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Transcript for the audio podcast: Hospital Emergency Preparedness and Response During Superstorm Sandy

From the Office of Inspector General of Department of Health and Human Services

[Ben Gaddis] I am Ben Gaddis, with the Office of the Inspector General, speaking with Petra Nealy, a senior analyst for our Office of Evaluation and Inspections. We're talking about the newest report in a series about healthcare facilities' disaster preparedness and response. This report focuses on how hospitals managed during Superstorm Sandy. Petra, tell us how you got started.

[Petra Nealy] Sure! OIG has a body of work examining healthcare facilities' disaster preparedness and response dating back to 2006 and we started by looking at nursing homes in the Gulf States that were hit by hurricanes, like Hurricane Katrina. We found that many nursing homes had insufficient emergency plans or they didn't follow their plans. For our Superstorm Sandy audits and evaluations, we looked into preparedness and response to wide-scale disasters.

[Ben Gaddis] Tell us why you decided to look at hospitals?

[Petra Nealy] Sure. During disasters, hospitals have to care for more than just their own patients. Hospitals also provide treatment, triage, and medical services for the community. With some major natural disasters in 2011 and 2012, the medical community and the public raised concerns about emergency preparedness and training for hospital staff. So looking at hospital preparedness was the logical next step.

[Ben Gaddis] I see. So, how'd you go about doing this study of Sandy preparedness and response?

[Petra Nealy] Well first, we surveyed 174 hospitals in Connecticut, New Jersey, and New York. These hospitals were located in federally declared disaster areas and we found that most of these hospitals, about 93 percent, sheltered in place during Sandy. The remaining 7 percent evacuated. We also visited 10 hospitals located in some of the hardest hit areas, because we wanted to better understand the challenges that these hospitals faced during Sandy.

[Ben Gaddis] What did you find?

[Speaker] Most hospitals faced major challenges, whether they sheltered in place or evacuated. These included infrastructure breakdowns, like electrical and communication failures, and resource issues, like fuel, transportation, hospital beds, and public shelters.

[Ben Gaddis] What were some of the biggest challenges?

[Petra Nealy] Well, hospitals faced a number of interrelated challenges. While hospitals had a surge of people needing services, they had to deal with infrastructure problems and resource issues. In some places, hospitals were the only buildings with electrical power, so a lot of residents in the community sought shelter at the nearest hospital.

[Ben Gaddis] Well, how well did hospitals take on the role of community shelters?

[Petra Nealy] Providing shelter to community residents did put a strain on hospital resources. Some hospitals had a very hard and challenging experience responding to their patients' needs while trying to help community residents. But, overall, hospital emergency preparedness and response was better than we anticipated, given the size and scope of Sandy.

[Ben Gaddis] Why do you think this was the case?

[Petra Nealy] Well, we think there were several reasons. First, this region went through several large-scale emergencies, including September 11th. The year before Sandy struck, Hurricane Irene, and a major snowstorm hit the same region. And after Hurricane Katrina, hospitals around the country seemed to have a heightened awareness and focus on emergency preparedness. So in some ways, these hospitals were better prepared for Sandy.

[Ben Gaddis] That's interesting. What else helped these hospitals respond to Sandy?

[Petra Nealy] Well federal agencies and outside organizations appear to have influenced hospitals to prioritize emergency preparedness.

[Ben Gaddis] How so?

[Petra Nealy] For example, the Office of the Assistant Secretary for Preparedness and Response, within Health and Human Services, actively promotes hospital preparedness and funds community-wide drills. And accrediting organizations that inspect most hospitals require hospitals to conduct large-scale emergency drills every year.

[Ben Gaddis] So what did you recommend in this report?

[Petra Nealy] We recommended that the Office of the Assistant Secretary for Preparedness and Response continue to promote Federal, State, and community collaboration in major disasters. We also recommended that the Centers for Medicare & Medicaid Services examine existing policies and provide guidance on flexibility on reimbursements when a disaster strikes.

[Ben Gaddis r]Petra, thank you for sharing this important work on hospital emergency preparedness and response.

[Petra Nealy] Thank you, Ben.


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