Our Unmatched Anesthesia Experience. Your OR s Advantage.

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1 Government officials issued dire warnings to millions of residents, businesses and health care facilities along the entire East Coast of the United States in late October 2012 to prepare for an imminent hurricane dubbed, Superstorm Sandy. Hurricane Sandy was second only to Hurricane Katrina, which hit the Gulf Coast in 2005, as the costliest hurricane for property damage. Sandy caused an estimated $75 billion in destruction according to the National Hurricane Center. The hurricane and subsequent flooding and storm surge caused 72 deaths in eight states, primarily in New York (48) and New Jersey (12). Lower Manhattan, Staten Island and Long Island in New York and beach towns along the entire New Jersey coast were particularly hard hit by the storm. Millions were without shelter and power for weeks and even months. The storm forced the closure and evacuation of hospitals, nursing homes and health care facilities for a prolonged period of time. Our Unmatched Anesthesia Experience. Your OR s Advantage.

2 There is no greater time that we, as medical professionals, have to put on our white coats as when there s an emergency or natural disaster. JOHN DI CAPUA, MD Deputy CEO and Chief Medical Officer for North American Partners in Anesthesia (NAPA), Melville, New York SITUATION While many hospitals and health facilities, especially in New Jersey and New York, evacuated in advance of Hurricane Sandy others were caught off guard. NAPA s ongoing commitment to emergency preparedness demonstrates the importance of comprehensive crisis management, as evidenced by the magnitude of the 2012 storm. NAPA s staff cared for evacuated patients and provided for staffing shortages before, during and after the event. In addition, many physicians and clinicians became displaced from hospitals that were flooded or shut down indefinitely. NAPA expedited and extended clinical privileges to displaced medical staff at its facilities that were unaffected by the storm or to hospitals that were fully operational and accepting patient evacuees. During Sandy, it was relatively easy to triage from the command center and send messages to 1,500 people. I could communicate with every NAPA employee with one stroke. The hospitals chiefs created customized contact lists to use for their hospital-specific messaging. Those lists were downloaded into the emergency communication system before Hurricane Sandy. We were confident that we were effectively communicating with our entire staff throughout the event. JOHN DI CAPUA, MD TWO HURRICANE SANDY THREE

3 IMPLEMENTATION With the applications of lessons learned from Hurricane Irene, NAPA worked on improvements and better solutions in several key areas prior to Hurricane Sandy. Emergency Preparedness NAPA S SOLUTIONS NAPA offers solutions to meet every health care For example, a year before Superstorm Sandy, organization s ability to manage and provide a secure Dr. Di Capua directed NAPA s emergency operations and safe environment when tested with shortages and during Hurricane Irene which hit the East Coast in late displaced staff during natural disasters, terrorism or August NAPA provided 100 percent medical other unexpected traumatic events. Advanced planning coverage to storm-affected facilities and at regional puts emphasis on several core practices that any hospitals temporarily accepting transferred patients, hospital or health facility can emulate and implement, particularly if any of the hospitals staff were unable to as needed. get to work. NAPA s approach during Irene was to use administrative staff to make phone calls to essential As the nation s largest single specialty anesthesia and staff a time consuming and less-than-optimal perioperative management company, NAPA provides process. After the storm, NAPA s leaders identified areas personnel to its client hospitals no matter what the that needed significant improvement, especially with circumstances. communications, and worked throughout the year to upgrade its systems before the next major event. PREPARE AT HOME AND IN THE WORKPLACE At NAPA, clinical staff and administrators are accountable for not only participating in emergency training and safety protocols at work sites, but also applying these tactics to their own personal home and family lives. NAPA s senior leadership and medical and administrative staff are expected to prepare their personal circumstances in advance well before disaster strikes to safely get to work, take responsibility, care for patients and perform their duties. PLAN FOR EARLY ARRIVAL During Sandy, NAPA s staff prepared to stay at assigned hospitals for the duration of the event. Many arrived earlier than needed or before their active duty. The staff came well-prepared with personal items to use between shifts and to get rest or sleep. DEPLOY STAFF FOR MANY ROLES As trained emergency response professionals, anesthesiologists and CRNAs can adapt to any clinical situation not only the operating room. NAPA notified hospitals located in the storm s path or in flood zones to access its staff for more than anesthesia-related purposes. NAPA directed its staff to respond to shortages of medical staff wherever they were needed the intensive care unit, as house physicians overseeing patient floors, for pain management issues or in the emergency room. INVEST IN STATE-OF-THE-ART COMMUNICATIONS TECHNOLOGY Advanced planning includes investing in technology that rapidly and efficiently reaches everyone involved. Months before Hurricane Sandy, NAPA re-evaluated its approach to emergency communications by investing in a geographically-based, high-speed notification system. The new system features multifaceted global capabilities, similar to those used by many school districts and municipalities across the country. It streamlines and alleviates many labor intensive manual processes while quickly disseminating messages. NAPA s anesthesia chiefs trained on the new system months before Superstorm Sandy hit. VOLUNTEER AT EMERGENCY OPERATIONS CENTERS (EOC) NAPA s anesthesiologists and clinical staff actively support every involved hospital s EOC team. Staff provided back up to the hospital s chief medical officer or executive director for any type of support, such as answering telephones, helping solve unforeseen problems, allowing for breaks and rest and providing general assistance throughout the entire event. FOUR HURRICANE SANDY FIVE

