As Hurricane Sandy loomed, hospitals in its path prepared for potential power outages and disruptions in communication that could impact care as well as the safety of both patients and staff.
"We did everything we could to keep the staff, patients and community informed," said Terry Lynam, vice president of public relations, North Shore-LIJ Health System, headquartered in Great Neck, NY. "We communicated through every means possible to ensure there were minimal interruptions to patient care."
Through teamwork and a variety of communication tools, impacted facilities maintained contact with staff, patients and the public despite overwhelming conditions.
Incident command centers were activated, which streamlined communication between departments and the public. For North Shore-LIJ Health System, which encompasses 16 hospitals and employs more than 44,000 people, centralized communication was imperative.
"Our centralized emergency operation system was activated the Friday before the storm," said Lynam. "Each facility in our health system has a command center, which allowed us to maintain communication at every location."
All but two of North Shore-LIJ's facilities relied on generators at some point during and after the storm. Leadership used the command centers to make the necessary arrangements to ensure every location remained operational. All departments were represented, guaranteeing every aspect of care was provided for.
"Whether it was a staffing issue or generator maintenance, we were ready to facilitate assistance," added Lynam. "The corporate command center was located in our Center for Emergency Medical Services, which houses 100 ambulances.
"We were ready to dispatch emergency vehicles at a moment's notice, which allowed us to supply our facilities with whatever they needed to continue caring for our patients and the patients arriving from other facilities."
For Hoboken University Medical Center, Hoboken, NJ, the command center was vital when faced with severe flooding.
"The entire first floor of the hospital was flooded, and the hospital was surrounded by water, approximately 4 to 5 feet in depth," said Ellen Refowitz, MSN, RN, NEA-BC, senior vice president of patient services/CNO at Hoboken.
"Assessment, planning, logistics, and staffing needs were addressed through the command center," she added. "We always had a nurse or physician available to talk with patients who called so they could be appropriately directed for help or have their questions answered."
Command centers utilized a variety of communication tools to guarantee no one was left unaware. Traditional methods including emails, phone calls and text alerts were used, as well as staff meetings.
"We had meetings every couple of hours with our entire staff at every site to keep them apprised of not only what was going on within the facility, but also what was happening beyond hospital walls," said Rich Hader, PhD, RN, senior vice president of nursing, Meridian Health, a five-hospital health system spanning from northern Monmouth County to southern Ocean County in New Jersey.
"Leadership did not remain confined to the command centers," he added. "They were on floor, visiting the units, communicating with staff, patients and their families."
Telephone system failure, unreliable cell service, and brief interruptions to the emergency phone lines made face to face communication instrumental at Hoboken.
"Communication for staff in the hospital was conducted via meetings for department heads and rounds," said Refowitz. "We had IT and telephone expertise on site at all times, and they were able to help restore service fairly quickly."
At North Shore-LIJ, primary communication outlets included email, Facebook, Twitter, the employee blog and intranet. Twice-a-day conference calls also occurred between the corporate command center and facilities.
"Through our command center we were able to not only maintain communication with our staff, but also with the outside world," stressed Lynam. "We were using a mix of written messages, videos and photos throughout the course of the storm."
However, for some hospitals, traditional means were not an option when power failed and systems shut down.
For those left with no power or overloaded systems, leadership sought creative solutions to communicate effectively with their staff, patients and the community. When email failed at Meridian Health, social media, 2-way radios and website postings became the go-to resource.
"Social media was our saving grace," emphasized Hader. "Despite everything, cell phones continued to work and so we began to use social networks to send important messages."
"We had to learn new ways to communicate and stay in touch with our staff, patients and community," he added. "As time progressed our comfort level grew, which allowed us to provide and receive a constant stream of information, even in the face of such extensive power loss."
To communicate via social networks, mobile devices had to stay charged and so Meridian began to care for not only their community's loved ones, but also their cell phones.
"They were our new patients," said Hader. "People were coming in to charge their phones, iPads, etc. We set up power strips in our lobbies and waiting rooms so communication could continue."
"Care goes far beyond the patient room," he added. "We had well over 1,000 patients and their families relying on us, so it was important for us to meet as many of their needs as possible. The more we could give to the patients, the better off everyone was."
As facilities deal with the aftermath of Sandy, changes and additions to emergency communication protocols are being considered.
Hoboken is developing a reverse 911 system to expand their reach. "It will increase our ability to communicate critical information to more people, including attending physicians, and lessen the need for people to call the command center or hospital," said Refowitz.
In addition, the facility recognized the need for additional phone lines in the command center and a hotline with frequent updates for staff and patients.
Teamwork and open communication helped facilities cope with the destruction of Sandy and it will be the guiding force behind improvements to future disaster preparedness plans.
Constant communication was vital before, during and after the super storm not only for patient care, but also the community at large. Facility leaders did all they could to maintain it with the help of fellow healthcare professionals, the public and media outlets.
"As bad as it was, there was never a sense of panic," said Hader. "Everyone pulled together; the bureaucracy disappeared. People simply wanted to make a difference and make sure everyone knew what was going on so the proper assistance could be given."
A combination of teamwork and technology made it possible for facilities throughout the region to not only weather the storm, but also provide exceptional patient care in spite of it.
"We worked together and were able to communicate within our system and outside of it, so that anyone who asked for help received it," concluded Lynam. "We remained connected even during the most devastating moments and now as we begin to rebuild that connection will only strengthen."
Catlin Nalley is assistant editor at ADVANCE.