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Incident Annex: Tropical Cyclones (Hurricanes)


A tropical cyclone, also called a hurricane depending on its location and strength, is a storm system characterized by winds reaching a constant speed of at least 74 miles per hour and possibly exceeding 200 miles per hour. On average, a hurricanes spiral clouds cover an area several hundred miles in diameter. The spirals are heavy cloud bands from which torrential rains falls. Tornado activity may also be generated from these spiral cloud bands. Hurricanes are unique in that the vortex or eye of the storm is deceptively calm and almost free of clouds with very light winds and warm temperatures. Outside the eye, a hurricanes counter-clockwise winds bring destruction and death to coastlands and islands in its erratic path. High winds and heavy rains from hurricanes impact inland regions many miles from the coast.

I. PRE-SEASON AND GENERAL PREPARATORY PLAN

A. General

1. Tropical Storms are cyclonic disturbances with winds between 39 and 74 mph (34 - 64 knots).  A tropical storm may develop into a hurricane and is usually accompanied by heavy rainfall.

2. Hurricanes are major cyclonic disturbances with winds of 74 miles per hour (64 knots) or higher that normally occur between 01 June and 30 November of each year (Hurricane Season), with maximum frequency during August, September, and October.

3. In addition to high-wind concerns, a hurricane will normally cause a storm surge which may exceed 20 feet above mean sea level, causing serious damage and disruption of services.

4. Directors/Managers shall develop department/unit-specific plans to meet the requirements of this plan and the needs of their departments/units.  Checklists are encouraged where detailed steps are required to meet preparedness needs.


B. Planning

1. Pre-Hurricane Season: By 1 June of each year, all areas/units will conduct the following:
a. Educate employees on Hurricane Plans.

b. Review material requirements, and provide a list of special or extra materials to Materials Management. 

c. Departments should develop provisions to relocate critical equipment and documents from external facilities into protective areas as needed.



2. Hurricane Season:

a. All areas/units will keep their disaster manual updated at all times and keep the Emergency Preparedness Subcommittee informed of "exception" issues.

b. The Safety Officer will monitor tropical storm activity and keep Administration informed of concerns.

c. The Emergency Preparedness Subcommittee will assist areas/units with planning as required.

d. Engineering and Security will conduct frequent inspections of hospital facilities and grounds to ensure general readiness to withstand tropical storm force winds (39-74 mph) at all times.  Missile hazards (items/materials that can be carried by strong winds) shall be monitored closely and action taken to secure them during storm warnings and/or hurricane alerts.

e. Engineering shall monitor contractors to ensure their ability to respond to hurricane preparedness requirements.


II. SEVERE TROPICAL STORMS AND CATEGORY I HURRICANES  

A. Hurricanes are one of the most destructive forces of nature encountered along the Mississippi Gulf Coast. Hurricane winds and related tidal activity can cause major damage to facilities and serious injury to people.  This Hurricane Plan has been developed in order to minimize the impact of a hurricane on MHG operations, facilities, patients, and employees.

B. Administration will issue a hurricane pre alert status when the Hospital is located within the probable strike zone.  When a pre-alert status has been called, employees will begin implementing their personal plans and get prepared to be placed on full Hurricane Alert Status on short notice. 

C. MHG Hurricane Alert Status (HAS).  When a major tropical storm or a hurricane threatens the Mississippi Gulf Coast, the Hospital President/CEO or his designee may place the hospital in a Hurricane Alert Status, depending on the projected landfall and severity of the storm.  When HAS is implemented, all departments will activate the Hurricane Alert Status Tasking as outlined in this plan.

D. Full implementation of HAS may not be necessary.  Consideration will be given to the National Hurricane Center projections and strength of the storm.  Hospital Administration may modify the phased tasking outlined in this plan, as appropriate for the level of threat presented by a Category I Hurricane (wind speed 74-95 mph).




III. ORGANIZATIONAL CONTROL

A. Normal supervisory control will be maintained throughout the Hurricane Alert Status.

B. The Hospital President/CEO will assign a Incident Commander to direct emergency operations during the Hurricane Alert Status.

C. The Incident Commander in the Hospital Command Center (HCC) oversees and coordinates activities for hospital personnel during a hurricane.

D. Coordination with local agencies (Harrison County Emergency Operations Center, Police, Fire, etc.) for emergency support will be accomplished by the HCC.

IV. STAFFING

A. The Hurricane Team consists of employees designated by the Directors/Managers to provide essential staffing during the hurricane season.

