Lessons learned from past storms left many Houston-area hospitals relatively unscathed during Hurricane Harvey, according to an article in the November/December issue of the National Fire Protection Association's (NFPA) NFPA Journal. One large Houston health system discussed in the article evacuated only one of its 17 hospitals during the storm, the article said. That single hospital's move was “proactive and precautionary," with all 75 of its patients moved safely to another of the system's facilities a few miles away. The response to Harvey stood in stark contrast to the response to Tropical Storm Allison in 2001, during which nearly half of the $5 billion in damage to the Houston area occurred at a medical complex of research facilities, hospitals, and other healthcare facilities, the article said. After Allison, one Houston health system put in extensive building “hardening" to prevent floodwater from entering the facility, moved generators to higher ground, and sealed off underground tunnels. Another hospital, which had seen flooding in its basements and tunnels during Allison, sealed off its tunnels with concrete and poured concrete around the bases of its buildings, as well as moving critical electrical systems to higher ground and investing in “the most advanced roofing technologies available," the article said. Loss of power is, of course, one of the greatest threats to patient safety during a hurricane. A Houston hospital used NFPA 100 and NFPA 111, which deal with backup systems such as generators, as a guide to make sure its emergency power distribution was “as robust as possible," the article said. This meant more than just moving generators out of the basement and onto a higher floor, the article said; it also meant paralleling generators, focusing on fuel systems, and rigorously testing them. The response to Hurricane Harvey also contrasted that of Hurricane Irma, which struck Florida and the Caribbean a week later. More than 12 residents died at a Florida nursing home for heat-related reasons in the storm's aftermath, the article said. NFPA's emergency power requirements do not address air conditioning, the article said, but Florida has announced a new rule that will require nursing homes and assisted living facilities to have generators capable of keeping air conditioning on for at least 96 hours, the article said.

HRC Recommends: Healthcare facilities must have robust plans in place for weather-related and other natural disasters. Planning, training, and providing resources for disaster management are critical to a healthcare facility's preparedness, response, and recovery efforts. Risk managers should take heed of lessons learned from successful emergency management programs in facilities affected by hurricanes and other natural disasters and remain aware of available resources and assets, including resources from federal, state, and local governments.