EF-5 TORNADOST. JOHNS MEDICAL CENTER

JOPLIN, MISSOURI

Baylor Health Care SystemEnvironmental Safety and Emergency Management

Baylor Emergency Response Team

INTRODUCTION• St. John’s Hospital was directly impacted by an

EF-5 Tornado on May 22nd.• Baylor Health Care System sent a Liaison Team

from the Baylor Emergency Response Team (BERT) to survey the damage sustained to the hospital and the City of Joplin.

BERT LIAISON TEAM OBJECTIVES• The Baylor Emergency Response Team was comprised of

members from the Environmental Safety and Emergency Management Department as well as Faith In Action which donated numerous supplies to the Joplin area.

• The primary goal of the deployment was to capture information particular to the hospital in three primary areas:

BERT Objectives:

1. General preparedness prior to the incident, and the actions leading up to the impact.

2. The immediate actions taken in response to the tornado by the hospital and supporting agencies post impact (0-24 hours).

3. The short term recovery actions taken by the hospital (24-120 hours).

JOPLIN TORNADO IMPACTA quick review

EF-5 Tornado

Arguably the worst in US history

12 mile path, 1 mile wide

Lasting approximately 20 minutes

Damaging several major pieces of infrastructure:

• Utilities• Wal-Mart• Home Depot• 5 schools

St. Johns Hospital• 80 year old hospital• 9 stories• 186 patients

evacuated• 0 hospital employees

died

HOSPITAL PREPAREDNESS1. General preparedness prior to the incident, and the actions

leading up to the impact.

Hospital Preparedness

St. Johns had done exercises and considered themselves ready for most perils.

They had the same type of evacuation protocols as Baylor, “Severe weather” to get them ready, then “Code Black/Gray” to move patients.

They received support from their corporate office on their preparations.

Complacency existed among citizens due to frequent use of sirens.

INITIAL RESPONSE2. The immediate actions taken in response to the tornado by the

hospital and supporting agencies post impact (0-24 hours).

CommunicationThe hospital had initiated their Code Grey plan (BHCS=Code Black).

Most patients and visitors complied with the staff requests to move to interior hallways

Employees didn’t initially come to the hospital because “surely they would have called us if there was a problem”.

Some staff found it very difficult to make it to the hospital due to roads being closed from debris.

EvacuationTwo inches of water in the hospital.

Staff worried about the hospital safety due to a small fire and natural gas leaks.

Staff used doors that were blown off of their hinges to transport patients down the stairs.

Hospital was evacuated in 90 minutes.

No official call to evacuate – Staff instinctively “knew what to needed to be done”.

Triage and TransportInitial triage unit in the parking lot.

Secondary triage had to be set up across street at order of fire department due to gas leak

The community still coming for treatment even as they are evacuating.

Residents from the surrounding areas just showed up to help and to transport patients.

During catastrophic disasters, critical thinking skills and instinctive reactions take over.

SHORT TERM RECOVERY3. The short term recovery actions taken by the hospital (24-120

hours).

Hospital GroundsMemorial hall established as temporary ED.

Missouri DMAT set up field hospital.

Initial difficulty getting FEMA to assist.

The community and others came out in force and offered enormous resources to help.

The president and Board of Trustees moved quickly to purchase land for modular hospital nearby.

Hospital AdministrationConvention center used as hospital admin and EOC.

Excellent support from Mercy System.

Commitment by hospital CEO and leadership to employees (one page add in newspaper).

Mercy System assured employees that their pay and benefits would not be interrupted.

Agreements with other hospitals to utilize employees.

Lessons LearnedRedundant communications

• Social media

Public relations• To community• To employees

More Training• Evacuation drills• Debris management

training

Identify secondary offsite EOC sites

“Flashlights saved lives”

Community support and involvement

Reality Check – This could have been us!DFW, like Joplin is on edge of Tornado Alley, 5 EF3 or greater tornados touched down in last 3 years in DFW.There is very little preparation that can truly prepare for this level of destruction.Staff education on reality of such event will save lives as demonstrated at St. Johns.

Working with media relations to update and revise protocols for utilizing radio and other local media to broadcast messages to employees during land line and cell phone outages.

Enhancing Code Black process awareness. Ensuring activation protocols are concise and initial alert is timely.

Enhancing partnerships at the local, regional and state levels. Working with Emergency Medical Task Force coordinators to operationalize state assets at the local level.

Evacuation equipment is being implemented at all BHCS hospitals. Training on the equipment is occurring and full scale exercises are being planned in conjunction with local jurisdictions.

Power outage kits including various types of lights, glow sticks and other key items have been distributed.

Baylor Emergency Response Team (BERT) and Disaster Training Academy. We have obtained HR and Legal approval for the team to respond to a scenario like Joplin in support of other healthcare organizations if requested.

What is Baylor doing to prepare?