Virginia history. First, “The Derecho” blew through the valley late in the evening on June 29, knocking out power to thousands, some of whom had serious medical issues. Then the extreme heat made matters that much worse.
But Carilion Clinic, working with local public safety agencies, responded swiftly and worked out some innovative strategies during the critical period just after the storm. Assessing how it transpired weeks later, Paul Davenport, the Vice President of Operations for Emergency Services and Kim Roe, Senior Director of Emergency Medicine Operations, said they were pleased with the outcome.
Roe also works with the Velocity Care outpatient clinics on Electric Road and in Botetourt County. Davenport, an ex-firefighter, was the first incident commander on the Friday night that Derecho brought hurricane-force winds to the Roanoke Valley, knocking down trees and limbs and leading to extensive power outages. Roe was working in operations at the same time. Ironically, Davenport had been at Carilion Roanoke Memorial Hospital with his family visiting a patient when he was called into action that Friday night. Employees worked extra hours all weekend; CEO Nancy Agee came to the command center to offer her support.
The morning following the storm, “the community was assessing itself,” recalled Davenport. That meant no power in some cases and traffic lights that didn’t work. “The damage was there.” At Carilion Roanoke Memorial they started to hear updates through a regional Disaster Task Force. “The chatter began to increase,” said Davenport, about issues like the number of people requiring oxygen at home who might have to be temporarily located elsewhere due to a lack of electricity.
“Infrastructure problems,” at some area nursing homes also meant residents would wind up in emergency rooms or at the hospital. A “gentle rise,” in the number of patients being seen began that Saturday afternoon, according to Davenport, and some patients ready to be discharged couldn’t go home or to their nursing facility due to the lack of power. That slowed Carilion’s “through put,” and the turnover of beds said Davenport.
The situation triggered Carilion’s incident command team, an on-call group that sprang into action. ER physician Dr. Kevin Broyles first made the decision to call up the team, according to Davenport. Carilion’s incident command team members train for just such an incident and the power outage was a chance to put theory to work.
A formal structure of operations was established, similar to one that might be used for a large scale fire, with a commander, an incident commander and people responsible for planning, logistics and overall operations. A power loss at certain Carilion facilities (including hospitals in Giles and Franklin Counties) just made it more of a challenge. Generators helped keep vital functions and Roanoke Memorial Hospital up and running.
Roe went to work as the operations officer for the incident command team, making sure the resources were in place to deal with any emergencies, and that there was good coordination with outside agencies like police, security, public information and local fire/EMS companies. “My job was really to assess the needs of the system,” said Roe; “its amazing in times of extreme stress and disaster [that] our staff always rises to the top level of commitment. Getting people to participate was no issue.”
The Carilion team helped ensure that the cooling stations set up around the valley could handle people coming in with oxygen – keeping them out of emergency rooms – and worked with clinics like Velocity Care to make sure that for patients could be seen without delay.
Alternative clinic sites were also established within 24 hours when the power failed at one Carilion outpatient facility. Spokesman Eric Earnhart praised the plant engineering and maintenance staff that kept backup generators in good working condition. “I don’t believe we had any generator failures [that weekend],” said Earnhart.
Roe said the technology services division coordinated with her team, AEP and Verizon to get Carilion facilities operational again. “Everybody did an outstanding job.” In her 27 years at Carilion, Roe can’t recall a similar incident. Some of the information coming in was inaccurate; that’s where working with local public service agencies to get the real story was key.
“I’m really thankful for all of the months we trained,” said Roe, noting that the incident command team routinely goes through some type of exercise. As AEP worked to reconnect electrical power at Carilion hospitals they would also shut off generators temporarily. “It was like a roller coaster,” said Roe.
Davenport said the dedicated incident command team, trained and in place for years, demonstrated its value this time, terming the operation “exquisitely run.” Never before he said had there been an emergency situation,“ that speaks to the longevity and fullness that we had to use our team [for this time]. If it did escalate we needed to be prepared for that.”
It turned out to be “a great coordinated effort by many members of the Carilion health system and many outside agencies that pulled together,” said Roe. There was perhaps a five percent increase in the number of people admitted at Carilion Roanoke Memorial during that post-Derecho weekend.
The extreme heat, food-borne illnesses (perhaps related to spoiled food at powerless homes) and even minor injuries from car accidents where the lack of traffic lights might have been a factor led to the increase. The Velocity Care location on Electric Road (Daleville was closed due to the outage) and extended hours at the community care clinic inside Carilion Community Hospital helped keep people from jamming the ER at Roanoke Memorial.
Carilion also saw more laceration wounds, some from people who were trying to remove downed trees with their own chain saws. One clinic location (Westlake) ran out of sterile gloves before the Carilion materials management group came to the rescue.
“The incident command team [which shut down on the Monday following the storm] at Carilion really did a fantastic job of being able to forecast ahead,” said Davenport. “Whatever the end was going to be, it wasn’t going to trump our resources. An excellent validation of what people think of their role in serving the community.”
Roe said a post-incident review uncovered “some things we would do a little bit different, but all in all we were very pleased with how we managed …multiple incidents. It really touched every facet of our operations.”
By Gene Marrano