DECEMBER 17, 2012

VISIT OUR HEALTH BLOG: WWW.HEALTHBYTESNYC.COM

Special Hurricane Sandy Issue

Continuum staff took extraordinary measures to get to work, some of them riding bicycles from Queens or Brooklyn. Many employees stayed on the job from Sunday through Wednesday, demonstrating a genuine can-do attitude. We truly worked together as a team, Ms. Walsh says. That made all the difference.

When Hurricane Sandy barreled into the East Coast from October 29 to 30, the Continuum hospitals were well prepared, proving once again that they are ready for any emergency. Beth Israel Medical Center and St. Lukes and Roosevelt Hospitals played a leading role among New York City hospitals when Hurricane Sandy struck. Over the last decade, Continuum storm-hardened its infrastructure by investing

BI Emergency Room Physician Assistants Christine Smajda, left, and Cherie Vivona, along with other staff, keep things running smoothly during the height of Hurricane Sandy.

Hurricane Sandys fierce winds churn up the Hudson River.

in emergency generators and developing and testing many other emergency measures. While Hurricane Sandy presented many challenges, Continuum responded to this event with great success, says Walter Kowalczyk, Continuums Director of Emergency Management. Teamwork, patience and plans developed over the years helped expedite our response to the storm. Throughout a long and exhausting week, Continuum stayed in constant contact with New York Citys main health care command center, the Greater New York Hospital Asso-

Along with most of lower Manhattan, Beth Israel lost power on Monday night, but continued operating, thanks to its nine well-maintained emergency generators. Even so, the Petrie campus was dark as a tomb, Ms. Walsh says. Emergency kits provided extra lights through headlamps and glow sticks, which were useful in dark patient rooms. Fortunately, the server for the hospitals electronic medical records and clinical information system is housed offsite and never was disrupted. To stay in touch with each other, staff from various departments used walkie-talkies and the hospitals

While Hurricane Sandy presented many challenges, Continuum responded to this event with great success.Walter Kowalczyk
ciation and the citys Office of Emergency Management. According to Mary Walsh, MSN, RN, Vice President of Patient Care Services and Chief Nursing Officer, Beth Israel Petrie was a beacon of light, since it was the only hospital in downtown Manhattan equipped to accept patients during the storm. Anticipating possible difficulties, BI had already moved some of its patients to other care sites within the Continuum system, so they could continue to receive treatments.
St. Lukes pre-op nurses met nearly every hour to plan for evolving situations caused by Hurricane Sandy, as well as patient transfers from other New York City hospitals.

landlines. There was enough food for staff and patients, places for staff to sleep if they couldnt return home, plenty of bed linens, and sufficient fuel to keep the generators humming. Air mattresses were available for staff when beds ran out, and everyone received a hot meal each day.
Continued on page 2

Connections is published weekly by the Department of Public Affairs and Marketing, 555 West 57th Street, 18th floor, New York, NY 10019. Tel: 212.523.7772.

The Food and Nutrition Services management team came into work on Sunday afternoon before Hurricane Sandy hit and stayed the entire week. We were ready to meet the challenges of feeding staff and patients, says Director Barry Schlossberg. Prior to the storm, each site doublechecked their inventories, so we were able to secure additional foods on Saturday and Sunday.

community who worked so tirelessly and selflessly to keep the hospital fully operational. As I walked the halls of the Petrie Division during the height of the storm, I was moved and inspired by everyones enthusiasm and dedication despite the taxing situation, he says. I know that our colleagues at Beth Israel Brooklyn

I was moved and inspired by everyones enthusiasm and dedication despite the taxing situation.Harris M. Nagler, MD
demonstrated the same inspiring effort. All members of the Beth Israel communityno matter what your contributionsdeserve special recognition, he says. You demonstrated what it truly means to be a health care worker. The people of New York, and especially our patients, are most fortunate to have such outstanding caregivers on whom to rely for help. At the storms height, the emergency generators failed at NYU Langone Medical Center and Bellevue Hospital, forcing

BIS Pediatric team on duty during the storm. Front row, from left, Loriza Almodovar, PCA, Rose Marie Prince, MD, Sylvia Hewitt, USA, and Ann Espina, RN. Back row, from left, Christine Haller, RN, Robert Da Rossa, MD, and [name unavailable at press time.]

