EFEF--5 TORNADO5 TORNADO

ST. JOHNS MEDICAL CENTERST. JOHNS MEDICAL CENTER

JOPLIN, MISSOURIJOPLIN, MISSOURI

Baylor Health Care System

Environmental Safety and Emergency Management

Baylor Emergency Response Team

INTRODUCTIONINTRODUCTION

• 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 survey the damage sustained to the hospital and the

City of Joplin.

BERT LIAISON TEAM OBJECTIVESBERT 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: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 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 IMPACTJOPLIN TORNADO IMPACTA quick review

EF-5 Tornado

Arguably the worst in US

history

12 mile path, 1 mile wide

Lasting approximately 20 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 PREPAREDNESSHOSPITAL 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” 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 RESPONSEINITIAL RESPONSE2. The immediate actions taken in response to the tornado by the

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

Communication

The 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.

Evacuation

Two 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 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 Transport

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

hours).

Hospital Grounds

Memorial hall established as

temporary ED.

Missouri DMAT set up field

hospital.

Initial difficulty getting FEMA

to assist.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 Administration

Convention center used as

hospital admin and EOC.

Excellent support from Mercy

System.

Commitment by hospital CEO

and leadership to employees 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 Learned

Redundant communications

• Social media

Public relations

• To community

• To employees

More Training

• Evacuation drills• 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

What is Baylor doing to prepare?

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.