Damage from an unexpected pipe burst is forcing Atlanta's largest hospital, Grady Memorial, to limit surgeries and care for at least two months, and neighboring hospitals are feeling the strain.
While Grady Memorial Hospital's Level 1 trauma center is up and running, some services lines have been suspended after a water line burst on Dec. 7, which flooded the fourth, fifth and sixth floors of the hospital's A and B towers where medical and surgical units operate. As a result, nearby hospitals are experiencing higher emergency room volumes.
"ERs, at least within our community, are busy … and losing (services at) a large volume facility has added strain on some already strained systems," said Dr. Bryce Gartland, hospital group president of Emory Healthcare, which has five hospitals in the Atlanta metro area affected by the Grady incident.
Initially after the pipe burst, Emory saw a 25% increase in ambulance volume traffic to its facilities close to Grady. This week, those hospitals are seeing roughly 15% higher ambulance traffic.
Although Emory hasn't had to bring on any extra staff, Gartland said the incident at Grady is a reminder of how vital large healthcare institutions are to communities.
"It shows the potential risk to communities in the event that a key provider goes down for one reason or another," he said.
Piedmont Atlanta Hospital has also seen an unprecedented influx in emergency department patients, crowding the 44-bed unit, according to Dr. Patrick Battey, the hospital's CEO.
"We are not asking a lot of questions about where these patients are coming from, but you get the feeling you can tie it back to the lack of capacity Grady has in their ED," Battey said.
Piedmont Atlanta's 490-bed inpatient units are also at capacity, but the hospital hasn't brought on extra staff. Piedmont accepted eight inpatients from Grady since the water leak.
Grady is currently only receiving 50% of the emergency medical services traffic it received prior to the flood. Atlanta-area EMS companies are using a process to make sure patients are being transported to the appropriate facilities based on their medical needs and so emergency departments don't get overburdened.
In an email, Grady said it's in the process of working with the hospitals, state and emergency management agencies to end the full diversion.
About 220 of Grady Memorial's 700 beds aren't operational due to the leak. The hospital, which is a Level 1 trauma center, is only accepting emergency transports and inpatient admissions involving a small number of service lines: trauma, burns, emergency surgery, cardiac care and psychiatric care.
Those services were selected after discussions about where the "community needs us most," said John Haupert, Grady Memorial's CEO.
The decision to continue service lines unique to Grady was a smart tactic, said Scott Aronson, senior vice president of Russell Phillips and Associates, a leading emergency management consultant for healthcare providers.
"They are following logical steps," he said. "If they are still able to provide care and services that are their key service lines that differentiate them, they are fine."
The water damaged all medical equipment, flooring, plaster and beds on the fourth, fifth and sixth floors. The units will need to be completely rebuilt, starting only with the studs, Haupert said.
"It was a major significant internal disaster, and it still is," he said.
Given the stress the diversion is causing other hospitals, it would be a good idea for Grady to host follow-up meetings with the them to review what worked, what didn't and what can be improved if something similar were to happen again, said Nicolette Louissaint, executive director of Healthcare Ready, a disaster-response not-for-profit.
Perhaps some patients could have been transferred to hospitals outside of Atlanta, lessening the burden on the Atlanta-area hospitals, she added.
Despite the strain on operations, Louissaint said its unlikely patient access to care has been impacted considering Grady's swift collaboration with neighboring hospitals and full operations of its Level 1 trauma center.
"It has been clear to me they have focused on patients and protecting their workforce," she said. "They have done an exceptional job of doing an efficient diversion and the receiving hospitals were able to absorb and continue care—from what we have seen—without major disruption."
Grady is in discussions with Emory and WellStar to pay daily rates for some of their available and unstaffed beds. Grady physicians and nurses would treat those patients, Haupert said.
"Our responsibility as a public hospital and as a safety net is to maintain access to care that we have had … there are lots of individuals who rely on us for their care," he said. "We have to do everything within our power to make sure we can provide (care)."
That arrangement would also support Grady staff, and Haupert maintained they would not lay off workers due to the temporary closures.
The hospital also received a 30-bed mobile hospital late Tuesday from North Carolina. It will be used as an ED for patients who need to be placed on stretchers, said Michelle Wallace, Grady's chief of clinical operations.
Grady hasn't determined what caused the break in a water line connected to the air conditioning system. The pipe was repaired two days after it burst.
Louissaint said Grady should understand the reason for the break before it begins major repairs to understand if replacements should be done differently to avoid a repeat occurrence.
"The No. 1 thing is thinking about how they are going to use this as an opportunity to improve their readiness … that seems important especially for a facility this large and important to the city."