As other hospitals closed their emergency department doors, BIs ED continued to treat patientson most days, more than 400 individuals. In fact, there was a 70 percent increase in ambulance traffic, and the ED reached a record in overall volume, ambulance volume and admissions from the ER to the hospital. To keep up with this steady influx of

Ellen Miele and Kevin Elliott on the job at SLRs Emergency Department during Hurricane Sandy.

Beth Israels Dan Steinberg, MD, Vice Chair for Education and Residency Program Director, Department of Medicine; Martin S. Karpeh, Jr., MD, Chairman, Department of Surgery; and Henry C. Bodenheimer, MD, Chairman, Department of Medicine, serve food to staff during Hurricane Sandy.

these hospitals to evacuate and transfer patients to institutions that had power, including St. Lukes and Roosevelt Hospitals. SLRs primary challenge was to take care of 120 displaced patients. Sixty from NYU and 60 from Bellevue were admittedin roughly equal numbersto SLR. Dan Wiener, MD, Chair of St. Lukes Department of Emergency Medicine, says that space constraints posed a major challenge in providing for the transferred patients. We went from being at nursing capacity to being at physical The reputation of St. Lukes and Roosevelt Hospitals has been further enhanced by everyones efforts in responding to Hurricane Sandy. You are what make our hospitals such outstanding resources to all who turn to us for help. Frank J. Cracolici capacity, using all of our space to house these patients, he explains. Patients were safely discharged from Roosevelt Hospitals detox unit and St. Lukes pediatric unit to provide room for the influx of med-surg. patients. Beds on several sparsely occupied wards were commandeered, and SLRs Office of EmerContinued on page 3

patients, clinicians worked for 12 to 16 hours a day, slept at the hospital and then rotated back to work. Nurse Manager Lisa Dyer, RN, who stayed throughout the storm, says, Dealing with Hurricane Irene was a breeze compared to Sandy. This time, we had 100 patients in the ER, yet it wasnt chaotic. The staff banded together. At BI Brooklyns ED, many staff fought the elements to report to work. Some of them were the last people to leave Staten Island at the height of the storm to reach Brooklyn, says Nurse Manager Ann ONeill, RN. The generators were switched off when power returned to the Medical Center on the evening of Friday, November 2. BI President Harris M. Nagler, MD, expressed heartfelt thanks and gratitude to all members of the Beth Israel

gency Management brought in 150 cots to St. Lukes and 100 to Roosevelt to ensure that staffers had places to sleep. During the storm, several hundred staff slept in conference rooms and in the halls. Kim Bondy, one of the patients transferred to St. Lukes from NYU, had been hospitalized with an intestinal blockage. A former resident of New Orleans who was there during Hurricane Katrina, she couldnt believe she was going through a similar experience again. St. Lukes staff settled Ms. Bondy in a room after her transfer. Both St. Lukes and Roosevelt hospitals are equipped with emergency generators, but they werent needed. All

key to successfully coping with Hurricane Sandy. Sometimes we look at our practiced procedures as tedious, but thanks to them, we were able to rise to the occasion, he says. Joanne Miller, RN, MSN, Senior Vice President of Patient Care Service and Chief Nursing Officer, agrees. One One of the most important things we did was constantly communicate with staff about what was happening.Joanne Miller, RN, MSN of the most important things we did was constantly communicate with staff about what was happening, she says. Telecommunications was not affected as it was at Beth Israel, so staff were able to stay in touch with family members, which proved a huge comfort. The staff took care not only of patients, but each other. Since patients family members couldnt get to the hospitals, staff became patient advocates, making sure that everyone was getting enough food and sleep. There were many moving parts at all times, yet it was a smoothly run operation, says Ms. Miller. Mr. Cracolici lauded SLR staff for its unprecedented

