.Chapter 9 of the Guidebook will cover understanding the basics of overall disaster planning, which includes knowing how an Incident Command System (ICS) works. The book will be published online to help get it to the target audience.In 2008, Chad Ware, in addition to his other duties in the Emergency Department, was on a preparedness committee that worked on disaster planning. While it was closed, the hospital made improvements designed to reduce potential loss of property and medical equipment in future disasters.
Placing on the foil if the object you for a year would face a calculated danger the Living. The power failure at New York University Langone Medical Center during Hurricane Sandy shows that hospitals still may not be doing enough to prepare for disasters. It happened last year in San Diego, when generators at two hospitals failed during a blackout. And it happened last year in Connecticut, when a hospital had to be evacuated during Hurricane Irene when its generator failed. Hospitals, he said, are required by the Joint Commission, a hospital accreditor, to have back-up power capabilities. Wonder how much it costs for a major metropolitan hospital to close and be forced to evacuate numerous patients vs the cost of relocating critical backup equipment. My company used to make custom fuel tanks for generators and the company we made them for begged me to make sure there was no welding slag or grit in the tanks. There are three other caveats for hospitals to ponder; 1) everyone thinks their special piece of equipment is vital and essential, and they will find ways to connect it to the emergency power circuit. Additionally, have a process for isolation and decontamination in the case of biologic or radioactive threats.
Medical staff may be pulled from their normal floors to assist in the care of disaster victims.
Consistent review, practice, and re-evaluation of your plan are the keys to successful disaster preparation. Staff had to hand pump oxygen to critically ill patients until patients could be taken by ambulance to another hospital. Let’s look at how to incorporate these six elements in your plan and discuss the importance of regularly testing it. Control of individuals entering and leaving the hospital, as well as moving within the hospital should be maintained. Using the description box and website link below; describe the different categories of hurricanes using images. A hurricane or tropical storm warning means that tropical-storm-force winds will occur within 36 hours or sooner. This entry was posted in News and tagged backup generator, emergency generator, emergency kit, FEMA, hurricane preparedness week, hurricanes, NHC, NOAA, portable generator, standby generator, Tropical storms.
The Atlantic Hurricane Season begins June 1, 2014, and the Eastern Pacific Season has already begun and has already seen the first tropical cyclone of the season. When forecasters determine a storm threatens, the time has come to put that plan into action. And compliance function more must you be stranded for numerous days prior to parents get to you that. Ten years ago, the nation watched in shock as Hurricane Katrina devastated the city of New Orleans. That following year, Congress created, among other things, an Office of the Assistant Secretary for Preparedness and Response (ASPR) in the US Department of Health and Human Services (HHS), with a mandate to reach across government sectors and coordinate federal efforts to prevent, prepare for, and respond to the adverse health effects of public health emergencies and disasters. At the time of Hurricane Katrina, the public health, health care, and emergency management communities along the Gulf Coast were poorly integrated and lacked the systems, mechanisms, and plans to coordinate an effective, cross-jurisdictional response.
Today, our national approach to preparing for health emergencies is guided by a National Health Security Strategy, which recognizes that disasters require coordinated actions on the part of all stakeholders, governmental and non-governmental alike. A National Response Framework informs a unified, multi-sector national approach to providing information to a broad coalition of community organizations during emergencies and disasters.
When disasters strike, ASPR coordinates the federal medical and public health aspects of the response across HHS and the rest of the United States government. When Hurricane Katrina struck, many health care facilities in affected areas lacked the plans and resources to care for their patients through the disaster, especially as resources became scarce. We now recognize that all health care facilities, not just hospitals, must plan for disasters, have the basic equipment necessary to sustain operations and be able to allocate scarce resources fairly, and that such planning must take place with the recognition that each facility does not exist in a vacuum. The investments enhance the ability of communities and states to handle larger disasters without emergency federal assistance such as that provided through the National Disaster Medical System (NDMS). For example, after both the 2013 Boston Marathon Bombings and the 2015 Philadelphia Amtrak crash, when casualties needed to be addressed within a few hours, coalitions, which had been developed with federal support, helped direct patients to specific hospitals so that no one facility was overwhelmed. In contrast, many nursing homes, adult care facilities, and some dialysis centers had not sufficiently planned how to care for patients if facilities flooded or lost power, and many patients needed to be evacuated to shelters or other facilities and receive care there.
