Bob Michael may have one of the toughest jobs anywhere on the Treasure Coast.
As director of facilities services at Indian River Medical Center, he is responsible for keeping the entire 332-bed facility safe and secure whenever Mother Nature sends disruptive or even life-threatening weather events Vero’s way.
It has been about a decade since hurricanes Frances, Jeanne, Wilma and Charley pummeled this coast. When those storms struck, IRMC patients had to be wheeled into hallways as hospital windows of the time could shatter under hurricane-force winds.
Those windows were replaced shortly after Wilma, the last of the 2004 storms, moved on and now all glass doors and windows at IRMC are shatter-proof or shatter-resistant.
Power outages were also widespread in Vero Beach during those storms and as a result, the hospital installed three separate backup generators.
The National Hurricane Center reports that, “Most Floridians now say they’re not worried about the prospect of a hurricane making a direct impact on their state,” despite the fact that NHC also says, “40 percent of all land-falling U.S. hurricanes from 1851 to 2010 have impacted the Florida coast.”
In other words, given more than a decade of near hurricane-free seasons, we’ve grown complacent.
With six weeks left in this year’s hurricane season, that’s a luxury Michael can’t afford.
When tropical storm Erika approached Vero a few weeks ago and Hurricane Joaquin formed near the Bahama’s last week, the prospect of severe weather was greeted by the public with a kind of casual disdain. A few storm shutters went up and some folks may have gone out to fill their gas tanks, pick up a few groceries or re-stock their liquor cabinets, but that’s about it.
Michael faces an infinitely longer and far more complex pre-storm checklist.
There’s a 44,000 gallon tank of diesel fuel that needs to be full. There are three on-site power generators that have to be ready to kick-in at a moment’s notice. Food and water for upwards of 490 people must be on-hand and that’s just the beginning of Michael’s “to-do” list.
“We’re required to have emergency backup power for storms,” explains Michael, “also to be prepared with 72 hours of supplies on hand and plan for 96 hours and be able to sustain operations without any support from the outside.”
During 2012’s hurricane Sandy, scores of hospitals along the Atlantic seaboard learned some harsh lessons. Many of them lost all power when their backup generators – usually located in basements – were flooded and rendered useless.
Learning from that experience, IRMC’s largest backup generator, a 1500 kilowatt behemoth, was raised to about 16 feet above sea level and encased in a structure designed to withstand the force of a category five hurricane.
“We also have a second generator,” adds Michael, “that serves specifically for the open-heart rooms and the emergency department and a [third] 1100 KW generator that is specifically for the central energy plant. It provides the power to keep our air conditioning and our boiler running,” adding that, “We leave our boilers on for super sterilizations.”
Generators, however, aren’t even close Michael’s top concern. Expecting the unexpected is.
Back on September 20-22, an underground waterline break affected some 131 IRMC patients. 31 had to be transferred to other facilities. That was in conditions made difficult by near 90-degree temperatures, but it could have been much worse.
In addition to potable drinking water, the hospital requires a steady water supply for its air conditioning chillers to keep the buildings and sensitive pieces of medical equipment cool.
Michael and his team had to navigate the subterranean world of waterlines, have a replacement for the nearly 40-year old broken pipe shipped up from Miami, bring in outside contractors to fix the problem and, hopefully, prevent anything like that from happening again under far more dangerous wind and weather conditions.
Planning for such unforeseen circumstances may well be Michaels’s most difficult and time-consuming task.
“Every year in April,” according to Michael, “we ask all department heads to develop specific department [emergency response] plans.”
The hospital’s “environment of care” committee meets every month to review and update those plans from utility management to medical equipment management to life safety team management to security and hazardous waste.
Medicare and the Joint Commission mandate two emergency drills a year for U.S. hospitals but Michaels says, “We actually do four drills here. We [also] test our emergency notification software which basically is a computerized system that allows us to reach out to the management team and our vendors.”
“We also do a full-scale multi-agency exercise annually. We usually do that in February.” That drill involves the sheriff’s department, the Florida Department of Health, county management services and the fire department.
Those emergency drills aren’t cheap. The American Hospital Association puts a price tag of close to $20,000 apiece on them and Michaels says, “That’s probably a fair number.”
One thing Michael says he needs to make clear to everyone is that the hospital is not a shelter.
It is, he says, the absolute wrong place for otherwise healthy local residents to seek shelter from a storm. Simply put, the last thing the hospital needs in a hurricane is an influx of people who could – and should – seek shelter elsewhere.
The Agency for Healthcare Administration,” explains Michael, “really requires a hospital to defend-in-place. They require us harden our buildings and test our generators because they realize evacuation (of hospital patients) is a last resort.”
Hospitals are, in fact, required to meet much more rigorous construction standards than private homes, businesses and even local and state office buildings. They’re also required to have the backup generator capacity and in-house food and water supplies mentioned above along with shatter-proof or shatter-resistant windows and doors, emergency radio communications, an appropriate supply batteries and, of course, all necessary medical supplies available while operating with a skeleton staff, made up of hospital employees who are on call to spend 24 hours a day at the hospital during emergencies, when other staff members can’t get to hospital.
Included in that skeleton staff are 100 to 150 medical staff members, along with an electrician, a plumber, a mechanic and a couple carpenters. As Michael puts it, “Basically everybody that [that is needed to] respond to any issues that arise in the building.”
Another reason why the general public shouldn’t seek shelter at the hospital is space. During an emergency, any patients on the fifth floor are moved to lower levels of the building and emergency staff members are housed on that top floor.
Like everyone else on the Treasure Coast, Michael hopes it will be at least 10 more years before another hurricane strikes this area, but his job is to make sure IRMC is always ready to “defend in place” just in case Mother Nature has other ideas.