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Communication a weak spot in hospitals' disaster preparedness

GULFPORT, Miss.—As hospitals along the Gulf Coast recover from Hurricane Katrina, administrators at two facilities that managed to stay open through the storms say their No. 1 challenge was communication—internally and with police, fire and emergency responders.

Experts say communication gaps are a weak spot in the disaster-preparedness plans of hospitals nationwide. As first responders prepare for the next disaster—whether it's a hurricane or a public health threat such as avian flu—they're looking to use the lessons from Katrina to heighten preparedness across the county.

Hospitals are constantly preparing for the worst. Last year, facilities across Mississippi were given satellite phones and radios to ensure that information was relayed effectively, said Jim Craig, the director of health protection at the state's health department.

That would have worked, said William Peaks, the chief executive officer of Garden Park Medical Center in Gulfport, if Katrina's winds and rain hadn't damaged the hospitals' satellite dishes.

"There was a time period when we were kind of on our own," he said.

When the storm came, the receiver on Garden Park's satellite dish had to be recalibrated. Peaks said the hospital had short-wave radios, but they were rendered inoperable when the towers they rely on for transmission were damaged. During Katrina, the hospital's roof was damaged, and its first floor—which houses its emergency room, operating rooms and radiology services—flooded 4 to 6 inches deep. So far, $4 million has been spent on repairs.

In a perfect world, all hospitals, health-care facilities and public safety personnel would use a standardized communication system when disaster strikes, said Colleen Conway-Welch, the dean of the Vanderbilt University School of Nursing. Conway-Welch has helped coordinate the National Center for Emergency Preparedness, which trains health-care providers and emergency responders how to react in mass casualty situations.

"In all of these plans there is a huge paralysis of communication in these areas," she said. "I'm not sure that any hospital could be able to respond" to a disaster on Katrina's level.

She advised hospitals to examine the locations of their generators and any other equipment that might be vulnerable to natural disaster or terrorist attack.

When their cell phones died, the staff members at Memorial Hospital in Gulfport relied on human "runners" to relay information, said Gary Marchand, Memorial's CEO and president. Luckily, Marchand said, Memorial includes in its disaster-preparedness plan someone responsible for monitoring TV broadcasts and posting updated information on a bulletin board.

As a result, walkie-talkies and antennae for TV's will be added to Memorial's disaster plan, Marchand said, adding that a "single source of communication" among health-care facilities and federal, state and county governments would make the response more flexible.

Experts agree that designers of the best-laid plans couldn't have calculated destruction on the scale of Katrina.

"Katrina was the worst disaster probably in U.S. history," said Craig, of Mississippi's health department. "It becomes a question of capacity more than training when you have a disaster of this magnitude."

Both Garden Park and Memorial, Peaks and Marchand said, were stocked with enough food, linens and medicine to help them weather Katrina without any storm-related deaths.

On a typical day, 150 people are treated at Memorial's emergency room. That surged to 450 to 600 a day during Katrina and its aftermath.

A hospital's ability to handle "surge capacity"—when the number of people who need medical assistance exceeds the hospital's capacity—is another area that many haven't addressed adequately, according to Dr. Irwin Redlener, the director of the National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health.

Clinics and other community health centers are crucial to helping hospitals deal with massive overflows, Redlener said. Health organizations also should cultivate relationships with local businesses before a disaster occurs so that in a crunch, money is only a phone call away.

Redlener is a co-founder of the Children's Health Fund, which operates within Columbia's national preparedness center. The health fund is establishing mental health programs throughout the Gulf Coast to aid hurricane-affected populations.

"The illusion is that help (from the federal government) will be there minutes later, which is really not the case," Redlener said.

Some employees at Garden Park and Memorial hospitals remain homeless, and Peaks and Marchand said their disaster plans were still works in progress.

Both hospitals regularly participate in in-house and statewide preparedness drills focused on hurricanes, bioterrorism and other disasters, and they send their staffs to training sessions. Both also were able to retain power throughout Katrina using generators.

Disaster response "lives in every policy we have," Marchand said. "It's a plan that is alive. It's never finished. We're always critiquing; we're always modifying the plan."

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(Lee reports for The (Fort Wayne) News-Sentinel.)

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(c) 2005, Knight Ridder/Tribune Information Services.

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