B. Directors/Managers will take measures to minimize staffing during a Hurricane Alert Status.  The ability of the hospital to support (house, feed, and care for) personnel seeking shelter is extremely limited.  

1.  Disciplinary action, up to and including termination, may result for failure to report for duty, or to complete duty assignments, during a disaster including hurricanes

2.  An employee must receive approval from his/her manager prior to making assignment or schedule changes.

C. The Hurricane Team is discouraged from bringing their dependents to the hospital.   Whenever possible, dependents should go to a community shelter or leave the Coast.  If no other arrangements can be made the employee will have to request an exception. Exception requests must be submitted to the employees Manager who will forward it to Administration for final approval.

D. The President/CEO or designee will determine when non-essential personnel should be released and the Hurricane Team activated.  Employees assigned to work or requested to be present at the hospital will be on a waiting to work status.  All hours will be computed as hours worked and employees will be paid according to their status. 

E. Medical Staff personnel will be coordinated by the Chief of Staff and the Director of Medical Staff Services.

1. The Chief of Staff will be responsible for physicians in the hospital and for assigning them to areas of responsibility.  The following specialties will be available: Pediatrician; Obstetrician; Urologist; Orthopedic Surgeon; Neurosurgeon; Anesthesiologist; Family Practice; General Surgeon; Internist; Hospitalist; Psychiatrist; Radiologist; Cardiac Surgeon; Cardiologist; and Pulmonologist.

2. Any physician who wants to be in the hospital during the emergency may come in and will be assigned to medical duties as needed.

3. Patient care areas will contact the patients regular physician as necessary and if possible, but if the physician is not available, an in-house physician will care for any patient.

4. Physicians should be discouraged from bringing their dependents to the hospital during HAS.

5. Medical Staff Services will register physician family members, report occupancy to the HCC, and provide a list of physicians and family members present at the hospital to Human Resources.

6. If when the Medical Staff Departmental plans are implemented there is any physician specialty, as noted in Section E.1 that remains uncovered, the Chief of Staff, or his designee, will contact the on call physician for that specialty to provide coverage.

V. HURRICANE SHELTERS

A. Memorial Hospital is not a shelter.  All persons seeking shelter should report to one of the local shelters.  Locations will be announced by the Harrison County Emergency Operations Center.

B. Employees released from work should seek shelter in local hurricane shelters instead of the hospital. 

C. If during the storm persons come to the hospital seeking shelter then they will be temporarily sheltered until such time that its safe to leave.

VI. PUBLIC ANNOUNCEMENTS / MEDIA INQUIRIES

A. All media inquiries will be directed to Community and Corporate Relations.

B. Public Announcements:

1. Obstetric patients who go into labor, who are projected to go into labor within 4 weeks, or who have a history of premature or precipitous labor will be instructed via media/public announcement.  The announcement should be checked for appropriateness with the Chief of Obstetrics and will be broadcast beginning approximately 24 hours prior to expected landfall.

Example:  "Any pregnant woman who is within 4 weeks of delivery or has a history of premature labor, and who lives more than 15 minutes from her hospital, should consider going to a shelter near the hospital where she plans to deliver."

2. Seminars or support group meetings that have been scheduled to occur shortly before, during, or after the expected storm will be canceled.  Community and Corporate Relations will notify the media of the cancellation upon communication with the individual responsible for the specific group.

C. Community and Corporate Relations will obtain a list of open shelters that will care for the sick, elderly, and pregnant from Harrison County Emergency Operations Center, and will release information on those shelters as requested.

D. Community and Corporate Relations will obtain a list of open community shelters from Harrison County Emergency Operations Center and will provide information to employees as requested.

VII. VISITORS

A. In-patient visitors are discouraged.    In any case, except for emergencies or other special circumstances, in-patient visitors will be limited to one per patient.  Customer Relations will visit patients before the HAS is implemented to make patients and visitors aware of what to expect.

B. Visitors who remain in the hospital during a storm will be registered by Human Resources as they enter the hospital and will be encouraged to remain in the host patient's room.

C. Security will monitor areas to ensure that visitors remain in their designated areas, except for meals and/or other appropriate services.

VIII.  PHASED TASKING - CATEGORY II - V HURRICANES

A. Phase 1 

1. The Hospital President/CEO or designee will activate the Hurricane Alert Status and will call a Management Conference meeting.

