January 06, 2015 | | Comments 0
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Now that Superstorm Sandy has taken on the rosy hue of nostalgia…you mean it hasn’t?!?

By now I’m sure you’ve seen information regarding the CMS report that weighs in on hospital response during Superstorm Sandy and the challenges faced by hospitals during that October 2012 event.

Now, some of the media reports covering this particular issuance from CMS have painted kind of a bleak picture, but I don’t know if that is strictly the case. Certainly, there were, and likely will continue to be, challenges relating to response to any emergencies, but in looking at the data contained in the report, I ultimately can’t help but think the response efforts on the part of the hospitals in the New York metropolitan area and adjacent areas were pretty darn good.

Again, some of the coverage seems to highlight the 89% of hospitals that “reported experiencing critical challenges during Sandy, such as breakdowns in infrastructure and community collaboration” and equate “experiencing critical challenges” with “not being prepared.” Now I will freely admit that I have not exercised operational responsibilities in a hospital for about 13 or so years, but my recollection about such things is that one of the things that makes emergencies, like, emergencies, is that you experience critical challenges that could include breakdowns in infrastructure, etc. For me, the most important nuggets that are presented in the report are that:

  • Only 7% of the hospitals involved had to fully or partially evacuate (and yes, I do indeed recognize that evacuation is an entirely acceptable and appropriate response if the conditions dictate)
  • Only one hospital indicated that its emergency plan was not useful
  • No patient perished as the result of a hospital’s inability to appropriately respond to the disaster

Of course, there were a number of instances of flooding out of infrastructure components and some challenges relating to the whole idea of clinical folks not being able to use powered equipment to deliver IV fluids, etc., (I think it’s probably a good idea to look at those pesky clinical interventions in the case of utility systems or medical equipment failures; something tells me that this might become a wee bit more of a focus during your next TJC visit), but I will direct you back to #3. To me, this means that there was definitely some rough sledding as Sandy came and went, but the folks on the ground were able to keep things together, which is a pretty good measure of preparedness. If nothing happens, how do you know for sure you really were prepared?

Again, if you haven’t had a chance to read through the report, it’s a pretty interesting read (even for the Feds) and I think that some of the stories regarding somewhat rocky interactions with the community might sound at least a little familiar to folks. As with any emergency, there are lessons to be learned and there is much in this report to think on for just about everyone involved with hospital emergency management.

But perhaps the most instructive thing of all is the “tenor” of the conclusion and recommendations section, which doesn’t really point any fingers at the hospitals involved in responding to Sandy. Sure, there are some rather generic references to findings during previous Joint Commission surveys that could have had an impact on response capabilities, but to me it appears nothing more than a classic case of post hoc ergo propter hoc (for those of you not “down” with Latin, that translates roughly as “after this, therefore because of this”). They really don’t seem to be able to tie any survey findings to what happened, but I guess they have to tie the survey process in somehow—such is life.

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Filed Under: CMSEmergency managementHospital safetyThe Joint Commission

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Steve MacArthur About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Briefings on Hospital Safety. Contact Steve at stevemacsafetyspace@gmail.com.

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