Iowa facility describes what worked during its response A flooded hospital’s recovery efforts not only offer lessons for other healthcare facilities, but inspiration too. Joanie McMahon Nurse

1. Iowa facility describes what worked during its response
Flooding shuts down another hospital
A flooded hospital’s recovery efforts not only offer lessons for other healthcare facilities, but
inspiration too.
When preparing for a disaster, it’s difficult to gauge what people will do and how they will pull together to
manage the situation. But Mercy Medical Center in Cedar Rapids, Iowa found that staff members will find the
energy and inventive ways to accomplish difficult tasks in the face of a catastrophe.
The hospital evacuated June 13 after floodwaters rose on its downtown campus following torrential rains. The
facility is now reviewing its response actions and incorporating changes into the emergency operations plan,
says Joanie McMahon, administrative supervisor of emergency management at the hospital.
“There are a lot of things we will take away from this,” McMahonsays about the real-world experience she will
work into the emergency operations plan. “Overall, things went pretty smoothly considering we had to deal
with a lot of issues,” such as electricity going on and off, generator use, and water damage.
Emergency planning tips to ponder
Now that the hospital is mostly back to normal operation, McMahon offers these five tips to
other facilities to sharpen their preparedness:
Drill for internal disasters. In her experience, most of the exercises in which she had
participated—especially those coordinated with outside agencies—involved external crises away from the
hospital. Include massive internal disasters that affect your facilities too.
Imagine phone lines going down. You rely on phones and other communication methods all day, but in a
disaster, these services can fail. Plan for alternatives such as call trees.
Work public health efforts into evacuation plans. This approach helped the hospital spread evacuees
throughout a larger area, since officials knew what medical centers throughout the state had empty beds.
Build physician and nurse evaluations into evacuation plans. Such clinical input helped Iowa
authorities decide which patients went how far away in the evacuation, based on acuity.
Line up industrial hygienists and disaster recovery specialists in advance. If a disaster affects many
local businesses, this kind of essential outside help might be in short supply.
The same advice applies to vendors who supply generator fuel and boiler parts. Although these services were
built into the preparedness plan, so many flooded Cedar Rapids businesses were asking the same vendors for
similar items that “you almost needed a backup plan for your backup plan,” McMahon says.
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2. Hospital didn’t expect high waters
On June 12, waters rose in Cedar Rapids. Mercy Medical, situated about 10 blocks from the Cedar River,
lost power, went to backup generators, and canceled non urgent care. When water began to seep in to the
building, leaders began seeking alternative Emergency Department (ED) locations—the vacant eye surgery
center was top on the list—and worked on plans for dispatching employees to help in the community. Hospital
officials had decided to continue operating in the face of the flooding, a logical decision considering it was
situated outside the boundaries of designated flood plains. However, that situation changed by the end of the
day, when the basement filled with water. Fearing electrical dangers, hospital officials decided to evacuate June
13, and began moving 183 acute- and long-term care patients to other facilities throughout the state.
“It was quite a sight to see the ambulances and transport vehicles lined up outside,” McMahon says. “We had
some lighting issues, so we had to bring in some special exterior lighting so everyone could see what they were
doing. It was still raining … but everyone got out safe and sound, and that was our No. 1 priority.”
National Guard troops assisted with patient transport in Humvees. Staff members, including doctors, nurses,
and volunteers, sandbagged the exterior of the hospital.
After flooding, public health concerns,
Water spilled into the first floor of Mercy Medical after the patients evacuated, and the river finally crested at
32 ft. The water damage necessitated a large cleanup to dry everything, get the electrical system running, and
rid the building of mold and bacteria. Such work precipitates inspections and reinspections by authorities.
“Our facility and operations [leaders say jokingly] that because we’ve had so many regulatory inspectors in
here, our hospital will be the cleanest … hospital in the nation,” McMahon says. “I honestly feel we will be able
to eat off the floors by the time we’re done with this [cleanup].”
Communication ideas prove successful
On June 26, Brock James Chapman became the first baby delivered in the hospital’s birthing center. That was a
major testament to the hospital’s drive to recover from the flood as quickly as possible. It was also a morale
boost.
“The birth was a milestone in terms of making people feel comfortable,” says Karen Vander Sanden, Mercy
Medical’s PR specialist, who adds that the delivery helped put to rest rumors circulating among employees and
the public about the hospital’s air quality. “If there are patients who feel comfortable coming here to have a
baby, it must be a safe place to be,” Vander Sanden says. Based on Mercy Medical’s efforts, she offers the
following tips to those who might be responsible for communication in their organization’s disaster planning
process:
Be aware of community and staff member concerns. The hospital’s air quality turned out to be a large
worry for employees and patients. Press releases and other content on Mercy Medical’s Web site addressed the
hospital’s successful measures to test and maintain air quality using an outside industrial hygienist.
Use daily newsletters—even basic ones—to keep workers updated. At one point, with e-mail down
and phones on the fritz, Mercy Medical distributed hard-copy updates at tables and posted them on bulletin
boards.
Ensure that you have backup Web sites. Mercy Medical’s Webmaster ended up maintaining the
hospital’s site from a computer at home with help from the facility’s Internet service provider.
Create and stock an emergency press kit. Vander Sanden has a PR “emergency office in a bag,” she says,
which includes paper phone books, call lists, media contacts, signs, press ID badges, markers, notebooks,
paper, and other appropriate supplies. This allows you to work with the press without computers for a while,
and that’s exactly what happened.

3. Celebrate incremental gains in the recovery effort. The hospital announced the return of online
services one by one, up to and including the ED reopening July 2, at which time the hospital was fully
operational.
Homeland Security classes helped hospital planners
Before flooding shut down Mercy Medical Center in Cedar Rapids, IA, a free Department of Homeland Security
training course provided a wealth of information for emergency planners at the facility.
Joanie McMahon, Mercy Medical’s administrative supervisor of emergency management, and
five colleagues took the course at the Center for Domestic Preparedness (CDP) in Anniston, AL.
The hospital leadership course they took offered useful methods for running an effective and efficient incident
command center, McMahon says. The CDP, housed in a former Army base, has a hospital to use in drills. That
facet added a hands-on feel to the exercises and provided a deeper understanding of logistical issues that arise
when real disasters happen.
“It was helpful for us to come back and then utilize some of the things we learned in our own
hospital and update and educate our own staff,” McMahon says. “It was one of the best classes I
ever took, a real eye opener … It preps you for the real thing, so when it happens you tend not to
be so panicky.”
To learn more about CDP courses, go to https://cdp.dhs.gov.
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