2. The Hospital President/CEO or designee will make the determination regarding closing the off site clinics.

3. The Hospital President/CEO will delegate authority to a Incident Commander.

4. Directors/Managers will activate the Hurricane Team and notify all applicable employees.

5. Patient Care Units:

a. Initiate discharge requests, and contact physicians to encourage discharges and discourage admissions.

b. Consolidate patients to minimize open units and provide reserve areas for emergencies and admissions.

5. Engineering:

a. Based upon projected landfall, Engineering will provide adequate time to:

1) Retrieve and install window protection panels from storage.  

2) Test emergency generators and related equipment.

3) Test back-up water supply system and related equipment.



6. Environmental Services will coordinate refuse dumpster pulls.

7. Materials Management will arrange for additional materials and linen to be delivered by vendors.

8. Food & Nutritional Services will arrange for delivery of additional food stock to cover Hurricane Alert Status.

9. Community and Corporate Relations will release public announcements to media as appropriate. 

10. Human Resources will set up the Employee Information Line (x 3073) in Human Resources. The number for the line shall be disseminated and regular departmental updates will be made to all employees by the Director/Manager on his/her voice mail.

11. Security will secure the parking garage for hospital-owned vehicles, employees of the Hurricane team and visitors as required.

12. Memorial Behavioral Health follows the same procedures as the Main Facility. The Administrator will oversee all the phased tasking requirements and report to the HCC.  Specific information for MBH employees may be obtained by calling 575-1909.

B. Phase II

1. Medical Staff Services will provide a listing of physicians who will be providing medical support during the hurricane to the Hospital Command Center. 

2. If needed, a meeting of Directors/Managers, Emergency Preparedness Subcommittee, and other designated personnel will be called to disseminate information and address any questions.

3. Department Directors or Managers shall adjust staffing as needed to provide staff time for preparation.

4. Security will activate special security measures as directed by the HCC.  These measures may include:

a. Continuous monitoring of unsecured entrances.

b. Check identification of all persons entering the hospital and confirm required presence.

c. Control corridor activity/traffic.

5. Communications will:

a. Report to HCC to install telephones and ensure equipment is working properly.

b. Test Emergency Communications networks.

7. Engineering will install window protection panels.  All panels must be completed prior to leading edges of winds arriving. 

8. All areas/functions, after receipt of authorization, shall notify Hurricane Team of staffing assignments and release non-assigned employees.

9. Directors/Managers will inform released employees to contact the hospital regarding back-to-work status.

C. Phase III

1. The Vice President of Patient Care Services and/or designee will coordinate sleeping assignments for Hurricane Team.  Directors/Managers will provide assistance as necessary.

2. The HCC shall be activated and notify assigned departments to acquire the number of staff and/or the staffing needs.

3. Communications will activate communications plans as appropriate.

4. All areas will update shelter registration as required.

5. Surgery will cancel all non-emergent surgery cases for duration of storm.

6. Activate Employee Sign-In Log by units/departments, list all personnel, their location, and status (working, sleeping, etc.). The log is for location purposes only.  Payroll time will be maintained through normal time clock procedures, but double-checked by the log if necessary.

7. Open designated sleeping assignments as directed by HCC.


8. Directors/Managers, ensure that employees remain in their assigned work area in order to decrease traffic/congestion in the corridors.


D. During Storm

1. Except to assist with receiving patients in the Emergency Room, no one should be allowed to exit the hospital without the express consent of the HCC (x3212).

2. Everyone entering the hospital (other than patients) shall be registered as Shelter Occupants by Human Resources.

3. Activity in corridors shall be kept to a minimum in order to ensure adequate room for emergency response.

4. The hospital will stay on normal electrical power as long as possible.  The Director of Engineering will decide when/if to switch to emergency power.

5. Areas requiring assistance (wind/water intrusion, etc.) will contact the PBX.  A "Code 1 - Area" will be announced.

E. All-Clear

1. The Harrison County EOC will advise Administration when the danger of threatening winds or additional damages has passed, at which time Administration may initiate on-site recovery procedures and begin to stand-down from the HAS.   At this time, Engineering will survey the building and grounds to assess damages and initiate essential repairs.  Employees and staff should not be released until the all-clear has been announced by Harrison County EOC and/or Hospital Administration. The Hurricane Team will be released as their replacements return to the hospital. Volunteers, medical staff, patients, and visitors should be discouraged from leaving the hospital until the official all-clear has been announced.

2. The official all-clear will be announced by Harrison County EOC when the storm threat has passed, and an initial damage assessment has been made to determine and clear immediate threat damages, i.e., downed power lines, broken gas lines, etc.