DISASTER PREPARATION
The report, released Oct. 30 by accounting and consulting firm PricewaterhouseCoopers, found that planning and communications gaps continue to exist between many U.S. hospitals and local emergency-response agencies.
It also found that private-practice physicians often are left out of health care disaster plans that focus on hospitals and public health workers.
Additionally, the report found that federal disaster-preparedness funding for hospitals has declined in recent years and that large states that are more vulnerable to disasters receive a disproportionately smaller share of the aid than less populous states.
The report, which broadly examined the preparedness of health care systems nationwide to contend with catastrophes such as earthquakes or pandemic diseases, came on the heels of wildfires in Southern California that forced the evacuation of one hospital in San Diego and tested the region's health care system.
Many officials have given San Diego County's health care system high marks for its performance during the fires, which included the transfer of 200 patients from Pomerado Hospital when flames threatened the Poway, Calif., hospital and the deployment of dozens of doctors and nurses to Qualcomm Stadium and other disaster-relief centers.
Others acknowledged that the challenges would have been far greater had it not been for the low numbers of deaths and injuries caused by the blazes and the limited threat that the fires posed to most local hospitals.
"It would be a different situation with more casualties," said Don Stanziano, a spokesman for Scripps, which operates five acute-care hospitals in the county.
Dr. Jon Cohen, managing director of PricewaterhouseCoopers' health advisory services, said the report is intended to prod health care systems to do more disaster planning and drilling, and federal and state governments to provide more resources for the work.
"Everybody has a responsibility here. You can never plan enough," Cohen said. "Funding is never going to be enough. It's a matter of prioritization."
Concerning hospital disaster-preparedness funding, California received $143.2 million from the federal government in 2007, more than any other state. But that amounted to only $3.93 for each resident of the state, ranking California 44th on a per capita basis.
When Palomar Pomerado Health District officials decided to evacuate their hospital, as the Witch Creek fire advanced, they received plenty of support from San Diego area police and fire departments that helped with the relocation of patients, said Michael Covert, the district's president and chief executive officer.
Still, some things could have been done better, he said.
Non-clinical nurses should have been riding on buses that carried evacuated patients to monitor the transfer of their records to new facilities and provide directions to bus drivers who were unfamiliar with the area, Covert said.
Command centers at the district's hospitals could have used more telephone lines to handle the flood of calls they received, he said. And arrangements should have been made for clearing hospital workers through road blocks set up between their homes and the hospitals.
"I would say for the most part we had very good coordination in working with the (emergency) command centers and the county and cities where we're located," Covert said. "Some issues of logistics could be improved."
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