By Attila J. Hertelendy, PhD
In South Florida, hurricanes aren’t a matter of if, but when. For healthcare facilities, comprehensive preparation can mean the difference between continuing critical care operations and catastrophic failure. As we face the 2025 hurricane season with recent changes in FEMA leadership that may impact resource availability, hospitals must emphasize self-reliance and resilience more than ever before.
The traditional hurricane preparation checklist—securing supplies, testing generators, and reviewing evacuation plans represents only the starting point of true preparedness. The reality is that hospitals rarely face singular challenges during disasters.
The most dangerous mindset in emergency preparedness is assuming you’ll only deal with one crisis at a time. Hurricane Milton in 2024 is a recent example where unprecedented tornado activity impacted several communities across Florida. This complexity necessitates functional exercises that simulate multiple concurrent events a practice too often overlooked in favor of simpler tabletop drills.
While tabletop exercises have value for initial planning, functional exercises provide the robust testing that hospital systems require. These exercises involve actual response activities where personnel perform their emergency response functions in a simulated environment. For South Florida hospitals, functional exercises should include scenarios such as:
- Complete power loss coinciding with generator failure during patient surge
- IT system compromise occurring during evacuation operations
- Staff shortages combined with supply chain disruption and facility damage
- Communication system failures while managing critical care patients
These exercises must involve all departments, from clinical staff to facilities management, security, and administration working together under realistic pressure. Several studies have identified the importance of CEOs being actively involved in these drills in order to improve organizational resilience.
The key to valuable functional exercises lies in their design and execution. When designing your exercises either internally or hiring an external consultant, consider the following:
- Create realistic scenarios based on historical hurricane impacts specific to Florida.
- Introduce unexpected complications midway through exercises (it’s very important to simulate multiple incidents occurring simultaneously) such as a cyberattack or mass casualty incident occurring at the same time a hurricane is making landfall.
- Deliberately restrict resources to force innovation and alternative procedures.
- Include actual equipment deployment and physical tasks.
- Rotate leadership positions to build depth in emergency response capabilities and redundancy.
Most importantly, establish a structured after-action review process that leads to concrete protocol improvements. Document these improvements and ensure they become standard operating procedure before the next hurricane season.
With recent changes in FEMA leadership this hurricane season potentially impacting funding streams and resource distribution, hospitals must develop enhanced self-reliance capabilities. Self-reliance begins with hard questions: Can your facility maintain operations for 7-10 days without external support? Have you established redundant communication methods? Are critical supplies stockpiled beyond minimum requirements? This self-reliance extends to staff preparedness. Hospitals should establish comprehensive personal preparedness programs for all employees, ensuring they can report to work while knowing their families are secure. Hospital resilience also depends on integration with community resources. Establish memoranda of understanding with nearby facilities for patient transfers, resource sharing, and staff support. Create relationships with local suppliers who can prioritize hospital needs during recovery. Work with municipal emergency management to ensure your facility’s needs are understood before disaster strikes. As FEMA undergoes leadership transitions, local coordination becomes increasingly vital. Infrastructure improvements represent a critical investment in hurricane resilience. Modern building standards, redundant power systems, and water management solutions can dramatically improve a facility’s ability to maintain operations. Consider technological solutions that enhance disaster response such as:
- Implement remote monitoring for critical systems.
- Deploy portable medical technology that functions during infrastructure disruptions.
- Establish satellite communication backups.
- Utilize predictive analytics for resource management during extended events.
As Florida hospitals prepare for the 2025 hurricane season amid FEMA leadership transitions, prioritizing functional exercises and self-reliance will distinguish those facilities that merely survive hurricanes from those that continue providing essential care throughout disasters. True preparedness isn’t demonstrated during planning meetings, it emerges during the chaos of actual emergencies when multiple systems are stressed simultaneously.
Dr. Attila J. Hertelendy, CEO, Great White Emergency Medical Solutions, LLC, can be reached at ceo@greatwhiteems.com.