Riding Out the Storm: Hospital Planning For a Catastrophe

Jason Schroer is a principal at Dallas-based architectural firm HKS.

When disaster strikes, evacuation is not an option for many hospital patients and the people who care for them. As Hurricane Harvey bore down on Texas recently, dedicated health providers sheltered in place at hospital facilities to maintain continuity of care for patients throughout the storm. Designated ride-out and recovery teams remained on site at hospitals for several days before, during, and after the hurricane to ensure critical health care services were not interrupted.

The design of a facility can impact a health care organization’s ability to house hospital staff for the duration of an event like Hurricane Harvey. By including strategies for ride out and recovery in discussions about emergency preparedness, master planning and facility design, hospitals and health systems can ensure staff members’ needs are met during a crisis, so they can meet the needs of vulnerable patients.

Houston health care executives report that advance planning is key to accommodating staff during a multi-day ride-out and recovery effort. Health care professionals understand this type of event comes with the job; staff members volunteer or are assigned to shifts on the ride out or recovery teams. Appropriate planning and a flexible facility design can help keep these teams as safe and comfortable as possible when they need to deploy for a major storm or other catastrophic event.

Designated areas for sleep and respite are among the most important aspects of a facility’s ride out and recovery plan. As the patient census goes down in the lead-up to a storm, the remaining patients can be consolidated on designated units with the needed infrastructure to shelter patients in place. Staff can sleep in the remaining patient rooms, as well as in conference rooms or similar spaces selected for this purpose. If cots are to be provided for staff, a place to store them is needed. If the storage area is offsite, a plan for transporting the cots to the facility in advance of the storm is necessary, too. Utilizing conference rooms as sleep areas is an efficient use of space, but this solution is not always popular with staff. If alternative spaces exist, these should be explored when possible. In the event of a storm, make sure appropriate window protection is installed where staff members sleep.

Another important consideration is how to manage personal linens and food. Some hospitals instruct members of the ride-out team to bring their own pillows and sleeping bags, so hospital linen is not needed for staff use; staff members may also bring their own food and snacks, so hospital food can be reserved for patients and their families. Other facilities provide meals for all staff members as they ride out and recover from a catastrophe. Each alternative presents different requirements for storage and food preparation. In making plans for supplies and storage, it is important to remember that the night shift eats, too, so any plan must account for more than three meals per day. Understanding the requirements for supplies is crucial to a successful ride out and recovery.

Laundry and shower facilities and supplies are needed, too. A nearby medical office building or gym may be able to support these activities, if electricity is available.

In planning for emergency power generation, bear in mind staff members will need to charge cell phones to stay informed and in contact with family and friends as much as possible during the storm.

Jason Schroer is a principal at Dallas-based architectural firm HKS and director of its Houston office.