Dr. Campbell indicates that the Red Cross shelters needed more trained medical personnel, although they had ample donations of medication from doctors’ offices in the form of samples, and from hospitals and pharmacies. They did not have a pharmacist, however, and he relied on his dual training to provide some of the services that Dr. Smith in Galveston also identified. He was saddened by the devastation. He visited the Superdome and indicates that the debris and human waste told a sad and shocking story.
Patient Satisfaction
Sixty-year-old patient Emelda Zar evacuated from LaFitte, La., before Hurricane Katrina. She landed in a crowded but hospitable shelter in Jackson, Miss. Some days later, her daughter called an ambulance as Zar’s health deteriorated. She was admitted to St. Dominic-Jackson Memorial Hospital and diagnosed with heart failure.
Recently discharged and about to relocate to an apartment and planning to remain in Jackson, she and her grandchildren have nothing but good things to say about the hospital and, in particular, the hospitalists who provided care.
She arrived with no medical records and a serious health problem. Her hospitalists listened and created a care plan. She left the hospital with not only a clear idea of what she needs to do, but with a scheduled follow-up appointment in the community. Like so many of the people we heard about from healthcare providers, she remains upbeat and optimistic.
Progress Notes
Shortly after Dr. Smith and Dr. Weaver were interviewed in Galveston, the news was full of a new threat: Rita. This time, the hurricane’s target was a few hundred miles west of Katrina’s path. Karen Sexton, RN, PhD, vice president and chief executive officer of Hospitals and Clinics for UTMB shared the story of how Katrina changed their response.
During routine monitoring they saw tropical depression #18 develop on Sunday to the point that it was named Rita on Monday, and began to look like trouble for Galveston. By Tuesday, the city mayor had declared a voluntary evacuation, applying one lesson from Katrina: Residents could take their pets in government evacuation vehicles. The university went on emergency status. UTMB looked at decreasing their activity and reducing the hospital census. They sent the students home.
Tuesday night, their hospitalist service and other key physicians wrote transfer summaries for all patients, beginning with those who were gravely ill. This was a change of policy based on their experience with Katrina. They chose to move critically ill patients while they had the greatest control. The pharmacy prepared medication for all patients, and parts of medical records deemed most important were copied.
Wednesday dawned, and it was clear: Rita was coming in as a level 4 or 5 hurricane. For the first time in 114 years of existence, UTMB evacuated under Dr. Sexton’s direction as the incident commander. Using resources sent in part by the governor, their team discharged and evacuated 427 patients in 12 hours.
“We were all a little teary eyed when the first patient left,” says Dr. Sexton. “We knew we had never evacuated before and we knew were making history.”
Key to the success of UTMB’s evacuation were checklists on the units and at two evacuation stations. This, too, was something they learned from Katrina: Track patient disposition and send as much information as possible. With the goal of improving patient safety, UTMB recently started training staff on an aviation model that mimics what the aviation industry does to ensure safety.
They tracked what went with the patient, where the patient went, and that family notifications were done. The staff’s increased awareness and use of checklists were key components for a successful evacuation. No patients were “lost.” As the last patient left, Dr. Sexton found herself with a hospital staffed to support 500 to 700 patients, no patients, and the realization that staff also needed to evacuate but might not be able to navigate the exodus traffic.