In addition, electronic health records (EHRs) can provide support for accessing a patient’s health records during a disaster.

The HHS Office of the National Coordinator for Health Information Technology has prioritized the need for individuals’ health data to follow them in times of disaster; remotely hosted and cloud back-up are making this increasingly possible. Following Hurricane Katrina, many individuals with chronic mental illness were displaced and unable to access care, resulting in an increase in suicides and mental health crises in the areas immediately affected by the storm as well as in neighboring states that absorbed displaced residents.
Today, behavioral health is incorporated into the formal federal disaster response, addressing the needs of survivors and responders. After the Deepwater Horizon Oil Spill, Substance Abuse and Mental Health Services Administration launched a national Disaster Distress Line for individuals in areas affected by disasters to access help or psychological support. While the progress in health care and public health emergency preparedness in the last decade supports more timely, seamless, and holistic responses to disaster, there is more that must be done.
While Katrina was a local tragedy of national consequence, an even greater tragedy would be for communities across our nation to forget the importance of a trained, ready, nimble, and coordinated public health emergency preparedness system able to care for individuals and communities in the wake of disaster, including those who are most vulnerable. Its really hard to believe that Hurricane Katrina, many individuals with chronic mental illness were displaced and unable to access care,and US gov.
But anyone following the recent history of how hospitals and nursing homes have fared in American disasters had ample reason for concern.
The VA moved all of its 132 patients out of the building before Sandy's arrival, discharging those who could safely go home, and transferring others to hospitals less threatened by rising waters. Though health officials do not much like to talk about this aspect of emergency preparations, it's also expensive for hospitals and nursing homes to shut their doors proactively. The system's hospitals began accepting transfers from NYU Langone, and later Coney Island and Bellevue hospitals, 158 by Wednesday night, including the critically ill infants. According to doctors I spoke with, it was initially difficult to find appropriate beds for the many patients who needed to be moved from disabled hospitals and nursing homes. Last year, these commissioners decided that many of the same hospitals and nursing homes should be evacuated before Hurricane Irene, many of them shutting their doors for the first time in history in part due to the lessons of Katrina. The answers I came away with after reporting from crippled hospitals in Manhattan and Coney Island and darkened, sand-swept nursing homes by the ocean in the Rockaways highlight the complexities of that decision and raise some serious questions.
Before Hurricane Irene hit last year, Farley and Shah helped oversee the transfer of roughly 10,000 patients from seven New York City acute-care hospitals and 39 nursing, psychiatric and adult-care homes in partnership with the city's fire and homeless services departments, emergency management office, the Greater New York Hospital Association, North Shore-LIJ and many others. Navy hospital ship with over 400 empty beds and all the hospital supplies necessary dropped anchor off the Louisiana coast after Katrina made landfall. Bellevue Hospital continued to evacuate its patients on Wednesday after flooding inundated the basement and knocked out electricity.
It was much better, they said, to move patients in a controlled, calm environment with full power than it would be to empty hospitals in the midst of an emergency.
I hope, though, that you will devote a chapter in your upcoming book to identify who really caused those patients to die at that New Orleans hospital and the evidence trail leads back to the Oval Office and the White House Situation Room.
Blame seems appropriate and a big dose of shame on you to NYC government and to all hospitals that fail to address critical infrastructure issues. Mercy Medical contracted an Independent Industrial hygienist to work with the hospital and contractors to ensure the flooded areas were healthy and safe before they reopened.
This Cedar Rapids, Iowa, case study will include the NWS precipitation and flood forecasts, flood outlooks, and watch and warning products from the flood that were used by hospital administration to make decisions regarding that flood, and to illustrate how hospitals and other institutions can use such products.McNally says that healthcare, disaster-planning, and meteorology communities were all equally represented as he was preparing the book. The mitigation measures of building safer, smarter, stronger proved to be invaluable in 2008 when Hurricane Ike struck, as the hospital received only minor damages.JACK WILLIAMS was the founding editor of the USA TODAY Weather Page in 1982.
