Don Boyce had been working for emergency management for Mount Sinai Health System in New York for just eight months when he got the alert on Saturday night: the lights were out in midtown Manhattan.
Mount Sinai West was among the facilities that lost power and relying on backup generators the night of July 13. Boyce, one of the members of the Mount Sinai emergency management group, was going to see the health system’s emergency system in action.
Within minutes, a notification went out that there was a major problem at the hospital. Messages were immediately sent to the emergency managers located onsite at each of Mount Sinai’s medical facilities, along with Chief Operating Officer Timothy Day. Critical staff were notified via the health system’s email and then a program—known as Everbridge—connected them directly to the conference call via the email.
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Assessing the outage
In the early stages, the team did not have knowledge of the greater Con Edison outage happening throughout several city blocks.There was to be an initial huddle for the incident management team.
The initial call included debriefing from security and engineering and the nursing supervisor—those on the ground of the situation. Being a Saturday, the primary emergency manager for Mount Sinai West was not in the building. His back up, Michael Redlener, MD, medical director for EMS and disaster preparedness, was on duty in the West emergency department (ED).
Boyce said that the team set a list of priorities to address the power outage.
Many questions were asked: Were the backup outlets working? Were all patients, staff and visitors safe? Was anyone trapped in an elevator?
And most importantly, were critical pumps preserving life working as needed? Was the quality of the medicine and food compromised?
“I've done this my entire profession,” Boyce said. “The first call is always messy and addresses what we need to work on in the first couple of minutes. This usually changes over the next hour or two.”
As soon as the call ended, staff mobilized into action.
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By the time Boyce arrived at Mount Sinai West, the onsite engineering director was on the scene along with the chief operating officer and three emergency management staff.
“No patients were pushed into extreme circumstances and there was no loss of life. That is a testament to our preparedness and the real-life practice and drills we perform,” Boyce said.
Preparing for possible evacuation
While the engineers anticipated the power coming back up soon, Boyce could not take that chance. His team prepared for two days out with no power.
Boyce had to consider shift changes. If new staff needed to arrive at the hospital by 7 a.m. the next morning and the subway was still not running, the hospital would need to arrange for a bus to pick up staff at a rallying point.
He was also worried about the ventilation, the air conditioner overnight and the humidity in the hospital. He was also concerned with possible IT glitches that could occur or potential power surges when the electricity did come back on.
“Even though we are managing the event of the moment, we had to think about the consequences over a 72-hour period,” he said.
After discussion, Boyce was informed that the generators could move cold air but not produce it and that with a forecast of high heat for the next day, the team needed an evacuation plan.
So the next step was to contact other Mount Sinai facilities to identify available for beds for Mount Sinai West patients. Boyce said he was also contacted by three major private hospital competitors to offer resources if needed.
During emergencies like these, the information is shared well-beyond the affected health system. A New York fire department inspector was contacted to update the hospital of what is going on in the surrounding community. Hospital officials also contacted the Greater New York Hospital Association so that the organization can brief the public on the disaster impact and to help secure any resources the health system may need.
In the end, it turned out the extra preparation wasn't needed.
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Less than five hours later, the power did return to the hospital and midtown Manhattan.
But after the emergency situation played out, the presidents and CEOs of the health system’s hospitals and all of the emergency action participants had a closed-door discussion on what worked and what could be improved upon. Boyce says that after this blackout, there were people asking to be made aware of an emergency situation sooner.
He also said he was left thankful that he’d formed relationships and worked with emergency management on every level—local, state and federal—prior to the incident. In this case, it meant when a real emergency occurred, he knew and trusted the people he was working with.
“We’re always working to enhance communication,” Boyce said. but what everybody forgets is that in those first five or six hours, adrenaline kicks in and you’re working on crisis management.”