GALVESTON — For months, the University of Texas Medical Branch had been talking about how it might evacuate patients in the event of a major hurricane.
Last month, with Hurricane Rita bearing down on the Texas Gulf Coast, that talk turned into reality.
“When we saw on that Monday that the storm was tracking directly toward us, there obviously was a flurry of activity,” said Karen Sexton, vice president and chief executive officer for hospitals and clinics.
“We started taking measures then to limit our patient population. We began to discharge patients who were healthy enough, and we began to reschedule elective procedures.”
The medical center started talking to city and county officials about their plans, and it contacted the state to begin making arrangements to move as many patients as possible out of harm’s way.
On Tuesday, the situation had grown worse.
“The hurricane was still tracking in our direction, and it looked like it would be at least a Category 4 if not a Category 5,” Sexton said.
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Emergency status
By that afternoon, she had placed the medical center on emergency status. UTMB called off classes, sending students home for the rest of the week. It also began shutting down its laboratories, and it told nonessential employees not to report to work Wednesday.
Essential employees were instructed to report to work Wednesday morning with plans to stay through the storm.
The staff also began copying patients’ medical records and making sure it had the needed medications to send along with them. It began notifying families.
“We had been watching what happened to hospitals during Katrina, and we were determined to do it differently,” Sexton said.
On Wednesday morning, Sexton made final arrangements for the ambulances, helicopters and airplanes it would use to move the more than 400 patients still in the hospital.
To begin the process, the hospital set up triage stations.
“We wanted to get the sickest of the sick out first,” Sexton said.
The idea was that those would be the patients in greatest jeopardy if the medical center were to suffer significant damage.
Administrators were careful to make sure everyone was accounted for. Staff members went through a checklist before each patient left the floor, and they went through the list again before the patient left the hospital.
Throughout the process, Sexton said, the focus was on patients and their families.
“A number of patients left the hospital in the arms of nurses,” Sexton said.
For Pam Watson, the experience was an affirmation.
“It really made me think about what the education of nurses is all about,” she said.
Watson is dean of the school of nursing, but in the midst of the evacuation, she was simply a nurse.
“I thought about what I could do to make myself useful, and I decided that where I needed to be was with the patients,” she said.
Watson worked side by side with other staff members helping to prepare patients for their trips in ambulances, on helicopters and in airplanes.
“Some of the nurses I worked with were former students, and the caring they showed really made me proud,” Watson said.
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Saying goodbye
The hours were filled with emotion. Watson recalls being there as patients said goodbye to family members.
“They wouldn’t say anything, but you could see the tears running down their faces,” she said.
At one point, the departing patients were premature infants, some so small they would fit in the palm of a hand.
“One after another, the families would come down, and we’d help them on their way,” she said.
Michael Megna, the man in charge of UTMB’s prison hospital, is also responsible for the medical center’s emergency planning and called the evacuation effort a great success.
“It was orderly and safe,” he said. “We got all of our patients out of here with no added medical problems.”
In less than 12 hours, the medical center had moved 427 patients.
“It was just short of a miracle,” said Sexton.
When the last patient had departed, everyone involved breathed a sigh of relief.
“For a moment,” Megna said, “we almost forgot about the hurricane.”
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Evacuating the staff
Soon, though, folks like Megna and Sexton began to realize that the medical center had a whole lot of staff members and not a single patient.
“We needed every one of those employees when we were in the process of evacuating,” Sexton said. “We didn’t really need all of them once we had the patients safely on their way.”
Now, with a major hurricane bearing down, it seemed only fair to give those staff members a chance to leave.
“But we were already hearing horror stories about the traffic,” Sexton said. “It didn’t seem reasonable to just send them home.”
Sexton called the state for help.
“I basically demanded that they provide us with some planes,” she said.
After lining up two troop transports, Sexton presented the remaining staff members with a choice. They could stay where they were, they could head for home or they could get on a plane bound for Fort Worth.
About 130 of them opted for the plane, and then it was up to administrators to come up with a plan to get them to Ellington Field.
“We used all of the vans we had, and then we mobilized some personal vehicles,” Sexton said.
Watson spent much of that day processing the employees who were flying out. Throughout the weekend, she said, people found their roles changing.
“Everybody pitched in together,” she said, “and a lot of them, like me, were doing things they wouldn’t normally be doing.”
She met people in many departments of the institution.
“And I got to know them not for what they did but just as people,” she said.
There were moments of terror.
“On Friday morning, I thought, ‘I might die here, and I just hope it’s quick,’” Watson recalled.
In the end, of course, the storm spared Galveston, and the medical center sustained relatively minor damage.
In the days and weeks ahead, Sexton, Megna and others will be looking at the evacuation effort and assessing what went right, what went wrong and what can be done to make future efforts more successful.
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Lessons learned
“I’m sure a lot of people learned lots of things,” Megna said, “and we’ll be putting those lessons together very soon.”
One thing they know they’ll examine is staffing.
“I always worry about the number of people we’re putting at risk,” Megna said. “We always want to look at who really needs to be here.”
They’ll also look at what they can do to avoid having ambulances caught up in a traffic jam.
“One thing we can do is start earlier,” Megna said. “Another thing we can look at is evacuating more patients by air.”
Sexton stressed, though, that the early reports were favorable. No one had tried such a massive evacuation before, she said, but others will likely copy UTMB’s blueprint.
