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One-on-One With Mercy Medical Center CIO Jeff Cash, Part I

October 2, 2008
by root
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Mercy passed the ultimate test of disaster preparedness by keeping its IT systems running during a flood.

This past June, Iowa was hit some of the worst flooding in the state’s history, and right in the thick of it was the 370-bed Mercy Medical Center. More than 4,000 homes in the area had to be evacuated, and the hospital was forced to move 176 patients to nearby facilities. However, despite the fact that water levels rose so high that sandbags had to be piled up outside the doors, physicians were never left in the dark, as the facility’s network, EMR and communication systems stayed up during the entire ordeal. For Jeff Cash, Mercy’s vice president and CIO, it was the ultimate test for his staff’s preparedness.

KH: How long was Mercy Medical Center directly impacted by the flood?

JC: The flood waters themselves impacted us directly for about three days. What happened was, we got hit with the flood on June 12, and that was the day that the water came into the hospital. We made the choice to close our doors to new patients and evacuate our existing patients on June 13.

On June 14, the flood waters started to recede away from the hospital and that’s when we were able to start our flood mitigation. So it was about 48-72 hours after water hit that we had the water receding enough where we could go in and start taking care of things in a serious way.

KH: When you started evacuating, where were your patients displaced to?

JC: We worked with state of Iowa, they have an emergency command center that helped us work through the relocation of about 176 patients that we had in the hospital. Almost all of them were transferred to other hospitals in the state of Iowa. A percentage of them went to another hospital here in our town called St. Luke’s Hospital. Some went to the University of Iowa Healthcare Center, which is a tertiary health center, and the remainder went to smaller hospitals throughout the state.

The state did help us find places and coordinate that. They arranged for the transportation; we had ambulances from a number of services and a number of hospitals, and we also had the National Guard here and they were able to transport some of our patients as well.

KH: So what was the primary driver behind the decision to evacuate?

JC: The reason they chose to close and evacuate that part of the hospital was that as the water continued to come into the basement area, where is where our electrical distribution services are, we had lost power from the city and weren’t sure when that was going to come back. We were running on our generator services; we do have adequate generator power that we could have run for an extended period of time, but at that point we weren’t sure if the water had crested or not. It was a little over five feet right outside the front doors and it was making its way in, so we were concerned that if water got into the switch distribution systems, that we wouldn’t be able to provide adequate electrical power, and we made the choice to evacuate the patients for that reason.

One of the things that happened with the basement was it wasn’t just water from the outside. The way our hospital sits, I guess you might say it was on the west side and south side of the hospital where there is a corner, and the flood waters came up, all the way to the front entrance. They had sandbags stacked five feet outside the building, and the waters came up over the top of those.

The bigger part of the problem for us, however, came in terms of groundwater that had so much pressure outside the facility that it was finding gaps in the foundation itself and there were areas where it actually started squirting in, under pressure, through the foundation. That’s what worried us about the electrical gears, so we had covered most of it with plastic sheets and plastic tarps. It wasn’t so much that the water was coming up from below and going to get into the switch gears — it was coming in from all around.

We also had a back-up of the waste water or sewage system, and we started getting that coming in. The pressure on that was pretty immense as well, in the extent that we had a lot of contracts come to help us during the flood itself. They tried putting what they call rubber bladders inside some of the plumbing fixtures like toilets to keep water from coming back up into them. And in some cases, the pressure was so strong that it burst the porcelain fixtures right off the walls. Water just continued to come in.

The flood water itself was only part of it. We got hit with three areas of flooding: the flood water, the ground water that was making its way into the hospital, and the back pressure on sewage systems. We ended drilling about 60 sand points into the basement of the hospital right through the foundation into the outside ground, and actually sucking water out of the ground through our foundation and then sending it back outside to some piping that we had set up to discharge it in an attempt to relieve some of the pressure from the outside of the building.

KH: How close to the river is your facility located?