Background: Situated in coastal Florida, the four hospitals/1,000 beds in the Health First Integrated delivery network are located right in hurricane alley. Our hospitalist program had to plan for, communicate, and execute our hurricane staffing and disaster plan twice in one year.
Purpose: Lessons learned from the implementation of our Hospitalist staffing and disaster plan may help other hospitalist programs effectively respond to disasters which threaten patient care.
Description: We developed a four phase hurricane plan to address the challenges faced pre, during and post hurricane landfall. Annually- Hospitalists sign an exemption form, indicating an exemption or that they will fully participate in our hurricane staffing and disaster plan. An exemption is approved for extraordinary circumstances. Those not claiming exemption sign the document attesting to their availability. A table top exercise is run, roles and expectations discussed at staff meetings along with compensation during hurricane lockdown and consequences associated with policies.
Phase I – Hurricane conditions 1-2 days away: On-week Hospitalists working during probable landfall confirm shift assignments. Off week hospitalists asked to evacuate only as far as necessary in order to fulfill post storm duties.
2x daily informational huddle meetings attended by all hospitalists (On and Off- week). Huddles have call in option and roll is taken. Brief information (bullets) shared post call.
A staffing grid is published/updated daily.
Phase II – Hurricane conditions 1 day away: Off-week Hospitalists notified to report to their respective facility for 4 hours, allowing on-week providers time to secure their homes and families.
Phase III- During storm (Lockdown)- As heavy winds begin, our county government closes roads. Facilities move to lockdown procedures, not allowing anyone to leave.
Hospitalists scheduled to work during lockdown asked to bring provisions (sleeping bag, clothes, food water) for themselves. Respite/sleeping areas for Hospitalists created and a schedule posted, noting where each physician was sleeping during lockdown. Respite for Hospitalist family members created in each of our hospitals.
Hospitalists given instructions and materials for EMR downtime procedures.
A few local physicians did not participate in lockdown (not in house during hurricane). Coverage for these physician’s patients reverted to our hospitalists.
Phase IV: Post storm Recovery: Off-week Hospitalists notified of post storm recovery roles in Phase I. Included are On week Hospitalists with signed exemption.
A recovery team schedule for off week and exempt hospitalists was created with handoff assignments. Recovery team hospitalists came into the hospitals (post lockdown) for assigned hours to relive locked down hospitalists.
Conclusions: A well formulated, communicated and reinforced disaster plan is vital to any hospitalist program. Preparing on week and off week providers for their responsibilities, developing a communication strategy and sequencing the tasks to prepare a hospitalist team will yield enormous benefits for your hospital and community you serve.