Hospital workers evacuate a patient from NYU Langone Medical Center during Hurricane Sandy on Oct.
As Hurricane Sandy headed toward the East Coast, New York City Mayor Mike Bloomberg said Sunday, he was assured that hospitals were ready. Bruce Altevogt, a senior program officer at the Institute of Medicine who has studied crisis standards of care, lauded NYU for safely evacuating patients.
Actually having them work when needed is another aspect…especially if rarely used for long periods of time. There needs to be analysis for every major component in a system, and what it can be affected by. Load testing for prolonged periods of time is the best way to insure that these systems will actually work in a real emergency. All hospital staff should be trained for their roles in a disaster situation and be aware of the chain of command during such an event. Your plan should account for patient triage, assessment, treatment, transfer and discharge as needed during a disaster. But he said the incident should prompt a new discussion about where hospitals place generators and how to ensure they work when they're needed. The problem is that the hospitals don’t consider the equipment key in their mission so they neglect them. Though a disaster can be extremely taxing, the goal should be to provide continuous, safe patient care. Last weekend’s hurricane left in its turbulent wake dozens of healthcare facilities dealing with the aftermath of a massive evacuation effort. Take your emergency disaster supply kit with you, along with clothing, medications, and personal items.
If you live on or near the coast where hurricanes are possible, then you should already have a plan in place in the event a hurricane or tropical storm threatens. Katrina was followed closely by Hurricane Rita, impacting Western Louisiana, and these storms collectively have become synonymous with systemic failure of disaster preparedness, response, and recovery policy. It also recognizes that strong, day-to-day systems, ranging from public health surveillance to a well-functioning trauma and emergency care system, are critical to disaster response.
Incident command systems are used not only by traditional first responders, but also by virtually every health department and a majority of hospitals in the country, improving coordination during disasters. The response to Superstorm Sandy, the largest natural disaster since Katrina, demonstrated progress and remaining gaps in this national response capability.
For example, fuel shortages and restricted transportation into New York City meant that critical health care facility generators couldn’t refuel and their personnel, including those who provided substantial amounts of home health care, could not get to work or reach their patients, thus causing many more people to require evacuation to hospitals and shelters. Many facilities lacked basic evacuation plans, redundant communications infrastructure, electronic medical records, or backup generators. The nation has invested significantly in public health and health care system preparedness and in strengthening these day-to-day systems through electronic health records, equipment such as generators and temporary hospitals, and through training and exercising, building resilience at the local, state, and federal levels.
The benefits of this broader community-based approach were evident during Superstorm Sandy, when hospitals were able to effectively implement their evacuation plans and safely transfer patients to other facilities while maintaining continuity of care. This shortcoming highlighted the need for sustained focus on community-wide disaster planning.
Following Hurricane Katrina, the Office of the National Coordinator for Health Information Technology stepped in to support the development of a makeshift electronic health record to provide pharmacy and other information for evacuated residents. Following the Sandy Hook shootings and the Boston Marathon bombings, HHS deployed mental health response teams to help affected communities along with first responders who, in the acute aftermath of the tragedy, provided services until the community could implement its own plans. The Distress Line often is publicized in communities affected by disasters, even those that do not require additional federal support. To sustain preparedness, both residents’ and responders’ behavioral health needs must be considered in community response and recovery plans.
Given the shift from hospital to home-based care, such real-time awareness of population-level needs, and the ability to respond to them, not just during disasters, but day to day, is critical. Federal funding for state and local health preparedness declined by 38 percent from 2005 to 2012 and has continued to do so, placing communities at risk. Health information technology systems, though significantly advanced in the past few years, must become fully interoperable to support a coordinated and effective response to a catastrophic disaster or emergency. This will require continual planning, sustained funding, and attention among all sectors of society — including individuals and communities, governments, non-governmental organizations, and the business community. In many New Orleans hospitals after Hurricane Katrina in 2005, floodwaters knocked out vulnerable backup power systems.
Most of the hospital's essential facilities, including its elevator banks and steam systems, are at sea level or below, she said.
