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Hurricane Dorian: A Collaborative Effort Among Clinicians

In the wake of Hurricane Dorian, we spoke with Dr. Ruby Sahoo, TeamHealth regional performance director at Grand Strand Medical Center in Myrtle Beach, South Carolina, to learn more about her team’s response to this major storm.

Can you talk about what you and your team at Grand Strand Medical Center experienced during Hurricane Dorian?

Dr. Sahoo:  Being in Myrtle Beach, South Carolina, we’ve weathered hurricanes before, but it seems that, in the past couple of years, we’ve had a higher number of storms and the severity of the storms is increasing. In 2018, we had the first-ever evacuation of our entire hospital for Hurricane Florence, which was memorable, to say the least. When we heard Hurricane Dorian was coming toward Myrtle Beach, South Carolina in September of this year, we felt that uncertainty all over again.

From a clinician standpoint, our responsibility is to work every day to help others. Then a storm like this puts us in a situation where we have to figure out how to help our families, loved ones, and neighbors, while at the same time as performing the duties of our job and helping those in the hospital. It becomes a cascading responsibility, and a stressful event overall, just because there’s so much unpredictability with this type of situation.

I really want to highlight the efforts of every single person on the team here at Grand Strand Medical Center because it was everyone’s effort collectively that made the entire operation such a success. There was no lapse in patient care because everything was very well organized. It really just came down to making sure everyone felt supported as we worked together as a team, which is exactly what we did.

You mentioned the evacuations due to hurricanes last year. Can you speak to what goes into to evacuating a hospital and how you continue to take care of those patients when you’re moving them?

Dr. Sahoo: When we evacuated last year that was a game-changer. As physicians and APCs, our responsibility is always, to our patients. So, we, if we’re scheduled to work during that time, even if the hurricane’s coming at us, we’re there. We want to make sure that we’re taking care of the patients. As the director of the hospitalist group, my advice, and guidance to our team was always we’ve gone through this before; we’ll get through this one, too.

I literally would break it down in an email and put flyers up so everyone was aware of the plan. We may be in a mandatory evacuation area, but our hospital will typically apply for an exemption from that evacuation, which the governor usually grants because Grand Stand in a critical area that we need to provide services to anyone that is remaining. It’s not the entire area we service that’s evacuated, so there are people that will remain, and we need to provide services to those people. We’re so close to the ocean that we’re almost always in an evacuation zone. We know what we need to do. We need to physically be at the hospital. I tell everyone to bring blankets, sleeping bags, cards, and we’ll just camp out at the hospital if the weather’s too bad to go to the hotel across the street, and always be prepared for the worst-case scenario.

From facility to leadership level, we knew that we were likely going to go on generator power at some point, and then intubated and ventilated patients take priority. If there’s no electricity, we know what we need to do for the patients to still get the care that they need. Once it gets to a certain level where the hospital can no longer provide services, then we have an evacuation process. Last year was the first year that happened. Once the decision was made to evacuate last year, we had already discharged everyone that was medically stable. We didn’t want any loss of life. There were tons of ambulances lined up at the front door ready to take patients to other facilities inland. They had what looked like charter busses, but with three stretchers along the walls to evacuate everyone in time. It was pretty dramatic. From the physician’s side, we had to give a report to over 100 physicians nationwide where our patients were going to get them out safely.

For Hurricane Dorian, you didn’t end up having to evacuate, correct?

Dr. Sahoo: That’s correct. We were prepared in case that needed to happen, but we ended up not having to evacuate. We did transfer some patients out and tried to reduce our chances, but we all stayed at the hospital.

Approximately how many clinicians and team members are you working with to get these communications out and to monitor the storm?

Dr. Sahoo: Our work team consists of over 50 physicians and APCs. What we were doing was prioritize calling the physicians and APCs that were working during that time during the hurricane to make sure that they had a safe way to get to the hospital, or check to see if needed a hotel room and coordinated a way to make sure that everyone got the information. Not everyone checks their email as obsessively as others do, so I wanted to make sure everyone got any important communications going out.

That sounds like a huge effort as you and your team monitored the storm, I’m sure there was a sense of relief when it maybe died down in strength and you didn’t have to evacuate.

Dr. Sahoo: Absolutely. Until I went through it myself, I didn’t realize how much we, as hospitalist physicians and APCs, had to think about in a situation like this. I gave advice to the clinicians in our group that the first step is to get your family evacuated and get your own personal things secure. If we know the storm is coming 72 hours from now, get your family out of the town or make appropriate hurricane preparations. The hardest thing when you’re working at the hospital and having to take care of others is not knowing if there’s a storm leveling your house or if your family is safe. That’s the concern that every clinician is thinking about.

From an organizational standpoint, what we do is run down a checklist. In case of a hurricane, do this first, do that second, and so on. Starting weeks out from hurricane season, we look at the South Carolina hurricane preparation guide. Get to know the evacuation routes. Know where there are pet shelters if you have pets you don’t want to leave your dog or cat at home. It’s basic family emergency planning, but so many things that you have to think about before you even get to the hospital for your shift.

It sounds like you’ve been through several hurricanes. How long have you been at Grand Strand Medical Center?

Dr. Sahoo: I started at Grand Strand in 2013. First as a hospitalist, then moved up to assistant medical director, and then became the medical director. This fall I became a regional performance director.

Is there a way TeamHealth has helped you from an organizational, resource level?

Dr. Sahoo: We’ve always had a tremendous amount of support from TeamHealth. My biggest request has always been if we can make sure to contact every one and confirm they have a safe place to go during these storms. To make sure they are aware that this is the time the hospital’s evacuating; we don’t know when we’re going to reopen; if we do need to reopen, to let us know if you can’t make it in for your shift. It was a lot to coordinate calling every clinician individually, so TeamHealth was able to help immensely with providing that support.

We did that same thing this year, where we had an emergency contact list in advance to know if you do need to evacuate where you planned to go and how we can contact you. We want to make sure they’re safe first and foremost.

TeamHealth individually called people and made sure everyone arrived safely at their destination, because of flooding after the storm last year, and they helped get people back from airports, which was incredible. The way TeamHealth goes above and beyond to care not only for the safety of their patients but also their clinicians helped to reassure during Hurricane Dorian, that people come first.

At TeamHealth, we know hospitals must always be prepared to respond at a moment’s notice to powerful stormshurricanes, tornadoes, mass casualty events and other potential disasters. Read our blog on disaster preparedness strategies to see how TeamHealth can help ensure your hospital ready to manage the unexpected.