4 RESULTS Lessons Learned & FUTURE Planning As the nation s largest single specialty anesthesia and perioperative management company, NAPA provides personnel to its client hospitals no matter what the circumstances. NAPA deployed more than 1,000 anesthesiologists, The new global communications system that NAPA nurse anesthetists and clinicians and over 225 purchased and implemented after Hurricane Irene in administrative staff to 38 hospitals and health care 2011 reached thousands of people with specific, facilities throughout states in the Middle Atlantic up-to-the-minute messaging sent to land lines, and New England regions. cellular phones, computers, fax machines and pagers Clinical and administrative staff were ready and in in the form of voice messages, texts and s. place before the storm hit, minimizing shortages and Backup NAPA staff worked with the EOC team at optimizing patient and staff safety measures. each affected hospital, in addition to the staff working at central command. NAPA s executive and clinical leadership attend mandatory meetings during the year to brainstorm and strategize on quality improvement, including emergency management. After Hurricane Sandy, NAPA s senior management met to make adjustments to continue to improve emergency protocol for future incidents. These include: Instructing NAPA s Human Resources Department to reserve large blocks of hotel rooms near hospitals, well in advance of a storm, to better accommodate staff. Providing NAPA staff that are minimally affected or unaffected during an emergency with credit cards or other purchasing mechanisms to buy items in short supply, such as generators, to help staff and others in storm-affected areas. Devising a distribution system for NAPA-purchased emergency supplies, if needed, that is more streamlined and efficient prior to a major disaster or event. SIX HURRICANE SANDY SEVEN

5 *HFMA staff and volunteers determined that Anesthesia Department Management has met specific criteria developed under the HFMA Peer Review Process. HFMA does not endorse or guarantee the use of this service. Contact NAPA Call Mailing Address: North American Partners in Anesthesia 68 South Service Road, Suite 350 Melville, NY About North American Partners in Anesthesia Founded in 1986, North American Partners in Anesthesia (NAPA) is the leading single specialty anesthesia and perioperative management company in the United States. NAPA is comprised of the most respected clinical staff, providing thousands of patients with superior and attentive care. The company is known for partnering with hospitals and other health care facilities across the nation to provide anesthesia services and perioperative leadership that maximize operating room performance, enhance revenue, and demonstrate consistent patient and surgeon satisfaction ratings. NAPAanesthesia.com