Tampa General CEO: Make Emergency Preparedness Part of Your Routine Operations

John Couris shares lessons learned from Hurricane Ian, which made landfall in Florida at the end of September.

By the time Hurricane Ian made landfall in Florida on September 28, 125 miles south of Tampa, it was a category 4 storm. It left a path of damage across southwest Florida, destroying buildings, flooding communities, and leaving many without electricity for days.

Hospitals and health systems weren't immune to the effects of the storm. Luckily, Tampa General Hospital (TGH) did not suffer any damage during Hurricane Ian, CEO John Couris told HealthLeaders. The storm had shifted course to the south so it didn't directly hit the Tampa area, but TGH was still prepared for the worst.

Recently, Couris shared how TGH prepared for the storm and what lessons the organization learned, he also offered advice for other organizations in preparing for disasters.

This transcript has been edited for clarity and brevity.

HL: When did you start preparing and how much time did you dedicate to preparing for the storm?

Couris: We started preparing about a week out. We started bringing in our emergency supplies, med-surge supplies, emergency water [and] food. We started to put up our AquaFence, which is a fence that goes around the entire facility that can push back about 15 feet of storm surge. We [consistently] test our central emergency power plant, but we started testing that about five to seven days out before the storm hit.

HL: What are your emergency protocols for hurricanes and other natural disasters?

Couris: [Our] incident command sits in our mar-comm operations. We have a big operating facility, about 8,000 square feet, and it uses artificial intelligence and predictive analytics to run the hospital. Part of that center is our emergency command center.

About three days out we turned on the emergency command center, and the protocol is we have an emergency management team that manages the emergency. Me, my COO, along with other executives like our chief medical officer and our chief people and talent officer come into the facility and stay through the whole storm. We sleep in our offices on mattresses on the floor and we stay with the team.

We're what's called Team A, and that's the team that comes in and cares for the facility and for the patients in the facility through the storm. And then Team B comes in after the storm.

When our emergency management team takes over, we are there to make decisions at a leadership level to support the staff and support patient care. And we're there starting 24 to 48 hours before the storm hits.

HL: What key learnings came out of your team debriefing? What worked? What needs improvement? Were you surprised by any of the learnings?

Couris: All the critical elements of responding to the storm worked because we practice this stuff all year long. We go through training and tabletop exercises all year to be ready for an actual storm. We practice mass casualties because we're a Level 1 Trauma Center. We're constantly practicing our policies, our procedures, our standard operating work, and all of that. Everything worked the way it should have worked, so we were very well prepared.

[Among the] lessons learned was sleeping arrangements. [Those] can always be tricky. We're almost a 1,100-bed facility. We had 2,000 staff members on team A caring for close to 900 patients, and most of those patients are critically ill and can't be discharged. And so [with] sleeping arrangements, we're always learning how to do that better. That's always tricky just because hospitals aren't designed to house thousands of staff for two to four days for a storm.

On a much more significant level, one of the things I learned is after the storm blew through Fort Myers and that area, a lot of those hospitals down there had to evacuate patients, not because they suffered damage to the facilities—some did, but most of those facilities down there weathered the storm really well—but they lost water. They had water main breaks in their towns and cities, and they lost water pressure. If you don't have water pressure and you don't have water, you can't operate, you can't do procedures, your fire suppression system doesn't work, [and] you can't care for people.

We took over 50 patients from that area and we're still working with those facilities where and when needed. We have five helicopters that were running patients along with ambulances from Fort Myers up to Tampa. What I learned was water was the problem; water was the primary reason why patients had to be transferred.

We got with our team almost immediately, and I said to them, 'I want a plan on how to build our own water supply.' We have tanker trucks positioned to move onto the campus to support us if we lose water, but that's not enough water. Tampa General is one large academic medical center; we also have 100 locations throughout the community and throughout the state, but on the main campus we use 3 million gallons a week of water to run the place. My question to my facilities team and my engineering team was, 'If water was the main culprit that drove hospitals to evacuate patients, if we lose our water on the Tampa General campus, how do we fix that? What do we do?'

We're drawing up plans right now to gain access to and create our own water supply in an emergency that would allow us to do all of the work we need to do in treating patients without any interruption. We will have an answer and something in place before next hurricane season.

HL: What advice do you have for other hospitals and health systems around having plans in place for natural disasters?

Couris: The hospitals that got hit the hardest—big kudos to those hospitals. Systems like Lee Health, Sarasota Memorial, HCA, those organizations performed really well in responding to the crisis after the storm. They should be very proud of themselves.

My advice to people, in general, is practice, practice, practice your disaster drills. Review your processes, review your systems, review your protocols, review your standard operating procedures on a consistent basis. That's critical because when a natural disaster occurs, you want to absolutely be prepared.

My team was absolutely prepared; they operated flawlessly. They did it because they practiced. You have to maintain a state of readiness always and the only way to do that is to practice, train, and review your material to constantly tweak it and make it better. Make it part of your routine business operations so when something really happens, you are ready.

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