CEO SUMMARY: This 600-bed hospital and core laboratory are in a crash rebuilding program as a result of flooding from tropical storm Allison. One important management lesson learned is the value of consolidating and integrating laboratory services within a health system. Previous lab integration efforts within the Memorial Hermann Health System are now contributing to the restoration of laboratory testing services.
EXTENSIVE FLOOD DAMAGE to Houston’s Memorial Hermann Hospital and the destruction of its main laboratory has triggered a crashprogram of rebuilding.
“We are learning about logistics and operational interaction on an accelerated basis,” observed James Faucett, AVP, System Laboratory Services at Memorial Hermann Health System (MHHS). “As one of the city’s two Level I trauma centers, we’ve had to move nimbly to maintain patient services and continue to provide the laboratory testing needed to support those services.”
The main lab, located in the basement, was totally destroyed during tropical storm Allison last month. Flooding ruined the first floor of the hospital and completely inundated the core lab.
“Within hours of losing power, almost 550 patients had been moved to other hospitals,” Faucett said. “About 60% of the patients were transferred to other hospitals within the Memorial Health System. Memorial Hermann Hospital is affiliated with the University of Texas Medical School and is one of Houston’s two Level I trauma centers. It is also a children’s hospital and a transplant center.
“Many of these services were relocated to Memorial Hermann’s seven community hospitals. The physicians and support staff here were deployed throughout the Memorial Hermann Healthcare System as necessary to support those services as well as the increased caseload at the community hospitals,” explained Faucett.
“Laboratory services within the Memorial Hermann system are organized around the core laboratory model,” noted Faucett. “Our core laboratory is located at the Southwest campus. For some time, we have been consolidating the central core laboratory with the high volume laboratory at Memorial Hermann. That’s helped us, because we have standardized instrument platforms, processes, and information systems. As a result, our Hermann technologists were immediately integrated into our other laboratories.
“Meanwhile, there is a goal of reopening Memorial
Hermann Hospital by mid-July, served by a new temporary laboratory.”
“Meanwhile, there is a goal of reopening Memorial Hermann Hospital by mid-July, served by a new temporary laboratory. We’ve been assigned about 12,000 square feet of temporary space and will become operational with a 70-test menu,” noted Fawcett. “We will be prepared to provide essential lab services to the high-acuity patients served by Memorial Hermann Hospital.”
Vendors Willing To Help
According to Faucett, vendors proved willing to respond to the emergency. “They’ve all pledged to help us,” he said. “The real challenge will be when the equipment arrives. That’s when we’ll need extraordinary support from our vendors to get the instruments installed, calibrated, and operational on an accelerated time line.”
The extensive damage and the urgency to rebuild Memorial Hermann Hospital is best illustrated by the fact that, within days of the flood, some 100 different companies were contracted for services and already have more than 800 employees working within the hospital.
“There is nothing that could prepare any lab manager for this type of experience,” stated Faucett. “Like most hospitals and labs, Memorial Hermann had comprehensive crisis contingency plans in place. But these plans were unable to anticipate and cope with such extensive destruction from a natural disaster exceeding anything predicted by experts.
“We recently completed a bi-directional interface between the Hermann LIS and our community hospital’s LIS. These all operate on the Cerner Classic system,” he noted. “This provides us with the flexibility of supporting Hermann with lab testing at the community hospital core laboratory. This core lab already performs non-urgent testing for the community hospitals and operates central microbiology and histology laboratories.”
Lab Management Lessons
Although the remarkable story of the destruction and rebuilding of the core laboratory at Memorial Hermann Hospital continues to unfold, there are several good lab management lessons already emerging.
First, contingency and crisis planning can never anticipate the full range of disasters and destruction which may befall a clinical laboratory. Certainly the remarkable amount of rain, as much as 36 inches in some parts of Houston, caught emergency planners by total surprise.
Second, clinical and operational integration of laboratory services within an integrated health network (IHN) can provide important back-up and service redundancy in times of natural disasters. The rapid and successful shift of patients, Level I trauma center activities, and laboratory testing from Hermann Hospital to other system facilities bears this out.
Going The “Extra Mile”
Third, vendor relationships do make a difference. During emergencies, labs rely on vendors to replace instruments and the supplies necessary to maintain testing services. The Memorial Health System lab team is about to find out which of their vendors are willing and capable of going that “extra mile” during this challenging time.
In the wake of tropical storm Allison, at last one lab company was blessed by lady fortune. During the past year, Dynacare, Inc. built and opened a new core laboratory near the Bush International Airport. This lab provides testing to Dynacare operations throughout Texas and other southern states.
Dynacare’s new lab survived the storm without damage or problems. Prior to the move to this new lab facility, Dynacare’s lab testing operations had been located in the Memorial Hermann Hospital core laboratory. Dynacare executives are unquestionably relieved at the fortuitous timing of that move, which spares them the same problems now challenging the laboratory administration at Memorial Hermann Hospital.
Repair Lab Facilities
All across Greater Houston, any number of clinical laboratories are working to identify damage, repair their facilities, and restore testing services back to pre-storm levels.
The experience of Houston is a reminder that the unexpected intensity of natural disasters continue to surprise us with a destructive force that overwhelms even the best crisis plan.
Lab Damage Seems Relatively Limited
DESPITE THE INCREDIBLE AMOUNTS of rain which fell upon Houston during tropical storm Allison, damage to clinical laboratories throughout the metropolitan area was limited.
Several hospitals reported storm damage to specific parts of their facilities, but Memorial Hermann Hospital has attracted the most attention because of the extensive way that tropical storm Allison damaged its main laboratory.
At least 2,000 hospital beds were put out of service. Both Methodist Hospital and St. Luke’s Episcopal Hospital were drawing power from back-up generators one week following the storm.
“Dynacare and Dynagene Labs managed to come through unscathed,” said Kevin Pishkar, President and CEO of Dynagene. “Our losses were limited to four courier cars, which were flooded while parked overnight.
“Extensive damage to Baylor’s research labs was widely reported on the national news,” noted Pishkar. “Following the loss of their lab facilities, the Baylor genetic laboratory has temporarily relocated to our Dynagene lab facility. Baylor’s staff is now working alongside ours.
“Right now, the Houston Medical Center is running at about one-third of capacity,” he added. “The lingering effects of tropical storm Allison continue to affect health services throughout the city. As a result, many providers are rethinking their emergency preparedness plans.””