As the high tide clock ticked down on Monday night for Staten Island University Hospital, tension spread through the North Shore-LIJ emergency command center, a vast room in a former warehouse near Syosset Hospital.
NYU Langone Hospital completed its evacuation on Tuesday afternoon, with some patients having spent more than 12 hours in a facility with little power.
Raising generators above flood level is just the first step in protecting a hospital's backup power. No one at a hospital had died in a storm-related incident as of Thursday morning, according to New York state health commissioner Dr. Several large screens projected television coverage and a spreadsheet of status reports and action items from the health system's hospitals.
There was a flurry of disaster response activity in the skies and on the ground in Alabama and Mississippi (two Katrina-devastated coastal states with Republican governors), but as soon as the two choppers passed into Louisiana (with a Democratic and a Democratic mayor of New Orleans) the pilots saw no disaster response activity on the ground or in the air.

Ceiling tiles creaked in the wind and television screens showed images of Hurricane Sandy slamming into New York City. Many of its staff members and doctors traveled with their patients to other hospitals, including sections of Long Island College Hospital and Maimonides Medical Center in Brooklyn. At the time of the flood he was a Program Coordinator in the Emergency Department.When the first floor of Mercy had to be evacuated, the hospital lost its access to diagnostic equipment, and the Emergency Department began diverting incoming patients to other hospitals. It happened in New Orleans after Hurricane Katrina, when hospital staff were on their own when electricity and water cut out.
And this afternoon, Bellevue Hospital in New York City said it is evacuating hundreds of patients because of failing power and deteriorating conditions.
Newly constructed hospitals are supposed to place their generators and fuel in adjacent locations above flood level.
Imagine if Sandy happened when the NYU medical center prepared and cooking the food for 5 NYC hospitals including NYU medical center, Mount Sanai Hospital, NYU hospital for joint diseases, NYU downtown and NYU queens located in Astoria. Your hospital should test its disaster plan at least twice a year, including at least one community-wide run through.
Working in the boiler industry, I see the lack of adequate fuel supplies at all the hotels and hospitals.
The problem with these at the hospitals is that they don’t take the systems seriously and then they crap out when they have an emergency.
When the forcefull flood of water entered the basement it made it’s way into the fuel pump room and tripped a safety feature meant to shut off the fuel pumps in case of a fuel spill. When New York City Mayor Michael Bloomberg last Thursday ordered nursing homes and hospitals in the city’s Zone A low-lying areas to evacuate by the following evening in anticipation of Hurricane Irene, facilities scrambled to action. Plan your escape route ahead of time and if you are forced by the weather or ordered by authorities to evacuate, exit along the planned route and go to the safe haven you have chosen. Basic capabilities that public health and medical care systems must have to be disaster ready are clearly articulated, and federal guidance and funding supports states and health care entities in achieving these capabilities.
Thus, when hospitals lost power during the storm, they were unable to evacuate patients, their medical equipment stopped working, they were cut off from emergency managers who might have been able to provide help, and they were unable to transfer important health information because their paper-based records were destroyed. Because of the extent of the damage and displacement of populations, the local health care system did require federal support; the National Disaster Medical System deployed teams and was operational within about four hours of the request for assistance. Funding from the HITECH Act subsequently offset the cost of adopting electronic health records in practice and supported community infrastructure to build information exchange platforms that can allow data to move with people, everyday and in disaster. By sustaining emergency preparedness and continuing to strengthen our health data system, we can continue to improve response and ensure continuity of care during disasters. It allows health departments to plan for population health needs, emergency managers to more effectively deploy resources where they are needed most, and community organizations to better understand potential needs and offer additional support.
Policymakers, like the public, seem to forget that disaster preparedness is critical, or subscribe to the view that preparedness can be ‘bought’ with a one-time purchase of equipment and supplies.