A lone pedestrian walks the Brooklyn Heights Promenade as Hurricane Sandy approaches New York City.

hospital systems remained fully functional through the storm, and the transition of care for transferred patients went smoothly. SLR administration was actively involved in coordinating operations. There was strong leadership and direction, notes Matt Landers, MS, FNP-BC, Nurse Manager, Emergency Department. The 24-hour emergency command center was opened early, and the Director of Emergency Management helped orchestrate staffing and resources. The command centers monitors flashed critical information on patients vitals and storm news from TV news organizations, and its phone system worked overtime to keep staff connected. The 24-hour emergency command center was opened early, and the Director of Emergency Management helped orchestrate staffing and resources.Matt Landers, MS, FNP-BC SLR President Frank J. Cracolici stayed on site all week, and administrators walked the floors to help wherever they could. We were happy to know that the administrators were backing us up, says Audrey Brown, BSN, MPH, Nurse Manager of the Neurological Medical/Surgical Unit. Patients were moved from the ED to patient care floors at a quicker than normal pace. Makeshift ID badgesstrips of paper with patients names and diagnoses taped to them were created. It made patients feel secure, because we could call them by name, says Ms. Brown. According to Greg Calliste, St. Lukes Administrative Officer, communication within and outside the hospital was

Concerned about The New York Eye and Ear Infirmary during Hurricane Sandy, the Wills Eye Hospital in Philadelphia sent a unique CARE packagePhillys famed soft pretzels. Enjoying them are, from left, NYEEIs Allan Fine, Ray Gearity, Gary Enriquez, Ralph Lambiasi, Kwok Chang, Charles Figliozzi, Sonja Tennaro, RN, EdD, and NYEEI President D. McWilliams Kessler.

demonstration of commitment to patient care during Hurricane Sandy. He felt staff truly went the extra mile to ensure SLRs mission to provide the highest quality of care, despite the storm. I extend my personal thanks to the SLR physicians and nurses who worked long, hard hours to ensure optimal delivery of care during those challenging days, Mr. Cracolici says. Special thanks also go to our CNAs, unit clerks, technical and ancillary staff, volunteers and other members of the SLR community who assisted in supporting clinical care, whether it was helping out in Food Service or Environmental Services, taking calls on the nursing units or in other meaningful ways. Lastly, I wish to acknowledge and thank my leadership team and all of the management staff who assisted in the Command Center and helped coordinate and monitor activities. The reputation of St. Lukes and Roosevelt Hospitals has been further enhanced by everyones efforts in responding to Hurricane Sandy, he says. You are what make our hospitals such outstanding resources to all who turn to us for help. n

Stories from the Frontlines

Coping with Hurricane Sandy generated countless stories on how the Continuum hospitals provided critical care to patientstheir own as well as those from other hospitals. Here are just a few of those stories. As patients streamed into Beth Israel Petries semi-lit lobby, they found comfort in the fact that the hospital was open. Victor Roriquez, 58, who recently had a stent placed in a blocked artery, came in after feeling tightness in his

