As agencies recover, more disaster planning tips, suggestions offered
Communications, gasoline, and patient records key areas to address
(Editor's note: This is one of a periodic series of stories that will follow up on the experiences of home health agencies, associations, and their staff in the Gulf Coast states affected by the hurricanes this year. Tips and suggestions they have as a result of their experience will help all home health agency managers better prepare for their own emergencies.)
The television crews are gone and other news items lead the 6 o'clock news, but the devastation of hurricanes Katrina and Rita are still everyday stories for the people who live and work in the Gulf Coast states affected by the storms.
"It is still extremely important that we continue to let the home health industry know that agencies in this area are still struggling with significant problems," says Warren Hebert, RN, CHCE, CAE, executive director of the HomeCare Association of Louisiana in New Iberia. For agencies that had only one location in New Orleans, the amount of damage makes it obvious that some won't reopen, says Hebert. "Other agencies that were located in parts of the city that weren't flooded as severely are able to repair their office locations and are beginning to have employees and patients returning to the area," he adds.
Because Hebert's association staff and volunteers have come into contact with a wide range of agency representatives as they have offered assistance, he says there are a number of lessons learned in this experience that can help all home health agencies better prepare for emergencies.
•Obtaining gasoline must be a priority
"When power is out, gas pumps don't work," points out Hebert. "Even when there are working pumps, gasoline is in short supply and home health nurses often found themselves sitting in long lines to receive a ration of gasoline that did not allow them to make all of their visits," he says. "Making sure your nurses get the gasoline they need is essential because their home visits can keep patients out of already crowded hospitals.
"Home health agencies should look at developing a relationship with gasoline providers that recognize the home health need for gasoline as a critical community service," Hebert says. "One agency manager in a small town contacted a local gasoline station owner and pointed out that rationing gas to her nurses affected patients in the community. The store owner agreed with the home health manager and said that home health nurses from her agency could, when they showed their identification, get more than the ration allowed for other customers so they could do their jobs," he says. "The owner also agreed to run a tab for the agency's nurses that the home health agency offered to pay."
•Explore alternate forms of communication
"Communication was critical in the aftermath of the storms but telephone landlines were not working and cell phone coverage was inconsistent," says Hebert. "Some people found that e-mail on a blackberry worked well," he says.
"Even with cell phones, text messages were easier to send than voice calls," says Stan Sweeney, RN, executive director of the Oklahoma Association for Home Care in Oklahoma City. Sweeney spent time in Louisiana, volunteering with Hebert's association and visiting agencies that were trying to see patients and resume business. "Text messages and satellite-based communications seemed to work better than traditional phone lines or cell phones," he adds.
One of the reasons that text messaging is often easier than voice phone calls is the fact that text travels on different channels than voice communications, says Patrick Kimball, spokesman for Verizon Wireless in Houston. "When a network is overloaded due to damage to cell towers or due to high call volume, text messages will not only travel on different channels than voice calls but because text messages take up less space on the channels, more text messages can be sent over the same network than voice calls," he explains. Another advantage to using text messages in the aftermath of a disaster is that if the system is busy, the message is held in queue and sent when the channel is open, he adds.
"One agency in our area also purchased satellite phones after the storms took out communications systems," says Hebert. Because the agency had not established satellite service prior to the hurricanes, managers of the agency were unable to hook up their phones as open satellite links were designated for use by the military and by Federal Emergency Management Agency personnel in the area, he adds. Satellite phone service for an emergency must be set up prior to the emergency to ensure access, he explains.
•Have backups for your backup plans
"The main recommendation I have brought back to our Oklahoma agencies is to decide how you will continue service following a disaster that destroys one or several of your locations," says Sweeney. Addressing this problem means thinking about what happens if all patient records maintained in the office are lost, as well as all computers, clinical supplies, employee records, and financial information, he points out. If you have other offices, make it possible to operate from that office with as little difficulty as possible by setting up duplicate systems, he suggests.
One of the ways that the HomeCare Association of Louisiana helped agencies was to open their offices as a business recovery center with staff and computers to enable agencies to continue billing for the patients they were seeing, says Hebert. "Few agencies took advantage of this, but we believed it was important for the association to do something immediately after the storms," he adds. "We have taken our business recovery efforts on the road, traveling to different agencies, asking what type of help they need, and offering advice on steps they need to take," he says.
"This hurricane season definitely points out the need for electronic records," says Hebert. "Agencies that have electronic records, with backups kept at distant locations, are in the best shape in terms of recovery."
•Make sure patients take medical records with them
The number of people evacuated from their homes, both before and after the hurricanes, resulted in a problem that has never happened on this scale, Hebert says. "Patients were relocated to different cities and different states, with no medical information available to the physicians and health care providers that were charged with caring for them," he says. "Part of any home health agency's emergency preparedness plan should be to be sure that patients carry an abbreviated copy of their medical chart with them when they evacuate," he continues. "Many agencies leave a home copy of the medical information and update it as needed each visit. Patients should know to carry this with them," he says. "Diagnosis, medications list, and treatment plans are the minimum amount of information they should have with them.
"Some agencies are evaluating the use of patient armbands, similar to those worn in hospitals, as preparation for other emergencies," Hebert says. The armbands would include patient information, including diagnosis, as well as family contact information and home health agency information, so that the receiving caregiver could get in touch with someone for more information, he says.
Another technological solution would also be the use of flash drives, also known as key drives due to their size and shape, says Hebert. "If the nurse uses a laptop for documentation, she could just update a flash drive that is kept in the patient's home. If patients evacuate, the flash drive is easy to pick up and carry with them," he adds.
While recovery from the hurricanes slowly and steadily moves along, Hebert says that the offers of assistance from people who want to volunteer time and from people who want to contribute to the association's recovery fund, which will provide money to agencies and agency personnel who need assistance, has been awe-inspiring.
"We've learned a lot about our ability to deal with a crisis and about our industry's support of our efforts," he says.
Hebert's association members will share their experiences at the association's annual conference that was moved from a November date due to lack of hotel space as a result of emergency personnel in the area, to Jan. 16-18 at the Hilton in New Orleans. "We planned the topic after the hurricanes," he says. It is appropriately named "Transcending Crisis. Transforming Your Future."
Sources
For more information about disaster planning tips, contact:
- Warren Hebert, RN, CHCE, CAE, executive director, HomeCare Association of Louisiana, 223-A East Main Street, New Iberia, LA 70560. Phone: (800) 283-4252 or (337) 560-9610. Fax: (337) 560-9606. E-mail: [email protected].
For more information about disaster planning resources developed by the HomeCare Association of Louisiana or about the national conference, go to www.hclanet.org.
The television crews are gone and other news items lead the 6 o'clock news, but the devastation of hurricanes Katrina and Rita are still everyday stories ...You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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