A surgery center administrator lost her home, her Hawaiian vacation was off, and the road to her workplace was barricaded, but things could have been much worse.
“Before the fire, someone turned off the center’s air conditioning, so we had very little smoke damage in our building,” says Marion Auld, BSN, MBA, administrator at Santa Rosa Surgery and Endoscopy in Santa Rosa, CA.
The surgery center was surrounded by other buildings that had burned and a scorched landscape in October 2017. Santa Rosa officials called the fire the worst their area had ever experienced. Hundreds of homes were destroyed, including many owned by doctors, nurses, and other healthcare professionals. The fire resulted in forced evacuations and the temporary closure of multiple healthcare facilities, including Sutter Health and Kaiser Permanente hospitals.
With its air conditioning turned off and vents closed, Auld’s ASC emerged from one of California’s worst fires relatively unscathed. The hospital near the ASC also escaped the blaze. Further, Auld says her center used a continuously refueled 72-hour generator that helped preserve medications.
Auld checked out the surgery center soon after the fire and helped organize its emergency recovery plan while the ASC was closed for 14 work days.
Foresight and preparation made all the difference. While ASCs maintain disaster preparedness plans, they might not have developed a post-disaster process and plan. Auld offers some advice on what to expect and how to prepare.
- Ensure key people can access the ASC.
It was luck more than forethought that Auld had her work badge with her when she returned to the ASC a few days after the fire. Thanks to this serendipity, emergency officials allowed Auld past the National Guard tanks and barricade that had closed the road to everyone without hospital or ASC business. Once she arrived, Auld used her badge to open the center’s electronic key lock.
“The property manager couldn’t get into the center because the person who had keys to the building had evacuated his home, so they waited for me to show up. Luckily, I had left my keys in my house, but the badge system worked, and we got into the building,” Auld recalls.
- Use air scrubbers as soon as possible.
“We put air scrubbers in the building to clean the air,” Auld says. “It was hard to be in the building in October when it was warm and we couldn’t run the air conditioning system.”
Air scrubbers can remove soot and particles from the air, deodorize the air, and returning the air to pre-fire conditions. If the facility has sustained chemical, fire, and/or water damage, the air scrubber also can remove mold and toxic chemicals.
- Contact employees and clean out supplies.
Equipment, like surgical trays, needed to be reprocessed. Keeping other supplies was a judgment call. “We felt like our medications in our fridges were OK, but to be on the safe side, we got rid of some of the medications,” Auld notes.
In preparing for both the disaster and the aftermath, ASCs should make certain all employees’ contact information and emergency contact information are updated and readily accessible. Also, employees could be instructed to call a landline and leave a message with contact information when the disaster has caused them to relocate.
“Some of our managers had employees’ numbers on their phones, but we had no email or calling service because the cell towers were all burned down,” Auld says. A better solution is to maintain all contact information at a remote location, far enough away from any local disaster, where it can be accessed quickly.
“If you have a list of employees at home, and you are forced to evacuate from your home, then that list is not the first thing you will grab,” Auld says. “We have 100 employees, and for one employee it took us five or six days to find her in a high fire danger area. People will be in places you don’t even think about.”
- Reschedule and move patients.
“We rescheduled some of our cases to another facility, and we sent some of our staff there to work,” Auld says. “We had to call patients and offer for them to go to another surgery center that was 40 miles away. We gave them that option.”
Patients who were willing to postpone their surgeries could reschedule for when the ASC reopened.
- Check property insurance coverage.
“People should know their property insurance and what’s covered under it,” Auld advises. “We need to know the agent’s name and what the policy will cover. This information should be handy.” Some insurance will cover staff wages during a disaster or emergency. For Santa Rosa Surgery and Endoscopy, a human resources representative called employees to ask how they were doing and to tell them that they would be paid for their time off, Auld notes.
“People were starting to get nervous, so they reached out and said, ‘We’ll pay you; insurance covers you when we’re closed,’” Auld adds. “That was such a positive experience for us.”
- Obtain all certifications and inspections for reopening facility.
When an ASC is closed for several days or longer, it has to reopen as if it were a new facility, Auld says.
“You have to get fire permits, gas certification, air quality checks, generator logs, and monitoring of temperature, medication, and refrigerators,” she says. “You need to be inspected by the fire department and receive a county permit before you can reopen the building.”
Other checks include fire alarm operability, the facility’s air flow, a water report (if the facility uses well water), life safety evaluations, department of health inspections, and an indoor air quality assessment.
- Reopen as soon as possible, and make time for emotional support.
When Auld’s staff returned to work, they helped stock the replacement supplies. Later, the center made time for people to tell their stories about the fire.
Including Auld, three employees lost their homes. Of the 120 physicians credentialed with the ASC, 35 lost their houses.
“You can’t just bring people back to work after this happens. They need time to tell their story,” Auld notes. “Everyone is distracted. On the day when we brought everyone back, they needed — more than ever — to be a part of a team.”
Some employees spent their time off volunteering at Red Cross shelters. Others had to deal with moving far away from their home. Once they returned to the surgery center, employees wanted to watch out for one another. Everyone was living in temporary situations, some with other people. But they had to come back to work, despite the unsettling feeling of personal limbo. Auld had to return to work before she could even take a look at the fire destruction of the home she had lived in for 30 years.
“The fire came at night, starting around 8, moving at 35 miles per hour,” says Auld, who lived 1.5 miles from the ASC and the adjacent Sutter Hospital. “I smelled smoke around 10, and by 11 at night the fire was 14 miles away. By 1:30 a.m., my house was gone.”
She lost everything except the little she had taken with her when her neighborhood was evacuated right before the fire engulfed it.
“Our fire burned 6,000 homes in the area one night and then lingered in the area for two more weeks,” Auld says. “We evacuated to a town 15-20 miles away, and had no clothes ... I just wore exercise clothes from the back of my car.”
All Auld had brought with her when she left her house was her packed bag for the trip to Hawaii. Working kept her mind off her family’s substantial losses.
“Coming to work was the best thing that could happen to me,” Auld says. “What are you supposed to do, sit in a house with no furniture? It was better to go to work.”
Plus, work felt more like home than anywhere else. “I had photos in my office, pictures, coffee mugs, three to four pairs of shoes under my desk, so my office was a comfortable place to be,” Auld explains. “For me, shopping was very painful, a constant reminder of everything I lost.”
Once Auld and other staff shared their disaster experiences, everything seemed to jell in the workplace.
“After that, the surgery center ran so smoothly,” Auld says. “I think the staff pulled together and they worked very smoothly as a team.”
While ASCs maintain disaster preparedness plans, they might not have developed a post-disaster process and plan. One ASC leader offers some advice on what to expect and how to prepare.
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