Responding to Harvey: How a Houston-area health care coalition modeled success

Houston, TX
A​ugust 2017​

On August 27, 2017, at the height of Hurricane Harvey’s catastrophic winds and rain, a 54-year-old man with a serious head injury arrived at the Harris Health System’s Lyndon B. Johnson (LBJ) Hospital Emergency Department in Houston, Texas. As a Level III trauma center, the hospital needed additional personnel and resources to treat the man; he needed to be transported to a Level I trauma center for neurosurgery.

Hospital officials asked for transport assistance, but the weather conditions were so severe that roads were impassable and helicopter transports were grounded. A colorectal surgeon at LBJ eventually performed the necessary emergency surgery to save the patient’s life, but he still needed care and monitoring in a Level I center.

Fortunately, LBJ Hospital is part of the Sout​hEast Texas Regional Advisory Council (SETRAC), a Houston-area health care coalition that fosters partnerships and planning between hospitals, public health agencies, emergency medical services, and other members of the health care, medical, and response community. The coalition’s Catastrophic Medical Operations Center (CMOC) contacted the U.S. Coast Guard to coordinate patient transport, and shortly after surgery the patient was transferred to a Level I center where he received the ongoing care he needed.

This example of coordinated coalition response was one of many during the 17-day disaster event.

SETRAC serves as a model for building and maintaining a successful health care coalition and leveraging that coalition in disaster response. Crucial to its success were resources provided by the Hospital Preparedness Program (HPP).

HPP provides federal funding, guidance, and technical assistance to promote health care system preparedness and response. The program brings together key players in health care and emergency response disciplines to prepare for, respond to, and recover from large-scale disasters. HPP funding allows SETRAC to conduct regular communication drills, hold regional exercises, and test preparedness and response capabilities. SETRAC counts the strong commitment of coalition members and robust buy-in from local jurisdictions as critical components for their success.

HPP promotes the development and maturation of health care coalitions and drives discussion around response capabilities. Response is the yardstick by which a health care coalition’s success is measured. This is not lost on SETRAC; over the past ten years, the coalition has shifted from purchasing supplies to investing in education and training. Coalition members often prefer investing in people at SETRAC who can help coordinate, plan, and respond, rather than buying medical supplies and equipment for individual facilities.

According to Lori Upton, RN, BSN, MS, CEM, SETRAC’s Director of Preparedness, CMOC mediated the coalition’s successful response. CMOC operated as a single coordinating entity during the disaster – an important function of effective health care coalitions – by overseeing information management, brokering requests for assistance and supplies, coordinating patient movement, and providing situational awareness across emergency response disciplines.

Although CMOC had been activated previously during localized flooding and for major public events such as the Super Bowl, Hurricane Harvey was different: The storm delivered more than five feet of rain in just two days and caused epic flooding in the region.

Regular communication between CMOC, SETRAC’s partners, the U.S. Department of Health and Human Services, and the military ensured that crucial information about coalition status, weather reports, partner needs, and patient movements remained up-to-date and readily available. During the disaster, CMOC coordinated a wide range of activities, including:

The coalition also participated in efforts to ensure that dialysis patients who were trapped in their homes or relocated to evacuation centers could continue to receive treatment.

When measured in terms of saved lives and reduced suffering, SETRAC’s response to Hurricane Harvey was a clear success. Fundamental to that success was the coalition’s relationship with HPP. “We use HPP as a foundation to identify gaps in preparedness and determine funding priorities,” says Upton. “HPP has allowed us to move concepts into realities.”

For more information about how SETRAC’s Catastrophic Medical Operations Center works, check out this Q & A with Lor​​i Upton.

If HPP has helped your community respond to a disaster, share your story!