now volunteers to play at BIs Surgical Intensive Care Unit, traveled from the Upper West Side on Friday after the storm to work his regular shift. He played for three hours instead of his usual 90 minutes. One listener was an 85-year-old patient who was a close friend of noted Brazilian songwriter Antnio Carlos Jobim. Others were a 92 year-old woman, I was impressed by the dedication of our staff, many of whom were displaced themselves and stayed at the hospital.Joseph Habboushe, MD and a young woman who just had brain surgery. Other musicians in the hospitals Music Therapy Department also found a way to get to the hospital that week, he says. They are dedicated people, and it was inspiring. The main concern for Frank Cefali, RN, Nurse Manager, 8 Silver, was to make sure that discharged patients got home safely. I gave money to a volunteer who went to a bodega on First Avenue and bought non-perishable food, he says. We then made goodie bags, so discharged patients could get through the next 48 hours, until home care or family arrived to assist or shop for them. At BI Brooklyn, one ED patient came in with a service dog. The staff adopted Sara during the many hours she was here with the patient, even taking turns to walk her in the middle of the storm, says At Roosevelt Hospitals ED, Nurse Manager Nurse Manager Ann Matt Landers, MS, FNP-BC, and Wendy OBrien, RN, Director, Patient Care Services, ONeill, RN, Depart- discuss patient admissions from other New ment of Emergency York City hospitals. Medicine. I am very fortunate to have such a dedicated team. Two BI Brooklyn employeesMarie Walsh, RN, Interventional Nurse and Sal Renda, Radiologic Technologist whose homes suffered extensive damage, including the loss of many personal itemsexhibited a remarkable sense Amidst the pain and concern, the ER was a place where the spirit of New Yorkers came through. John M. Samuels of responsibility to patients. Marie and Sal reported to work throughout the storm, says Radiology Administrator Vincent Monte. Their sense of compassion for others truly exemplifies what it is to be a professional health care provider. At 1:30 am on Tuesday morning, during the height of Hurricane Sandys fury, St. Lukes and Roosevelt Hospitals Neonatal Intensive Care Unit received an emergency call that babies were being evacuated from NYU Langone, which had lost electricity.
Continued on page 5

BI Petrie Interventional Radiology nurses and technicians employed headlamps during urgent procedures. Front row, from left, are Ammeruth Camilosa, RN, MSN; Michael Carrick, BS, RT; Rosita Macrohon, RN, BSN; Marinette Angeles, RN, BSN; Maria Dejesus, RN, BSN, CNOR; and Alexander Jaudines, RN, BSN. Back row, from left, are William Arroyo; Maria Davina Casulla, RN, BSN; Rosalie Handelman, RN; Israel Ramos; and Javier Diaz.

chest, and facing the daunting challenge of having to climb 13 flights of stairs to his apartment, which had no power or water. I feel safer here, he says. Its a fantastic hospital. Retired postal worker Tony Kwok, 65, had fallen down a flight of steps in his dark apartment building, suffering cuts on his legs and a bruise on his head. Normally, he would have gone to New York Downtown Hospital, but he came to BI. This hospital is very good, he said after getting a CT scanand a sandwich. Managing patients in the ER at the only downtown hospital open during Hurricane Sandy gave me a perspective on the spirit of New Yorkers, says John M. Samuels, Administrative Director for BIs David B. Kriser Department of Emergency Medicine. People ran into the ER anxious and desperate for medical and emotional care. Hospital employees, some of them victims of the storm, worked endless hours and cared for patients with grace and compassion. Amidst the pain and concern, the ER was a place where the spirit of New Yorkers came through, and people came together. Joseph Habboushe, MD, Attending ER Physician, says, I was impressed by the dedication of our staff, many of whom were displaced themselves and stayed at the hospital. Equally impressive were our administrators for enacting creative solutions to unique problemsa makeshift nursing home facility was created where we could admit the elderly and chronically sick who could not go home; and a plan was put in place to handle Level-1 trauma patients who normally would have gone to Bellevue. Andrew Schulman, a musician and former patient who

Based on our experience last year with Hurricane Irene, when we received nine babies from NYU and Bellevue, we were able to plan ahead of time, so when we received the call from NYU, we were prepared, says Farrokh Shahrivar, MD, Director of Neonatology at St. Lukes and Roosevelt Hospitals and Beth Israel. Everything went smoothly because we had formulated our disaster preparedness plan and communicated it to staff. Dr. Shahrivar and I also met days before the storm and discussed staffing, says NICU Nurse Manager Nori Yaun,

From left, Christina Dacanay, Wangdu Dolma, Cecelia Atienza, and Lorna Bryanour, members of SLRs Emergency Department staff.

