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Under Water, but not Under-prepared: Rural Hospitals Step up During Massive Flooding

March 23, 2009

Residents of Western Washington will recall the first week of January as an unpleasantly wet and cold start to 2009.

Heidi Keyes will remember it as a critical test of her employer’s emergency-readiness preparations.

Swollen rivers spilled flood waters over their banks, washing out bridges and forcing thousands from their homes after vital access roads were cut off – including the road that would bring Keyes to her job as assistant administrator at Morton General Hospital in Lewis County.

“I was stuck that first day – January 7 – but I had my cell phone and computer and did whatever I could from home,” Keyes said. “You have to think outside of the box.”
Administrators and staff at hospitals, which are well known as Ground Zero in disaster events, focus year-round on developing strategies for a variety of natural and man-made emergencies. Flooding isn’t unheard of in eastern Lewis County, but this year’s rapid onset caught many by surprise.

Morton General, a 25-bed Critical Access Hospital (CAH), escaped the direct path of flood waters. But with a service base of 10,000, and modest tax funding flowing through Lewis County’s Public Hospital District, Keyes and her co-administrators didn’t have the luxury of enacting elaborate planning. They knew a challenge lay ahead.

First, the hospital would operate without some staffers who were unable to show up for work. Those who were stranded at the facility were put up in a nearby hotel between shifts.

Food service was a priority, and kitchen staff worked grueling shifts to make that happen.

“We fed everyone – fed the staff, and prepared extra meals,” Keyes said. “We wanted to make sure they were taken care of.”
Food service also proved critical for Ocean Beach Hospital in Ilwaco when flood waters ravaged much of Pacific County in November 2007. Dietary supervisor Debbie Brisbin led efforts to set up a “soup line” for residents who were evacuated from their homes or had no power with which to cook.

“People were really grateful to have a cup of hot coffee. It’s just one of those things,” Brisbin said. “In an emergency, people look to a hospital for comfort and food. It’s the last thing you think of when everything is going well, but the first thing in a crisis. Hopefully the hospital is able to provide it.”

Brisbin said the soup line provided not just nourishment, but a community gathering place for distraught and impatient residents left stranded for days on end.
Though Morton’s event was shorter-lived, it presented dire challenges. City water supplies were cut off, forcing the hospital to tap into reserves stored in an outdoor shed that had several feet of piled snow blocking its entrance.

Meanwhile, county officials worked with the Washington National Guard to assess road conditions and open thoroughfares for essential traffic and, especially, emergency transport.

“There is the day-to-day stuff – babies are born, diabetics go into shock, and there are traffic accidents. You have to take care of that,” said Jill Kangas, Emergency Management Planner for Lewis County.

Kangas said severe weather events that block access to the larger Providence Hospital in Centralia pose a significant problem.

“We have quite a crisis when Interstate 5 goes under water,” Kangas said. “For us in Lewis County, it can be a two-hour drive to the next-closest facility anyway. Having the rural hospitals open and able to treat patients is absolutely critical.”

Patients in emergency events include not only evacuees and victims of traffic accidents, but first responders in public safety who may suffer cut feet and other injuries received while trying to access citizens in trouble.

Keyes said organized efforts from an excellent staff allowed Morton General to function at the top of its game during the crisis. No one in Imaging made it in, so an Emergency Room physician coordinated the transport of an X-ray technician from Mossy Rock to Morton on a National Guard helicopter. The Guard also opened roads for transport of critical patients by ambulance to airlift pads. And the hospital’s chief financial officer, Tim Cournyer, picked up workers and brought them to the facility.

But not every critical situation can be anticipated. The hospital picked up the hotel tab for out-of-state relatives of a dying patient, and an organ-harvest on a recently deceased patient which would normally be performed onsite was rerouted to the Medical Examiner’s office.

After five days of active disaster mode, conditions improved and the facility began to run as usual. Keyes said de-briefing by administrators and lead staff led to a unanimous conclusion: The staff at Morton General responded effectively, and with professionalism.

That sentiment is shared by many in the surrounding community, including Ellie Worsham of the Morton Chamber of Commerce.

“Morton General is so important to our region, as most health care is a long way away without it,” Worsham said. “It’s an up-to-date facility that we are most proud of.”

Article by Jan Rodak
aerial view of Mason General Hospital aerial view of Mason General Hospital

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