When Disaster Strikes: How to Leverage VectorCare to Evacuate Patients 4x Faster in an Emergency

The Problem: Poor Communication When Disaster Strikes

When Hurricane Irene threatened Brooklyn in August 2011, the Coney Island Hospital (now known as the NYC Health + Hospitals/South Brooklyn Health) was well prepared for an evacuation^[1]. Armed with a robust emergency management system and the experience of 20 disaster drills per year, the hospital had a full three days to prepare for an evacuation in the face of a large coastal storm. On Friday, August 26, at 8am, personnel began evacuating 280 patients to nearby medical facilities; the operation took 12 hours to complete. Despite being considered a highly successful evacuation, the Coney Island Hospital evacuation lasted a full day and necessitated patients being transported without their medical records to save time.

At best, even the most successful hospital evacuations take a day or two to transport patients to safety. At worst, a poor evacuation plan can jeopardize the lives of hundreds of patients. When Hurricane Katrina left 11 hospitals surrounded by floodwater in August 2005, emergency preparedness plans floundered ^[2]. The city had no plans for moving hundreds of patients at once, and lost telephone communications systems made it almost impossible to contact available ambulance companies. When help did come, hospital personnel found it difficult in the moment to separate patients by type, destination, and mode of transportation.

Though no crisis can be fully prepared for, hospitals often encounter the same problems in an evacuation. Most notably, communications systems are fundamentally unreliable in a crisis. To quote a study from the Eurasion Journal of Medicine^[3]:

“Although communication and coordination are critical in disasters, the communication systems usually do not function properly during a catastrophe. This situation is one of the most significant problems concerning disasters. It becomes even a greater problem if communication and coordination with necessary institutions have not been established ahead of a catastrophe.”

Hospitals generally rely on telephone communication to reach emergency transport services, and are left in the dark when phone networks frequently fail during emergencies. Though hospitals can call on the National Disaster Medical System (NDMS) for transportation help in the events of a major disaster, the request requires a presidential declaration and it can take days for help to arrive. When hospitals are finally able to secure transport, patients often travel without valuable medical records or care information.

The Solution: Leveraging VectorCare as a Disaster Management Tool

When the Tubbs Fire hit Santa Rosa, CA^[4], in October 2017, Kaiser Permanente (KP) needed to urgently evacuate its patients to safety. Using VectorCare’s disaster management technology, KP was able to evacuate its entire patient population quickly and seamlessly. “With the fires rapidly approaching, KP used VectorCare to broadcast an alert simultaneously to all transportation providers that their help was urgently needed to move all patients. Within 2 hours of sending the VectorCare notification, they had 35 ambulances, 30 wheelchair-­equipped vans, and many other KP buses and medical transportation vehicles ready to evacuate the facility,” said Phyllis Stark, RN and Continuum Administrative Operations Regional Director, Northern California, at KP.

“I can’t imagine that the team could have handled this sudden volume, [nor] track where every patient was taken, as gracefully and calmly as they did, if they were still doing things the old way. This solution makes sense for Kaiser Permanente, both from a day-­to-­day operations perspective, and whenever we need to quickly scale during times of crisis.”

Thanks to the quick-scaling nature of the VectorCare platform, KP was able to evacuate their patients at a rate four times the speed per patient of a nearby hospital evacuating at the same time.

In addition to speed, VectorCare solves another crucial issue during evacuation procedures: tracking patient movement and care needs. When several dozen ambulances show up to transport patients during a stressful situation, the number one priority is to evacuate patients out of the area of danger. Important details like tracking patient movement and specifying the level of care required for each patient can often fall by the wayside, and care quality suffers as a result. Regardless of the effectiveness of hospital staff, we know that any movement places patients in a high-risk scenario for safety and health outcomes^[5].

With VectorCare’s bi-directional, cloud-based platform, quality of patient care doesn’t need to be sacrificed during an emergency evacuation. Care teams can track specific patient movement, what levels of care the patient was provided with, and receive alerts about any incidents or complications that occur during movement. Care teams can even instantly communicate details with service providers via our instant messaging tool. When the dust settles after evacuation, nurses can view a clear record of each patient’s movement and care.

Under CMS’s new emergency preparedness requirements^[6], facilities in evacuation mode must have plans in place for “coordinating patient care within the facility and across different healthcare providers”. With the versatility of VectorCare's platform, not only is day-to-day patient communication seamless, but it's ready to scale instantly and handle an evacuation should disaster strike.

Read more about patient care logistics in our Journal. We did a write-up on CMS's dialysis transportation reimbursement here.

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^{1. “Hurricane Irene: Evacuation of Coney Island Hospital.” Case Studies in Public Health Preparedness and Response to Disasters, by Linda Young Landesman and Isaac B. Weisfuse, Jones & Bartlett Learning, 2014.}

^{2. “Hospitals in Hurricane Katrina: Challenges Facing Custodial Institutions in a Disaster.” Urban, by Brad H Gray and Kathy Hebert, July 2006.}

^{3. "Evacuation of Hospitals during Disaster, Establishment of a Field Hospital, and Communication." The Eurasian Journal of Medicine, June 2017. Published online 28 April 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5469841/}

^{4. "130 patients evacuated from Kaiser hospital in Santa Rosa." SF Gate, by Amy Graff, 9 October 2017. https://www.sfgate.com/bayarea/article/Kaiser-Santa-Rosa-fire-patients-evacuated-Tubbs-12264180.php}

^{5. "California Patient Movement Plan". November 2018. https://emsa.ca.gov/wp-content/uploads/sites/71/2019/03/Patient-Movement-Plan_Final-3-6-19.pdf}

^{6. "Emergency Preparedness Rule". Updated January 2019. https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-emergency-preparedness/emergency-preparedness-rule}