Lessons in emergency management from hurricane country for other health care systems

When it comes to storm preparations, some MUSC Health leaders are helping other hospitals do it by the book – literally. Tom Crawford, chief operating officer for the MUSC Health System, and Kimberly Bailey, system executive director of Emergency Management for MUSC Health, have written a comprehensive guide for other organizations to use as a reference. “Emergency Management for Healthcare Leaders” came out earlier this year.

“What we're really trying to do is to take a very pragmatic approach,” Crawford said. “This is how you can dovetail what works well for these larger events into something that's going to work very well for your organization and not put people in a position where they're set to fail but to put people in a position where they're set up to do what they were trained to do.” 

 

Bailey said they’ve seen that the ability to anticipate, monitor and act on real-time information differentiates reactive organizations from resilient ones. “That philosophy is deeply embedded in how we approach storm readiness across the health system. Whether we’re monitoring tropical weather systems or responding to a rapidly evolving infrastructure challenge, every decision must be grounded in a full understanding of the risks, resources and relationships in play.”

She and Crawford have plenty of experience to inform their writing. They not only deal with the types of emergency management issues that all hospitals try to prepare for; they’re also put to the test every hurricane season in the Lowcountry. 

You’d have to read their whole book to get a big-picture perspective from their examples and advice. But in the meantime, here’s what you could call a case study from Bailey and Crawford on managing one kind of emergency: the threat of a potentially catastrophic storm. 

Preparation includes training, positioning and plenty of weather watching

Hurricane season runs from June 1 through Nov. 30 each year. And according to the South Carolina Department of Natural Resources, the state ranks fifth in the country when it comes to hurricane impacts. So at MUSC Health, getting ready is a given.

But preparing for such storms doesn’t just take place once bad weather is on the horizon, Bailey said. “We train relentlessly. Checklists and exercises aren’t just about compliance – they’re about readiness.”

She called MUSC’s response model methodical, experience-driven and collaborative. “Mitigation is more than a buzzword; it’s a strategy that begins months before an event and continues into recovery. That means prepositioning high-water vehicles, topping off generator fuel tanks, validating patient transportation routes and maintaining continuity of care through comprehensive planning.”

 

It also means spotting vulnerabilities such as fuel supply chain issues, staffing challenges and patient transport barriers and resolving them before they escalate into crises.

That doesn’t mean she, Crawford and their Emergency Management colleagues don’t monitor the forecast along with everyone else. They just do it with an extra sense of urgency, knowing that their decisions may affect thousands of patients, families and employees.

So Crawford said they view weather forecasts early and often. “I watch for anything brewing that's going to impact the East Coast. If there is, I'll immediately start getting once-a-day weather updates, then up to three-times-a-day weather updates so I know exactly what we're dealing with.”

Bailey said the updates come from the MUSC Emergency Management team and contain official information from weather resource partners such as the National Weather Service and the National Hurricane Center.

When a storm’s brewing

If forecasters are predicting that a tropical storm or hurricane will hit the state, as they often do, Crawford sends word to hospital employees in the affected areas. “I need to be able to get enough people in the hospitals, build our teams A so that we can do shift work – generally 12 hours on, 12 off. Some shifts are shorter. But need to have enough people in the house to continue the great care that we provide,” he said.

That includes not only doctors and nurses but also everyone from patient care techs to cleaners to food delivery specialists. Those employees, including Bailey, Crawford and other hospital system leaders, come prepared to stay for a few days. 

“We try to do our very, very best to make sure that all of our employees are comfortably accommodated. And we tell people, you should probably bring in comfortable clothes to sleep at night, bring in bedding, things of that nature, so we can make it as comfortable as possible,” Crawford said.

While employees plan for extra hours at work, some patients head home ahead of a storm.

“If we have patients that are no longer severely injured or dangerously ill and they're cleared to go home and they feel they feel like they can go home safely, then we will try and reduce our census,” Crawford said. The census is the total number of patients.

“For those that are too sick, too injured – that's what we're here for, to continue to care for them.”

Shoring up supplies

That care requires life-saving supplies. “To keep patients safe through a storm, we need to have enough blood products, enough oxygen, enough pharmaceuticals on hand. We also need to have three to four days of fuel in the ground and make sure they have enough food, supplies, et cetera, to last through what could be a prolonged event,” Crawford said.

Flexibility is part of the package, Bailey said. “Situational awareness allows us not only to respond effectively but to anticipate needs, shift resources and protect the continuity of care across the system.”

Systemic response

That system includes multiple hospitals that Bailey and Crawford stay in close touch with. “My role, and that of the Emergency Management team, involves monitoring all four of our health system divisions – Charleston, Catawba, Pee Dee and the Midlands – using tools, relationships a blend of real-time data, field reports and established communication channels,” Bailey said.

They all use what Crawford called the PIP model: “What's the Problem? What's the Impact? What's the Plan?” he said.

“Each chief operating officer for the divisions is going to report back to us on their plans, and they're going to tell me their checklists are done, and they're prepared to ride out the storm. That's good. And if I have two or more divisions that are in emergency operations, we put the health system in emergency operations.”

Bailey said emergency leaders also work with county emergency managers, emergency medical services and state-level officials to align priorities and ensure they’re not just reacting but proactively addressing gaps in service delivery and resource availability.

Takeaway for the public

That’s a lot to tackle, but Bailey and Crawford said their team has it down to a science. “We are very, very well-prepared,” Crawford said.

Bailey agreed. “We expect the unexpected, and we lean into the strengths of our Emergency Management team and the structure we’ve built. In times of crisis, the public and our care team members are looking to us for confidence and clarity. And in the moments that matter most, that awareness becomes our most powerful tool – not just to protect life and infrastructure but to lead with clarity and calm,” she said.

Crawford had this message for the public. “I think the biggest thing to know is that if you find yourself in an MUSC Health facility, you'll be safe. We are well-prepared. We will have enough provisions to last the duration of the storm, and then, if something unforeseen were to occur, we always have other contingency plans.”