RN. Many remained here for days, separated from their families and loved ones. I especially wish to express my gratitude to those nurses who arrived at work hours before their scheduled start of shift. It is an honor and pleasure working with them. Besides caring for premature babies, SLR continues to treat evacuees from NYU Langone and Bellevue hospitals. We are providing NYU Langone and Bellevue physicians with a home for their patients, says Bruce Polsky, MD, Chairman of SLRs Department of Medicine. St. Lukes Hospital has created a NYU Langone Hospital Service Unit on Babcock 5W, with approximately 25 beds made available for patient transfers. The unit operated at close to full occupancy WABC-TVs Dr. Sapna Parikh, right, during the storm. NYU interviews patient Caroline Hughes, hospitalists, physician who was transferred from Bellevue Hosassistants and nurse prac- pital Center to SLR when Bellevue lost titioners rotated through emergency generator power. it, providing 24/7 coverage for patients. At publication date, the unit is still caring for five patients. To allow NYU Langone physicians to treat inpatients at SLR, the hospitals created an expedited credentialing Credentialing usually takes a couple of months under normal circumstances. We did it in a week, which is very rare.Bruce Polsky, MD process, and more than 25 physicians and 15 physician assistants and nurse practitioners were provided with credentials. Credentialing usually takes a couple of months under normal circumstances, says Dr. Polsky. We did it in a week, which is very rare. The process required a great deal of coordination from SLRs clinical departments and Medical Staff Office, in order to rapidly review each application for privileges and verify that institutional standards were met. In addition, expedited information systems training was necessary, so visiting staff could access and review computerized patient results and enter orders for treatment. SLRs Department of Nursing conducted orientations to introduce visiting staff to the clinical units. NYU Langone and Bellevue arrhythmia specialists also sent their patients to SLR. As luck would have it, we had just opened our Al Sabah Arrhythmia Institute, so we could handle the increased volume in a state-of-the-art facility, says Walter J. Pierce, MD, MBA, Interim Director of Electrophysiology. We were equally fortunate to have tremendous support from Nursing Services and Anesthesia. I know that NYU and Bellevue physicians appreciate the help we were able to provide. Most important, it is rewarding to help their patients get through such a stressful time. n

RN. We knew which staff members would be here, and they came to work the day before the hurricane with suitcases. Despite an already high census of high acuity patients, SLRs NICU took in four babies and a mother on Tuesday morning at 2:30 am. The NICU team worked rapidly to get the babies settled in, administering intravenous therapy and feeding regimens. An NYU physician filled us in on the patients medical conditions, and the nurse-to-nurse report was done at the bedside, says Ms. Yaun. We oriented the mother to the unit and then directed her to the Parents Room to get some rest. The extraordinary devotion of the staff under the most difficult conditions was amazing, since they stayed in the hospital for days, taking care of these patients and making arrangements for their families to be with them. According to The extraordinary devotion of the staff under the most difficult conditions was amazing. Nori Yaun, RN Glenda Miranda, St. Lukes Director of Patient Care Services, it was the heartwarming camaraderie among staff that helped SLR weather Hurricane Sandy and provide patients with the best possible care. Nurse Manager Avis M. Evans praised her Marvelous staff at St. Lukes, Clark 8 Inpatient Psychiatry Unit. All of them remained in the hospital and gave their all. They took care of patients and guest patients from NYU who arrived at 3 am. They took care of each other and me as well. I acknowledge and thank the members of my Babcock 9W staff who worked so diligently last week to care for our patients, says St. Lukes Nurse Manager Maureen Sullivan,

