In the Wake of Hurricane Katrina: Rescue of a Different Kind

NOVEMBER 01, 2005
Michael Vinson, PharmD, MS

As if anyone really needs it, here is a recap from the National Hurricane Center:

Entering the Gulf of Mexico Katrina began to strengthen, reaching category 5 strength on August 28, about 250 miles south-southeast of the mouth of the Mississippi River. Katrina's winds reached their peak intensity of 175 mph and the pressure fell to 902 mb the fourth lowest pressure on record later that day. Katrina turned to the northwest and then north?making landfall in Plaquemines Parish, La, just south of Buras, with 140- mph winds category 4 at 6:10 AM CDT on August 29. Continuing northward? Katrina made a second landfall near the Louisiana/Mississippi border at 10:00 AM CDT with maximum winds of near 125 mph category 3. Katrina weakened as it moved inland to the north-northeast but was still a hurricane 100 miles inland near Laurel, Miss. Katrina continued to weaken and became a tropical depression near Clarksville, Tenn, on August 30. At month's end?the remnants of Katrina were racing east-northeastward near Binghamton, NY.

Recitation of the cold, sterile facts does not convey the incredible devastation of life, property, and environment that ensued. More than a month after Katrina slammed ashore, causing what is likely "the worst natural disaster in the history of the United States," the breadth and depth of loss are still being assessed.

Health care institutions were particularly vulnerable, and Lallie Kemp Regional Medical Center in Independence, La, was no exception. Charged with the safety and well-being of their patients, the staff members of this 25-bed critical access hospital took no comfort in knowing that they were located some 70 miles north of Katrina's "ground zero."

The hospital survived the passage of Katrina in good physical shape, but its patients and staff were not out of the woods yet. As the damage was being assessed, it was discovered that the pharmacy department may have taken the biggest hit—its computer system was down! The department would have to operate in a totally manual mode for an unknown period of time. Patient medication profiles, medication administration records, even labels for medication containers and intravenous solutions would have to be handwritten. Operating efficiency in the pharmacy would be decreased, and the workload would instantly become a much larger burden. Moreover, demands on the hospital's inpatient and already large outpatient services were immediately and significantly increased by the destruction of health care resources in New Orleans and other towns to the south. The most important consideration, however, was that patient safety would be in danger of being compromised.

PharmaCare Services, a hospital pharmacy management and consulting company located in Mandeville, La, is responsible for providing pharmacy services at Lallie Kemp. That town, located on the north shore of Lake Pontchartrain, had been hit hard, and the link to the hospitals the company serves in the area was broken for a short time. Power, telephones, and Internet access were quickly restored. Yet, because Lallie Kemp is part of the Louisiana State University (LSU) charity hospital system, the pharmacy computer system was run not from the PharmaCare offices, but from a wide area network whose server was located in New Orleans, and which had virtually no hope of coming back on-line any time soon.

In the meantime, HealthCare Systems Inc (HCS), whose MEDICS pharmacy management system is installed in 22 hospitals that were in harm's way in Louisiana and Mississippi, was contacting its clients to find out what support was needed. In addition, John Thompson, president of HCS, contacted friends at PharmaCare to offer office space, telephone support, and computers.

A week later, HCS received a call from PharmaCare requesting help at Lallie Kemp. The pharmacy system was still not back up, and the staff was looking for another way in which to provide services while continuing to minimize therapy-related risks. HCS responded at once, sending the latest version of MEDICS by overnight express.

HCS support personnel configured the system as closely as possible to Lallie Kemp's operation. Instructions were included on how to install and customize the system to better fit the staff's needs. Everyone at HCS expected that it should not take much time for the pharmacy staff to become familiar with this new system, but everyone was nonetheless very pleased to learn that MEDICS went live in about 1 week. The responses from PharmaCare and Lallie Kemp's pharmacy department were equally gratifying: the HCS support team was praised for its patience and willingness to help. Mary Vuljoin, director of pharmacy, reported that MEDICS allowed the department to resume its services with electronic order input, labels, medication administration records, and billing reports amid the extremely difficult circumstances forced upon it by Katrina.

"We fast-tracked the installation," said Vuljoin. "Mary Matherne, a MEDICS expert from PharmaCare, guided the process. Even though no one in the pharmacy had used it before, the system was very easy to set up and to learn; even building the inventory files was a snap." Lallie Kemp is the only facility in the 9- hospital LSU system that has the pharmacy on-line again. Vuljoin stated, "MEDICS was like manna from heaven."

In the Katrina disaster, everyone suffered, but none were at greater risk than those who were ill and hospitalized when the hurricane struck. Chaos and confusion can work against the best of health care providers under these circumstances, interfering with their ability to render the highest quality of care.

Fortunately, disaster also brings out the best in people. The professionals at Lallie Kemp Regional Medical Center and at PharmaCare Services suffered major disruptions in the routine of their personal lives that will persist for months to years, requiring their attention and energy. Yet, they remain at their posts, serving those who need the care they offer. Likewise, the professionals at HCS offered their resources and expertise to those affected by the hurricane, and, when the call for help came, they responded quickly and efficiently to meet the needs.

In the aftermath of Katrina, people are discovering that, somewhat like rain clouds, hurricanes apparently have their silver linings too.

Dr. Vinson is a professor emeritus of pharmacy practice, retired from the University of Mississippi School of Pharmacy. He now serves as a patient and medication safety consultant for HealthCare Systems Inc of Montgomery, Ala.