About 20 employees, including nurses, an ED physician, a respiratory therapist and the assistant CEO, chose to stay. Some sheltered inside the hospital, while other staff stayed at a local hotel rated to withstand the most powerful storm, a Category 5. A few more holed up in an ED physician's home. CEO Clay and COO Emery evacuated together and ran incident command from Bradenton, Fla., just south of Tampa. Emergency medical services officials for the area were informed about each employee's location.
"A lot of the staff that stayed chose to stay because they care deeply about our community and they want to make sure that when those first responders are ready to get back on the road and start working, that they're here to provide for them," said Assistant CEO Matthew Conrad, who didn't evacuate.
The hospital closed its ED for the first time in a decade on the morning of Sept. 8. Just a few hours after Hurricane Irma blew through Key West on the morning of Sept. 10, the ED opened again at 3 p.m. for first responders and the critically injured. The hospital fully re-opened a week after the storm on Sept. 18.
Reopening the ED and the rest of the hospital so quickly took coordination and communication between the corporate office, Lower Keys' Medical Center leadership in Bradenton, medical staff on the ground in Key West, and city and county officials.
After the storm, the city sent a firetruck to track down the nurses and other staff who had sheltered in Key West and headed to the hospital to begin cleaning up. The hurricane had downed palm trees and stripped the mangroves bare of their leaves. A few of the hospital's windows shattered, but the ED was largely in good condition.
Medical center staff set up a makeshift command center in the front lobby to keep track of employees as they arrived back at the hospital during the week and dole out assignments. All employees pitched in to clean the inpatient side of the hospital, scrubbing walls and taking out the trash.
Coordination with CHS executives in Tennessee helped secure resources needed to re-open, including the fuses and engineers needed to get the chillers up and running, as well as the reagents needed for the laboratory.
Absent a working lab or radiology unit, doctors and nurses relied on their training to make clinical decisions without diagnostic tests.
"We fell back into the habit of doing what medicine used to be, which is making a clinical decision based on a history and physical and limited diagnostics and saying this person needs to be admitted or they don't," said Dr. Matthew Partrick, an emergency medicine doctor at the hospital
Though Key West didn't have flowing water after the storm, an aqueduct provided non-potable water. Before the city's water plant was operating, the fire department transported water via fire engines to keep its chillers running. That's a testament to the importance of building relationships, Clay said.
"Those relationships, you don't build those during a storm," he said. "Those relationships have to be developed along the way."