Responding to Harvey: How a Houston-area Healthcare Coalition Modeled Success
Author: Dan Hanfling, Special Advisor, Hospital Preparedness Program, Office of the Assistant Secretary for Preparedness and Response
Category: Public Health Preparedness; Hospital Preparedness;
On Aug. 27, 2017, at the height of Hurricane Harvey's catastrophic winds and rain, a 54-year-old man with a serious head injury arrived at the Harris Health System's Lyndon B. Johnson (LBJ) Hospital Emergency Department in Houston, Texas. As a Level III trauma center, the hospital needed additional personnel and resources to treat the man; he needed to be transported to a Level I trauma center for neurosurgery.
Hospital officials asked for transport assistance, but the weather conditions were so severe that roads were impassable and helicopter transports were grounded. A colorectal surgeon at LBJ eventually performed the necessary emergency surgery to save the patient's life, but he still needed care and monitoring in a Level I center.
Fortunately, LBJ Hospital is part of the South East Texas Regional Advisory Council, or SETRAC, a Houston-area healthcare coalition that fosters partnerships and planning between hospitals, public health agencies, emergency medical services, and community- and faith-based organizations. The coalition's Catastrophic Medical Operations Center, or CMOC, contacted the U.S. Coast Guard to coordinate patient transport, and shortly after surgery the patient was transferred to a Level I center where he received the ongoing care he needed.
This sort of coordinated coalition response was one of many during the 17-day disaster event.
SETRAC serves as a model for building and maintaining a successful healthcare coalition and using it in disaster response. Crucial to its success were resources provided by the Hospital Preparedness Program, or HPP. HPP provides federal funding, guidance, and technical assistance to promote healthcare system preparedness and response. The program is managed by the Office of the Assistant Secretary for Preparedness and Response (ASPR) and brings together key players in healthcare and emergency response disciplines to prepare for, respond to, and recover from large-scale disasters. The program also provides healthcare coalitions with technical assistance through ASPR TRACIE and regionally-based field project officers, and supports trainings and exercises that help prepare coalition members to handle real emergencies.
HPP promotes the development and maturation of healthcare coalitions and drives discussion around response capabilities. Response is the yardstick by which a healthcare coalition's success is measured.
According to SETRAC's Director of Preparedness Lori Upton, RN, BSN, MS, CEM, the coalition's Catastrophic Medical Operations Center mediated the coalition's successful response. CMOC operated as a single coordinating entity during the disaster – an important function of effective healthcare coalitions – by overseeing information management, brokering requests for assistance and supplies, coordinating patient movement, and providing situational awareness across emergency response disciplines.
Although the CMOC had been activated previously during localized flooding and for major public events such as the Super Bowl, Hurricane Harvey was different: the storm delivered more than five feet of rain in just two days and caused epic flooding in the region.
Regular communication between the CMOC, the coalition's partners, the U.S. Department of Health and Human Services, and the military provided a means to share crucial information about coalition status, weather reports, partner needs, and patient movements. During the disaster, the CMOC coordinated a wide range of activities, including:
The coalition also participated in efforts to ensure that dialysis patients who were trapped in their homes or relocated to evacuation centers could continue to receive treatment.
When measured in terms of saved lives and reduced suffering, SETRAC's response to Hurricane Harvey was a clear success. Fundamental to that success was the coalition's relationship with HPP. "We use HPP as a foundation to identify gaps in preparedness and determine funding priorities," says Upton. "HPP has allowed us to move concepts into realities."
For more information about how SETRAC's Catastrophic Medical Operations Center works, check out this Q & A with Lori Upton.
If HPP has helped your community respond to a disaster, share your story!
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