HJNO Nov/Dec 2021

STORM SURGE 16 NOV / DEC 2021 I  HEALTHCARE JOURNAL OF NEW ORLEANS   rooms if their houses are damaged. We’re doing all those things for our employees, so we can keep everything running and catch up to provide healthcare for our patients. Elder Ida likely contributed to additional delays in some routine procedures and appointments, but LCMC Health worked in the recovery phase to reschedule patients as needed. The decrease in COVID-19 inpa- tients post Ida allowed for us to resume out- patient procedures that had been delayed due to the August surge in COVID-19 patients. Torcson Yes. Anecdotally, here at St. Tam- many Health Systemwe are seeing patients presenting with more advanced symptoms fromhaving delayed care for cardiovascular and oncology conditions. Lorio Delayed routine medical care and screenings due to the pandemic certainly added a layer of complexity in managing chronic care patients. The lack of access to inpatient care within the region impacted how I would typically manage exacerba- tions of patients with COPD, asthma and pulmonary fibrosis, as well as acute pre- sentations with COVID infections. Many patients were extremely hesitant and even resistant to leaving the area to obtain healthcare outside of the community. In addition, post-hurricane recovery is add- ing to the strain on the healthcare system. Patients with chronic conditions or debility are pushing themselves past their usual lim- its to help with home and property repairs or are living in unsafe environments such as water-damaged properties or tents, increas- ing the frequency of exacerbations in previ- ously controlled patients. All healthcare organizations learned lessons after major storms like Katrina. What do you think the primary lessons learned will be after Ida? Hart From a preparation and facilities perspective, the lessons we applied from Katrina helped us quickly recover and maintain operations throughout and fol- lowing the storm. But the communications challenges were very difficult, and we’d like to find alternative solutions for moving for- ward. We also need to find ways to prepare our patients and arm them with the tools and resources they need in advance of a storm. Elder There will be a greater focus on how the damage/loss of utilities in the commu- nity affect healthcare operations outside of the hospitals. All the healthcare systems in the New Orleans area hardened their facil- ities post Katrina. From a facilities stand- point, our LCMC Health hospitals per- formed well during Hurricane Ida. We will take lessons learned from the prolonged utilities outages post Ida and pivot to limit the impact on healthcare operations in the future. Torcson Even redundant systems can be knocked out. Power and the internet are now so truly integral to healthcare deliv- ery that we, as an industry, have to look at how we prepare for electronic health systems when even our redundancies are interrupted. Lorio Important lessons fromHurricane Ida include having a highly detailed census list of patients that groups the patients together who have specific needs and requirements, including weight, to be prepared for possible mass evacuation. Also, have a clear plan for internal evacuation and transfer locations if multiple floors or units are damaged or become unsafe. Do you anticipate any changes to your operations based on this storm and the apparent increase in frequency and severity of storms hitting our state? Hart I think we will look at expanding our relationships and partnerships outside of South Louisiana. North Louisiana and Mississippi facilities were able to support us and were not experiencing weather impacts. In a similar vein, in the past, we always thought Team A needs to be onsite here in the facility during the storm and everyone else can leave until we are ready for TeamB to come in. But one of the learn- ings coming out of this is if you are not Team A and in house here, and we are relying on something from you and you stay local; in a situation like this when communication goes down, there’s actually benefit to hav- ing some people further away. We may need to have someone designated to maybe run some outpatient operations, but we don’t want them here locally necessarily, because if everything is down, we really need them off somewhere they can have better con- nections — internet, phone. We also really ramped up after the storm with people needing dialysis. I think we need to plan for that. We were able to get that up and running, but it needs to be on our radar next time. How do we make sure those dial- ysis centers are ready to go as soon as the stormmoves through? I think the state did a nice job, but some- thing we can improve on in the future is having places where people can get oxy- gen — planning ahead for that and being very clear where those places will be to get oxygen and medical supplies. While we took down barriers for people to get the medi- cations they needed earlier than normal so they could leave town, we need to better educate patients about getting their medi- cines ahead of time. And I think the communication piece may be something we look at — maybe staging one of those blimps, ready to go in where the lines are down, and get commu- nication going right away. We can hardwire these types of things a little more each time. Elder We learn after each storm. As dis- cussed above, a prolonged utilities outage has become a major threat to the commu- nity in a post-hurricane landfall.