As the Department of Veterans Affairs Medical Center, West Palm Beach enters the 2009 Hurricane Season, a number of initiatives either have begun or have been completed. The hardening of healthcare facilities to withstand a major hurricane such as Hurricane Katrina through mitigation measures to equal or exceed the Miami-Dade code standards is strongly recommended by emergency management officials and insurance industry entities. The mitigation goal should be to reduce the damage for any particular healthcare facility and thereby improve the odds for facility survival and patient safety. Over the past few years since the infamous ’04 and ’05 hurricane seasons, the Medical Center has completed numerous mitigation projects such as ensuring electrical power through the installation of emergency generators, special sealants applied around windows to control water intrusion, anchoring vents and roof piping systems, installation of a new membrane for the roof, and construction of a half million gallon potable water tower.

In preparation for this upcoming hurricane season, the Medical Center has been planning for increasing surge capacity and capability. The Safety Office has conducted psychological support planning for the purpose of addressing mental health issues that may arise as a result of a disaster. We also tested our Emergency Operations Plan in conjunction with the Palm Beach County Healthcare Emergency Response Coalition (HERC) on several occasions to manage a severe weather event, pre-event critical care patient evacuation as may be necessary, maintenance of care for at-risk patients, preparation for a surge of patients, and fatality management. This involved activating emergency management plans and developing public information messages consistent with local authorities and other healthcare providers in a rapid and timely manner for internal (current patients, staff, volunteers, physicians, visitors) and external dissemination (media, others).

The HERC exercises promoted in-depth examinations of Medical Center emergency plans. As a result of “Drilling to Failure”, one identified weakness is that transportation systems state-wide would be stressed to handle the anticipated patient evacuation load. This particular weakness has been identified by emergency planners as a result of the evacuation experiences during the hurricane seasons of 2004, 2005, and 2008. Hospitals may have to remain occupied during a disaster as a consequence. Identified strengths include (1) strong communications and support with the Palm Beach County Emergency Operations Center, and (2) excellent coordination and cooperation with other Palm Beach County hospitals in issues relating to disaster readiness and response, pre-event planning, and effective communication between hospital incident command centers.

In addition to hiring a new full time Emergency Preparedness Coordinator, the Medical Center has implemented an automated internal emergency notification system. This technology upgrade enables the rapid notification of facility staff with either content-triggered alerts based on a variety of facility-determined information, or emergency alerts in a crisis situation. The content-triggered alerts can be automatically programmed into the system to activate for such issues as communications failures, facility force mobilizations, IT alerts, and product recalls. Emergency Alerts can be manually triggered for business continuity issues, crisis operations, and security alarms. This alerting system will save the facility on notification time and ensure instant communication within and outside of the facility.

Future plans of the Medical Center include pursuing the development of alternative care sites when our main facility and/or our Community Based Outpatient Clinics’ offices are closed due to damage or loss of communications. Alternate sites for patients to receive primary care must be established as a staging site for evacuation out of the area or as a source of primary care after a disaster.