Planning and Private Resources
At the Hospital Giant HCA
Made Rescue Operation Possible
By GAUTAM NAIK
Staff Reporter of THE WALL STREET JOURNAL
September 7, 2005; Page B1
As New Orleans emergency services struggled last week, giant hospital company HCA Inc. ran a rescue operation that airlifted some 200 patients and 1,200 staff members with 20 helicopters it managed to find and hire.
The Nashville, Tenn., company cobbled together a rescue for patients and staff at Tulane University Hospital and Clinic, a facility that it owns and that was badly hit by Hurricane Katrina. HCA flew in amateur ham-radio operators, including two from the Tallahassee Amateur Radio Club to prevent midair accidents.
"We used ham radios to create a makeshift air-traffic control system," says Ed Jones, a vice president of supply chain operations at HCA, noting that there wasn't a single chopper mishap.
HCA's evacuation of critically ill patients in the midst of poor flying conditions, no electricity, weak phone links and frequent sniper fire stands out among rescue operations in New Orleans in the aftermath of the hurricane. It throws into relief a corresponding failure of the public-rescue system: No such operation occurred across the street, at state-run Charity Hospital.
Indeed, HCA helped rescue up to 50 patients from Charity, many of whom were critically ill. Although HCA's own patients and employees were in peril, the company's ability to launch and execute a rescue shows how advance planning and private resources gave HCA and its patients a far different experience than those at Charity and other public hospitals.
"We were unable to get any governmental help in evacuating," says Norman McSwain, a professor of surgery at Tulane and trauma director at Charity, who worked at both hospitals throughout the crisis. Two evacuated patients, both from Charity, didn't make it.
The evacuation was the result of bold decisions by senior executives in the heat of the moment, coupled with some careful advance groundwork. Last fall, top brass from HCA and its hospitals met at the Hyatt Hotel in Orlando, Fla., for a "Hurricane Lessons Learned" meeting. Three hurricanes had roared through Florida over the previous months, and HCA, whose 190 hospitals and 91 outpatient surgery centers are concentrated in the Southeast, wanted to better protect its facilities.
Some key gaps HCA identified: Cellphones often fail, so alternative phone systems are needed. Roads become impassable, so emergency supplies have to be stored closer to hospitals. Backup generators are vital for cooling lab and diagnostic equipment, especially in summer, when hurricanes tend to strike.
In the following months, HCA provided its hospitals with satellite phones, hurricane shutters and additional backup generators. It also struck deals with local businesses -- refrigeration and water companies, diesel and gasoline retailers -- to provide supplies quickly in the event of an emergency. In areas where hurricanes were likely to strike, it also began to move food, medical supplies and other gear to warehouses closer to hospitals.
When Katrina struck last week on Monday, Tulane Hospital initially withstood the onslaught. But as some levees collapsed, water began to seep into the hospital. By seven the next morning, senior HCA executives had gathered in the company's Nashville boardroom, which would become their command-and-control center for the rest of the week.
The group realized they would need to lease about 20 helicopters for the evacuation of patients and staff, a move HCA had never before made on such a scale. Jack Bovender, Jr., the company's chairman and chief executive, didn't hesitate. "Get them," he said, according to Mr. Jones.
HCA employees leased a motley collection of helicopters, including a privately owned Blackhawk belonging to firefighters in Ocala, Fla., and a Russian-made machine from a land developer in Panama City, Fla. Soon after, HCA's makeshift fleet was ferrying critically ill patients from the parking lot at Tulane Hospital to other facilities.
It was tough going. Two Tulane patients each weighed more than 400 pounds, and one heart patient awaiting a transplant was strapped to 500 pounds of equipment. The elevators were dead, so medics carried patients up several flights of stairs. At night, the helicopter landing zone was illuminated by the headlights of cars parked in the garage.
Things were far worse at Charity Hospital, where patients and staff were subsisting on canned fruit cocktail and a dwindling supply of water. Eventually, Charity patients were ferried to Tulane in boats and evacuated by HCA helicopters. Dr. McSwain says he counted 254 evacuated patients, from both Charity and Tulane. An additional 1,400 people, including staff and patients' family members, were taken out. "I don't know where to lay the responsibility," says Dr. McSwain. "All I know is we were left without help. And we got our own help."
Jeff Prescott
Director, Media Relations
Ph: (615) 344-5708
