Hurricane Ian Provides Acid Test for NCH Healthcare Emergency Plan

Paul C. Hiltz, president and CEO of Naples-based NCH discusses the health system's response to the cataclysm.

Hurricane Ian ripped into Southwestern Florida as a Category 4 buzz saw on Setember 28, bringing with it 150 mph winds, unprecendented 18-foot tidal surges, and claiming 119 lives so far, with early estimates putting the cost of the damages at $63 billion.

Naples, Florida sat about 50 miles south of the eyewall, but providers there were quick to assess the extent of the emergency for the region.

NCH Healthcare System President and CEO Paul C. Hiltz details the system's response to Ian, its role in the transfer of more than 400 patients from nearby hospitals, what worked, and what was learned, in this email exchange with HealthLeaders.  

HealthLeaders: When did you start making hurricane preparations?

Paul Hiltz: NCH Healthcare System sprang into action when we first learned that we were on the edge of the long-range forecast cone, even though then, models were suggesting that the storm could perhaps make landfall 300 miles to our north.

HL: Were your facilities damaged by the storm?

Hiltz: Comparative to many other facilities closer to our coasts and just 30 miles north of us, NCH was largely spared from major damage.  We did see flooding on our campuses and storm surge waters damaged some equipment chillers that are outdoors as well as some cars in our first-floor garages and parking lots at both of our hospital campuses in Naples, but water never intruded into the hospitals themselves, save for a couple of leaks in the roof that made themselves apparent during the storm. 

It is hard to gage total cost imparted by the storm because we continue to assess our properties and physician group practices for damage.

HL: Did you have a disaster preparedness plan in place? 

Hiltz: NCH has had a hurricane preparedness plan in place for years, and each time our plans are enacted, we learn something more and figure out better ways to refine our processes.  Each storm and their effects to our region are different, however, and that’s what can make planning for these things so challenging.  For example, the storm surge we saw with hurricane Ian has never-before been documented in our area.  Like many, however, we plan for the worse and hope for the best.

HL: How difficult is it to prepare when the healthcare sector has so many supply issues?

Hiltz: Certainly, the supply chain issues our entire nation is facing served to make attaining needed supplies in advance of the storm challenging.  However, NCH Healthcare System has strong supply chain partners who made sure we had what we needed to be as prepared as possible for whatever impacts were to come our way.

HL: What was your biggest challenge in preparing for Ian?

Hiltz: The biggest challenge for planning for any hurricane is the relative unknown of ultimately where the storm is going to end up. The forecasters do what they can with the information they have, but as we saw with Ian, the cone shifted from the west coast of Florida to the panhandle four days before appearing to swing back west to the Big Bend region, then Tampa Bay, Sarasota, and ultimately making landfall in northern Lee county – southern Charlotte county just to our north a day before landfall. But again, because we planned for the worst, NCH was as ready as it could be for whatever impacts Ian was going to throw at us.

HL: Once it was clear that the Naples area would be spared a direct hit from Ian, how did you pivot into a resource for other hospitals?

Hiltz: As the largest healthcare system in Collier County, we didn’t have to pivot much because NCH is always ready to be a resource for the patients of our region.  We were happy to be able to offer some available beds to our neighboring healthcare systems to the north who suffered greater impacts than we did, and we know if the situation were reversed, they would do the same for residents of Collier County. 

HL: What challenges did you face in relocating more than 400 patients into your hospital?  

Hiltz: Throughout the process of receiving patients from the impacted healthcare systems to the north, we have seen a rise in emergency department usage by our own community who have sustained injuries in the wake of the clean-up.  Likewise, mothers from as far away as Cape Coral are coming to NCH to give birth to their babies.  In response to this, NCH reached out to the state, and they sent us 50 RNs between our two hospitals.  We have asked the state for additional pediatric nurses to help us handle the influx of peds, NICU, and birthing mothers we have seen at our facilities as well.

HL: What lessons have you learned from Ian?

Hiltz: As was mentioned earlier, each storm is different, so there are different lessons to be learned from each storm.  From Ian, the greatest take-away will be the power and might of the storm surge, which all Florida residents hear about with an approaching storm, but most have never experienced in our state to the degree our region did just several days ago.  As a result, we will most likely be giving more attention to storm surge preventative measures as we move forward.  

HL: What weaknesses did you observe in the local-state-federal preparation and response? How could they improve their prep/response?

Hiltz: State and local government response could not have been better! Florida is used to storms, so power repair trucks were already in the area before the storm hit, national guard troops were here as well.  We also had NCH liaisons stationed at the county Emergency Operations Center so we could hear firsthand the information coming from our local government as it was being discussed. Additionally, the state sent us 50 nurses between our two hospitals to help us care for the influx of patients we got from our neighboring healthcare centers to the north.

HL: How long of a recovery time do you anticipate for NCH and other providers?

Hiltz: As of this interview, NCH Healthcare System is just about back to business-as-usual as our teams and colleagues quickly rose to the challenges and hurdles presented by this catastrophic storm.  Staff came forward in droves to come to work caring for our patients, setting aside their own personal impacts endured from the storm, to focus on our patients.

It will be a long road to recovery for many of our coastal communities, and as we always do, NCH Healthcare System will continue to be there with open doors that have never closed since we took our first patient back in 1956.  We continue to learn about and share new resources available for our community and our staff who are dealing with the greatest impacts from Ian, and NCH will continue to be there to support our community and our staff as we take this journey to recovery together.