How a hospital is prepped for the worst

Like city officials, MD Anderson’s Incident Command team began preparing for Hurricane Harvey long before it hit the Texas coast.

Extensive emergency planning, collaboration and a strong commitment to patients, were crucial to the cancer center maintaining operations during the unprecedented event.

Matthew Berkheiser, Dr.PH, chief safety officer and associate vice president for Environmental Health, Safety and Corporate Services, says the institution has a plan for responding to many emergencies.

“We actually have 18 incident-specific emergency plans that account for bad weather, fires, acts of violence and more,” Berkheiser says, “and teams of people who monitor various dangers so we can activate our plans as soon as a threat is imminent.”

When that time comes, MD Anderson opens its Incident Command Center (ICC), as it did for Hurricane Harvey on Aug. 23. The ICC is led by an appointed incident commander, who is accountable for final decision-making. Other ICC leaders who represented key areas focused on patient safety and experience, staffing, security and maintenance of all campuses, and coordinated operations and communications during the emergency. 

While it may seem counterintuitive, the goal is to have as few people as possible on-site during an emergency. This reduces risk, cost and strain on already limited resources such as food and water. That’s why providers were encouraged to discharge hospital patients, if clinically appropriate, ahead of Harvey. At the same time, staff members in critical areas were asked to report to work with an overnight bag in tow – just in case. 

Typically, the biggest threats in a hurricane are damaging winds and power outages. But Harvey was different. Because it made landfall south of Houston, winds weren’t as bad as they could’ve been. 

“The danger in this event was really the rainfall,” Berkheiser explains. “This was the first time MD Anderson activated a ride-out team for a flooding event and the first time we’ve formally designated staff already on-site as incident command and ride-out team members.” 

As heavy flooding turned streets into rivers, the ICC closed the institution due to unsafe travel conditions. The 1,000 faculty and staff on-site became the ride-out team, caring for more than 500 patients in the hospital and about 300 guests who were family and friends of patients. 

“By Monday morning, roads near the hospital were passable but our people couldn’t leave their homes,” Berkheiser says. “So we had to get creative.” He says he’s grateful to UT Police for bringing in critical clinical care providers in high-water vehicles. (Read UTPD served and protected by bringing in crucial supplies, staff and blood donations)

ICC leaders communicated frequently on-site, and via conference call, to evaluate weather conditions, operations and resources. Managers and clinical teams making local-level staffing and operational decisions shared information with their leaders who updated the ICC.

From Facilities, Dining Services, the Welcome Center and UT Police, to clinical care providers, pharmacists and lab technologists, employees aligned around shared ride-out and recovery goals and stepped up to help. They sacrificed sleep to cover an extra shift or floated between inpatient units to make sure every patient was safe. 

“Sometimes it’s hard to explain the bond an emergency can create,” Berkheiser says. “An effective response requires a solid plan, adrenaline, innovation and trust that everyone is working toward the same goals and making the best possible decisions, given the information they have in that moment.”