As Hurricane Matthew's anticipated path made it clear that Jacksonville, Fla.-based Lakeview Health would have to activate parts of its emergency preparedness plan for the first time, Lakeview's vice president of operations wondered how staff would respond for patients and one another in the first-ever implementation. Fortunately, the next several days would end up illustrating both the importance of a detailed plan and the dedication of a helping workforce.
Lakeview, which experienced disruption but minimal damage from a storm that moved through its community on Oct. 7, won't be compiling a full list of “lessons learned” from the event for another several days. But vice president of operations Jamie Stevens and vice president of marketing Gina Thorne say an overall positive rollout of its disaster plan means that staff likely won't see major changes to the plan for future emergencies.
“We have an emergency preparedness policy, and we also had developed a step-by-step guide for each department,” Stevens says. “When we developed this, each department wrote what it would be responsible for.”
Lakeview operates a 105-bed main residential facility, a neighboring 30-bed in-network program, and an intensive outpatient treatment setting located more than a mile away. It has some supplies on hand at all times for emergencies, such as generators and a week's surplus of bottled water. At Lakeview's first meeting on Oct. 4 to discuss the threat from Matthew, a sense of urgency had not yet kicked in. But by the next day's forecasts, it became clearer that the storm might largely spare the treatment and recovery hotbed of South Florida and be poised for a harder hit in the northern part of the state.
By Wednesday the 5th, with the hurricane a couple of days away, department leaders began going through checklists, making sure that tasks such as ordering advance supplies of patient medication were handled. Staff also began to sense that some patients were getting worried, and the clincial team began contacting family members of all patients to inform them of the facility's plans.
Some family members wanted to see leaders at Lakeview, located about nine miles from Florida's coastline and is not in a flood zone, evacuate the facility. “We explained to them that it was safer for us to keep everyone on campus than to evacuate,” says Thorne.
Lakeview would end up breaking precedent to allow patients to call home periodically from Wednesday through the peak of the storm on Friday into Saturday. “We could see that patients were getting more anxious,” Thorne recalls.
Riding it out
As it became clear that the area would at least experience heavy rain and wind on Friday the 7th, Lakeview for the first time activated its emergency work scheduling plan. All employees are listed as “A” or “B” employees for such scenarios, and they know which is their designation from the time they are hired. The As are responsible to arrive at work before a major event and to stay through its end. The Bs report to work after the event to relieve the As. The designations are not determined by role in the organization, but essentially split the staff into two equal halves.
Eighty-three A employees reported for duty last week at the start of the storm, including 12 leaders in the organization and two physicians. The worst of the weather occurred from noon to 9 p.m. on Friday the 7th, and the power went out around 3:45 p.m. that afternoon and was restored around 6 a.m. the next day.
“Our chef was able to supply hot meals even without power, with some of the work done by generator,” says Thorne. Alumni recovery support specialists conducted a candlelight 12-Step meeting. Other activities were designed to calm anxiety or simply to distract patients' attention toward something else. So the facility's yoga instructor ran a specialty group, and elsewhere a salsa dancing lesson took place.
Staff responsibilities were intensified because patients receiving care at Lakeview's other sites were moved to the main campus to enhance safety. “The in-network program is in an older building that has been under construction,” says Thorne.
Given the fury of its most powerful winds, Matthew largely ended up skirting the area around Lakeview. Besides a couple of leaks in the facility's dining area and a couple of downed trees and light poles around campus, damage at Lakeview was minimal. Most importantly, staff pulled together with a positive spirit, even a playful one at times, and patients overall handled the situation well.
Thorne credits the A group for doing much of the heavy lifting last week. She and her fellow B staffers mostly handled cleaning in the storm's aftermath on Saturday. Overall, “We're very proud,” Stevens says.
To Lakeview, having a written disaster plan in place appears to be essential. Leaders say they also benefited during the storm by keeping lines of communication open with patients' families, posting a web link that families could access for periodic updates.
Some decisions, of course, are not clear-cut in a disaster scenario. When a storm with the potential for heavy flooding approaches, it probably doesn't make sense to have a full swimming pool that could overflow. Then again, Lakeview wisely decided last week not to drain its pool completely. Had its water supply been cut off during Matthew, it would have had to use pool water to fill toilets.
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