Guest Commentary: As Texas hospitals learned in wake of Harvey, preparedness key to protecting lives

Last week, Houston-area hospitals displayed great resiliency as they faced catastrophic flooding from Hurricane Harvey's relentless rains over several days. However, some vital hospital services—understandably—experienced significant disruptions.

Health systems nationwide can learn vital lessons from Texas' planning and response to further strengthen their own preparedness and "harden" their facilities to all hazards.

So much happened in only 48 hours last week. Memorial Hermann Sugar Land Hospital successfully evacuated all of its 150 patients and shut down temporarily. Several hospitals canceled outpatient services. The world-renowned University of Texas MD Anderson Cancer Center closed to appointments for several days, but inpatient care wasn't disrupted. Ben Taub Hospital, the largest in Harris Health System, maintained continuity of care for its patients after halting a planned evacuation when water surrounded its facilities.

Effective planning and emergency response are closely related to this year's theme for National Preparedness Month in September: "Disasters don't plan ahead. You can." Harvey's extreme impacts serve as a powerful reminder of why it is essential to invest in preparedness. Texas providers learned their lessons from previous storms that pounded the state and from the damage and large loss of life inflicted by Hurricane Katrina in neighboring Louisiana.

According to the April 2017 National Health Security Preparedness Index, many U.S. healthcare systems remain unprepared to respond adequately to health security threats. These findings are concerning for many reasons. Infectious diseases that can migrate to the U.S., such as Ebola when it arrived here several years ago, have the potential to catch hospitals off guard, with potentially deadly consequences. Similarly, antibiotic resistance continues to raise health security concerns for hospitals that are often the frontline defense for these infections. In addition, hospitals are the epicenter for treating victims of deliberate, large-scale acts of violence in their communities.

Challenges in healthcare​ preparedness are particularly stark in some regions of the country. For example, the index found that states in the South and Mountain West regions experienced significantly lower marks in health security assessments than their counterparts in the Northeast and Pacific Northwest.

With the latest emergency preparedness regulations from the federal​ government, combined with threats of reduced funding, health systems face serious preparedness challenges that will require close partnerships among federal, state and local governments, and other health systems in their regions.

Hospital preparedness ramped up after the Sept. 11 terrorist attacks, typically as an effort for institutions to prepare individually. In the years since, it has become increasingly clear that hospitals and health systems need to collaborate with each other and with public health agencies. The growing emphasis on population health and community benefits under the Affordable Care Act have only increased the necessity of these relationships for outreach.

Preparedness also requires resources. Hardening facilities and other disaster preparations such as relocating generators and fuel pumps and installing backup communications systems are expensive. Meanwhile, funding is limited and shrinking quickly. For example, President Donald Trump's fiscal 2018 budget proposal reduces health security funding by $1.25 billion, which is the largest decrease to these programs in more than a decade. More funding, not less, is needed to protect our healthcare delivery system.

Just as fire departments constantly train and modernize their equipment to be ready for crises, we also can't afford to wait for the next emergency. Hospitals, health systems and other providers must establish strong preparedness plans, invest in the right infrastructure, and train staff accordingly.

Texas providers seem to have taken many crucial steps to be prepared and avert widespread tragedy on their campuses as Harvey came ashore. The rest of the country should be making plans and investments to improve the odds for similar outcomes.