Doing so is vital to ensuring that all communities across the nation are prepared to respond to and recover from future public health disasters and fulfill our collective promise to never again repeat the chaos, disorder, and despair that followed Hurricane Katrina. NYU Langone and Coney Island ended up, of course, being the two New York City hospitals that experienced extensive power and backup generator system failures during the storm. Unverified reports arrived of widespread flooding on Staten Island, of drownings and rescues and people swimming to the hospital for help. Even if backup power systems ran for longer periods, at many hospitals, they are not designed to power critical hospital functions, particularly heat, air conditioning and ventilation. On Thursday morning, two days after the winds subsided, patients were still being moved out of Bellevue Hospital, which had 712 patients when the storm came, according to Shah. Floodwaters had already wiped out power at a data center serving Staten Island University Hospital, forcing the hospital to shut down its electronic recordkeeping system. Hospital patients at New Orleans hospitals were left to die, instead of helicopters from the offshore U.S.
Hospital wiring diagrams I've reviewed in Katrina hospital liability cases look like masses of spaghetti.
New York hospitals have had experiences with generator failures before and have seen the consequences firsthand.
A large fire in the community, a train derailment, a tornado that destroys several homes in town, a bioterrorism attack- these are all examples of external disasters that can bring a sudden influx of patients to your hospital. Your hospital should have alternate communication pathways available if the community’s infrastructure is damaged.
I founded a non profit named Be Ready Bear (copyright 2008) which uses a friendly cartoon bear to educate adults and children about disaster preparedness.
Chris Gilbride, press secretary at the New York City Office of Emergency Management (OEM), says close to 10,000 people were moved from healthcare facilities before and during Hurricane Irene. Check your emergency disaster kit, identify missing items, and replenish them if necessary. After a tornado struck Joplin, Missouri in 2011, medical personnel working out of a temporary mobile hospital accessed patients’ electronic health records using remote support, and then transferred those records upon the patients’ move to other facilities.
Monday, Eugene Tangney burst into a meeting of doctors at the command center for Long Island's North Shore-LIJ hospital system. Someone suggested that the National Guard might bring displaced residents of the island to the hospital. There is no dress rehearsal for the days-long outages that are likely to follow a severe disaster like a hurricane. In 1987, a 22-minute power failure led to the death of a 40-day-old infant at New York Hospital. Even with a disaster preparedness plan in place, frequent review of the plan is essential to ensure that it is properly carried out during times of emergency. Say is owner and CEO of SSCOR, Inc., a medical device manufacturer specializing in emergency battery operated portable suction devices for the hospital and pre-hospital settings. The American Health Care Association (AHCA) offers on its website a list of resources and educational materials to assist long-term care communities in disaster preparedness. Stay informed by listening to your NOAA radio and by visiting the National Hurricane Center website. Public Health Service teams responded in hours, rather than days, to requests for assistance.
Federally deployed teams, such as those of the National Disaster Medical System (NDMS), can be purposely amplified to include providers whose language skills match those of the affected population to enhance communication and better address their health care needs. And even as it became clear that a decision to shelter in place had come out very differently at NYU, Tangney was convinced his most vulnerable hospitals, now serving their devastated communities, had made the right decision to remain open. Often the case is that professional planners have their hands tied and recommendations overruled. A decade before that Bellevue Hospital lost all power during the massive New York City blackout in 1977. Your plan should specify how your hospital will be notified of an external disaster and how this will be communicated internally throughout the hospital. MJHS had earlier worked with NYC’s OEM and the Greater New York Hospital Association to put an emergency plan in place. The 25-story hospital was on partial backup power without working elevators, its basement flooded along with many hospital supplies. During another New York City-wide blackout in 2003, an official report later said, "Despite prior testing according to applicable State and accreditation standards, [some] generators malfunctioned, experiencing, for example, problems with switches and overheating.
Have a documented inventory of supplies that would be needed if an external disaster should occur. It is important to understand the tropical storm and hurricane hazards and how they can affect your home. However, Shah said on Thursday morning that staffing at area hospitals was now back up to normal levels and there was again a cushion of extra space in the system.
Back at NYU, a hospital trustee, Gary Cohn, said that the board knew the facilities' generators were outdated and at risk, according to Bloomberg Businessweek. If your hospital does not have enough local inventory, make certain to have agreements in place with community, state and federal resources. And it is certainly worth it for everyone who might rely on a hospital in a flood zone across the country to look at whether their facility has similar vulnerabilities. Many hospitals were built years ago to different building codes and then expanded with additions, North Shore-LIJ President and CEO Michael J.

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