Assisting in the Recovery

St. Lukes and Roosevelt Hospitals each held blood drives to help ease a dire shortage. During the hurricane, the New York Blood Center had to cancel many blood drives in New York City, Long Island, New Jersey and the Hudson Valley areas, losing thousands of units it would normally have had on hand, says Mark T. Friedman, DO, Medical Director, Blood Bank and Transfusion Service, and Director of the Pathology Residency Program at SLR. BI Brooklyns Rosa Raffaele, left, and Yesenia The blood col- Perez helped organize a clothing, food and lected by SLR not only cleaning supplies drive that assisted hard-hit went to treat regular residents in that borough. patients, but to offset an increase needed for blood created by patients transferred from Bellevue and NYU Langone. Although the SLR blood drives were planned months ago, they turned out to be timely successes in the wake of the hurricane, and we thank all of the volunteers who came to donate or who otherwise gave their time to help out by recruiting donors or assisting at the drives, says Dr. Friedman. Also, special thanks to Grace Phelan, Nursing Education, and Uchenna Acholonu, MD, OB/GYN, who helped make the drives a success. At Phillips Beth Israel School of Nursing, the Student So far, we have collected more than 140 bags of clothing and blankets, plus three large boxes of shoes.Yesenia Perez Nursing Association conducted a relief drive for Staten Island and the Rockaways, collecting such items as blankets, batteries, bottled water, paper goods, shovels and brooms, cleaning products, flashlights, toiletries, medical items, and pet food. BI Brooklyn started a clothing, food and cleaning supply drive on October 31. Rabbi Jacob Hoenig, Rosa Raffaele, Marisa Ognibene, Irina Chaikhoutdinova, Maia Makharadze, Rose Mittman and Yesenia Perez organized the drive under the direction of Rhona Hetsrony, Vice President of Administration. So far, we have collected more than 140 bags of clothing, coats, and blankets, plus three large boxes of shoes, says Ms. Perez. Thanks to the generosity of BI Brooklyn donors, St. Marks Church from Rockaway Beach, Bailey Seton Hospital Shelter in Staten Island, Mary Queen of Heaven for Garritsen Beach, YMCA Shelter for Special Medical Needs in Park Slope, New Dorp Shelter in Staten Island and the American Legion Post from Oakwood Beach have received essential items. n

Water from the East River floods 14th St. and Avenue C, just blocks away from Beth Israel Petrie.

Were You Personally Affected by Hurricane Sandy?

Many Continuum employees suffered property loss and significant damage to their homes during and after the storm. In an effort to support them as they cope with their losses, Continuum has identified the following resources: n Free and confidential social work services are available to all BI and SLR employees. At BI, call Program Supervisor Carole Sher, LCSW, at (212) 420-4516 for information or to make an appointment. At SLR, call the Crime Victims Treatment Center (CVTC) at (212) 523-4728. n The Federal Emergency Management Agencys (FEMA) website has a Hurricane Sandy portal and an online application for assistance at http://www.fema.gov/sandy. In addition, FEMAs Call Center can be reached at (800) 621-FEMA. FEMA also has established mobile recovery assistance centers in Brooklyn and Queens. n Individuals with flood insurance for their homes can reach out to the National Flood Insurance Program (NFIP) at www.fema.gov/national-flood-insurance-program. n The Internet contains a lot of valuable information. For example, the lawyers at www.lawhelp.org have pulled together a comprehensive list of disaster relief resources. n The New York Legal Assistance Group (NYLAG) has a presence at Beth Israels Phillips Ambulatory Care Center, 10 Union Square East, and St. Lukes Hospital to provide individual legal guidance to staff. NYLAG also has mobilized a legal aid disaster relief program to help patients and staff deal with legal issues in the aftermath of Hurricane Sandy. The programs hotline number is (212) 921-5000. n Continuum is working closely with the New York City Bar Justice Center to secure volunteer lawyers to help employees report property damage and personal losses. n

The Connections staff thanks everyone who submitted stories and photos for this special issue.