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

As if anyone really needs it, hereis a recap from the NationalHurricane Center:

Entering the Gulf of Mexico Katrinabegan to strengthen, reaching category 5strength on August 28, about 250 milessouth-southeast of the mouth of theMississippi River. Katrina's winds reachedtheir peak intensity of 175 mph and thepressure fell to 902 mb the fourth lowestpressure on record later that day.Katrina turned to the northwest and thennorth?making landfall in PlaqueminesParish, La, just south of Buras, with 140-mph winds category 4 at 6:10 AM CDTon August 29. Continuing northward?Katrina made a second landfall near theLouisiana/Mississippi border at 10:00 AMCDT with maximum winds of near 125mph category 3. Katrina weakened as itmoved inland to the north-northeast butwas still a hurricane 100 miles inland nearLaurel, Miss. Katrina continued to weakenand became a tropical depression nearClarksville, Tenn, on August 30. At month'send?the remnants of Katrina were racingeast-northeastward near Binghamton, NY.

Recitation of the cold, sterile factsdoes not convey the incredible devastationof life, property, and environmentthat ensued. More than a monthafter Katrina slammed ashore, causingwhat is likely "the worst natural disasterin the history of the United States," the breadth and depth of loss are stillbeing assessed.

Health care institutions were particularlyvulnerable, and Lallie KempRegional Medical Center in Independence,La, was no exception. Chargedwith the safety and well-being of theirpatients, the staff members of this 25-bed critical access hospital took nocomfort in knowing that they werelocated some 70 miles north ofKatrina's "ground zero."

The hospital survived the passage ofKatrina in good physical shape, but itspatients and staff were not out of thewoods yet. As the damage was beingassessed, it was discovered that thepharmacy department may have takenthe biggest hit—its computer systemwas down! The department wouldhave to operate in a totally manualmode for an unknown period of time.Patient medication profiles, medicationadministration records, evenlabels for medication containers andintravenous solutions would have tobe handwritten. Operating efficiencyin the pharmacy would be decreased,and the workload would instantlybecome a much larger burden.Moreover, demands on the hospital'sinpatient and already large outpatientservices were immediately and significantlyincreased by the destruction ofhealth care resources in New Orleansand other towns to the south. Themost important consideration, however,was that patient safety would be indanger of being compromised.

PharmaCare Services, a hospitalpharmacy management and consultingcompany located in Mandeville,La, is responsible for providing pharmacyservices at Lallie Kemp. Thattown, located on the north shore ofLake Pontchartrain, had been hit hard,and the link to the hospitals the companyserves in the area was broken fora short time. Power, telephones, andInternet access were quickly restored.Yet, because Lallie Kemp is part of theLouisiana State University (LSU) charityhospital system, the pharmacycomputer system was run not fromthe PharmaCare offices, but from awide area network whose server waslocated in New Orleans, and whichhad virtually no hope of coming backon-line any time soon.

In the meantime, HealthCare SystemsInc (HCS), whose MEDICS pharmacymanagement system is installedin 22 hospitals that were in harm'sway in Louisiana and Mississippi, wascontacting its clients to find out whatsupport was needed. In addition, JohnThompson, president of HCS, contactedfriends at PharmaCare to offeroffice space, telephone support, andcomputers.

A week later, HCS received a callfrom PharmaCare requesting help atLallie Kemp. The pharmacy systemwas still not back up, and the staff waslooking for another way in which toprovide services while continuing tominimize therapy-related risks. HCSresponded at once, sending the latestversion of MEDICS by overnightexpress.

HCS support personnel configuredthe system as closely as possible toLallie Kemp's operation. Instructionswere included on how to install andcustomize the system to better fit thestaff's needs. Everyone at HCS expectedthat it should not take much timefor the pharmacy staff to becomefamiliar with this new system, buteveryone was nonetheless verypleased to learn that MEDICS wentlive in about 1 week. The responsesfrom PharmaCare and Lallie Kemp'spharmacy department were equallygratifying: the HCS support team waspraised for its patience and willingnessto help. Mary Vuljoin, directorof pharmacy, reportedthat MEDICS allowed thedepartment to resume itsservices with electronic orderinput, labels, medicationadministration records, andbilling reports amid theextremely difficult circumstancesforced upon it byKatrina.

"We fast-tracked the installation,"said Vuljoin. "MaryMatherne, a MEDICS expertfrom PharmaCare, guided theprocess. Even though no onein the pharmacy had used itbefore, the system was veryeasy to set up and to learn;even building the inventoryfiles was a snap." Lallie Kempis the only facility in the 9-hospital LSU system that hasthe pharmacy on-line again.Vuljoin stated, "MEDICS waslike manna from heaven."

In the Katrina disaster, everyone suffered,but none were at greater riskthan those who were ill and hospitalizedwhen the hurricane struck. Chaosand confusion can work against thebest of health care providers underthese circumstances, interfering withtheir ability to render the highestquality of care.

Fortunately, disaster also brings outthe best in people. The professionalsat Lallie Kemp Regional MedicalCenter and at PharmaCare Servicessuffered major disruptions in the routineof their personal lives that willpersist for months to years, requiringtheir attention and energy. Yet, theyremain at their posts, serving thosewho need the care they offer.Likewise, the professionals at HCSoffered their resources and expertiseto those affected by the hurricane,and, when the call for help came,they responded quickly and efficientlyto meet the needs.

In the aftermath of Katrina, peopleare discovering that, somewhat likerain clouds, hurricanes apparentlyhave their silver linings too.

Dr. Vinson is a professor emeritus of pharmacypractice, retired from the University ofMississippi School of Pharmacy. He nowserves as a patient and medication safetyconsultant for HealthCare Systems Inc ofMontgomery, Ala.