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What I Learned from NJEPC: An Overview of Hospital Response to Superstorm Sandy

By Leischen Stelter

In early May, I attended three days of the New Jersey Emergency Preparedness Conference in Atlantic City, NJ. First off, a disclaimer: I am not an emergency management expert. It’s a field I’m fascinated by (I’m currently enrolled in a Master’s program at American Military University for Emergency and Disaster Management), but honestly it’s a field I have no practical experience in. I think what attracts me to emergency management is that at the end of the day, everything one does is an effort to help people in times of crisis. But it’s more than just the altruism that attracts me. It is also the underlying reliance on partnerships and a focus on relationship building within the field and far beyond it. An effective emergency management manager has existing relationships with all levels of government agencies (local, state, region and federal) in a variety of departments, as well as established relationships within private and public organizations. Relationships and networking are critical to success.

And nowhere is the strength of relationships and unity of mission more apparent than during NJEPC. I guess it’s no surprise that everyone seemed to know everyone else at a state emergency management conference—it’s a relatively small field, of course—but there was a comradery during this show that I’m not sure existed last year.

Many of the sessions were focused around Superstorm Sandy, as you might expect. That’s certainly what I expected and the main reason I decided to attend this regional show. I wanted to hear, straight from the horse’s mouth, so to speak, what it was like to be an emergency manager during the worst storm to hit the East Coast.

[Go here to read Tom Ridge’s keynote address during the conference, praising the work of NJ emergency responders via Emergency Management Magazine]

I wanted to know how these highly experienced emergency managers dealt with this level of crisis and some of the lessons they learned and what they could share with the rest of us. Here’s just some of what I took away from this conference:

NJ Hospital Evacuation during Superstorm Sandy: The Good, the Bad and Maybe even the Ugly

I attended several great educational sessions, but I was most impressed by this session. Emergency managers from three hospitals (Hoboken University Medical Center, Jersey City Medical Center and Palisades Medical Center) discussed their experiences during the storm. During this session, attendees were immersed in play-by-play of the storm. Presenters did a great job of recounting the weather predictions and the other information they were receiving about the storm’s progress and how they used that information to make decisions. As we all know now, Superstorm Sandy was unprecedented. No matter how well prepared an emergency management professional is for this type of event, there will always be unpredicted issues to deal with, and lessons learned.

Hoboken University Medical Center

Hoboken decided to proactively evacuate its 164 patients ahead of the storm since the hospital sits only about five feet above sea level. Representatives from the hospital discussed the complex logistics of moving patients, several of whom required specialty care. This case study was considered the “good” of the session, however, there always remains room for improvement:  

  • Increasing training for more in-depth ICS roles, specifically how to jockey and track resources on scene. For example, they had 25 ambulances on scene and it was difficult to effectively utilize and track those vehicles
  • Establish patient priorities early and maintain those priorities throughout the process
  • Establish a documents unit control leader who maintains paperwork during the process. They found documents were misplaced and not always accessible when needed

Jersey City Medical Center

Jersey City Medical Center decided to shelter in place during Superstorm Sandy. As they assessed the weather, there was a growing sense of confidence that they were going to miss the worst of it – and then it hit. In 12-and-a-half minutes, the hospital went from being okay, to being under water as the Hudson River took over Jersey City. In those 12-and-a-half minutes, the water rose from 16 inches to four feet and for eight hours the hospital was cut off and on its own. The hospital did a vertical evacuation, moving patients to higher floors, but they stayed put, watching cars float by their doors.  The hospital was forced to go on divert and not accept any patients (although two swam up to the hospital) and at one point, every hospital in the county was not accepting patients.

As the water rose, the hospital decided to do a controlled shutdown of its computer servers out of fear that they would flood (which they fortunately did not). It took between three and four hours to shut down and about eight hours to get the servers back up and running. Immediately after the storm, the hospital was inundated with patients (which continued for the next two weeks). So not only was the hospital dealing with a major influx of patients, they were also working off paper records.  In order to lessen the hospital patient load they established external shelter operations and sent employees to a quasi-medical shelter.

Some things that worked well:

  • Transportation plan to get employees to and from the hospital. Security officers drove designated routes to pick up and drop off employees
  • Discharge task force, which went through and identified patients to discharge on a daily basis. Although the spots filled up immediately, patients were being moved through the system

What to improve:

  • Quality of food. They need to provide healthier food for staff to be able to sustain energy levels required during such a scenario (i.e. more than coffee and donuts!).
  • Gasoline and fuel supply need to be increased
  • Email system adjusted so there is one true “global” list serv can be used to send out information to all employees
  • Put in better flood protection for hospital
  • Improve press releases and means to get information out to the public informing them where to go for treatment. This must be done ahead of storm so people know how/where to get information

Palisades Medical Center

Palisades Medical Center is located right on the Hudson River. For eight days, the team evaluated the weather and made the final decision not to evacuate the 83 patients ahead of the storm. However, as soon as the storm hit it became apparent that the storm surge was worse than expected, taking out the hospital’s backup generator and flooding the hospital. Administrators determined that they needed to evacuate immediately. Fortunately, the hospital could rely on its county weather service to provide up-to-date and specific information for the area. It was determined that the water would recede, but then come back quickly, so there was only a small window of opportunity to evacuate patients. The hospital determined it needed to evacuate patients between 5am and 8:30am, with no room to deviate from the plan. The emergency managers involved described how the hospital requested additional support staff, as well as 30 local firefighters, to help load patients onto medical ambulance busses. Fortunately, the hospital had arranged to transport all of its 83 patients to the Hackensack University Medical Center, thus making it easier to take all patients to the same destination.

Things that went well:

  • No patients or responders were injured during evacuation
  • Personnel that were requested were on site and ready to work
  • Tracking of patients and treatment of critical patients during transport was successful

Areas for Improvement:

  • Establish a clear unified command structure
  • Getting patients processed and readied for transport quicker
  • Improve communication: The second bus load was turned away from Hackensack because of communication issues and directed to a different hospital. The bus was eventually instructed to return to Hackensack after the issue was cleared up, but the communication channel must be improved.

The Recap

As an attendee, it was impressive to hear these first-person accounts of the events of Superstorm Sandy. It was remarkable to hear the challenges each of these emergency managers faced and to learn about the information they had and how they prevailed in time of crisis. It is sessions like this, which enable emergency management professionals to share their lessons learned, that will help others be better prepared for similar worst-case scenarios.

Leischen Kranick is a Managing Editor at AMU Edge. She has 15 years of experience writing articles and producing podcasts on topics relevant to law enforcement, fire services, emergency management, private security, and national security.

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