Hurricane Florence Tests Team at Brunswick Medical Center

The rainfall unleashed across North Carolina by Hurricane Florence—about 8 trillion gallons, according to an unofficial estimate from the National Weather Service—meant several days of isolation for the team members of Novant Health Brunswick Medical Center.

“Brunswick County was basically divided into 3 islands,” said Perry Allen, pharmacy manager for the 74-bed acute care hospital in Bolivia, the county seat. “We were in the middle island, so most people in that area could get to us. But we couldn’t get out north to Wilmington. No one could get down south . . . and we couldn’t get west. So we were just basically stuck here.”

The hospital went on lockdown on September 12, which was 2 days before the vast, slow-moving storm would make landfall in the state.

One of the 5 pharmacy team members who stayed onsite was able to get home on September 17, and Allen and the rest returned home the next day. He said flooded roads remained a problem in the days after the storm when previously clear roadways became inaccessible due to rising waters.

Ryan Mills, pharmacy operations manager for Novant Health Kernersville Medical Center and Novant Health Clemmons Medical Center, both in the Winston-Salem area, said that before the storm arrived, the health system shifted some patients from Brunswick to inland hospitals with available rooms. He noted that Novant Health’s hospitals can leverage their electronic medical record (EMR) system (Epic Systems Corporation, Verona, WI) to verify medication orders at other facilities, if needed.

Tanya Goodin, the procurement technician for Novant Health Kernersville Medical Center and Novant Health Clemmons Medical Center, said the organization’s pharmacy group stocked up on standard and emergency medications in advance of the storm.

Novant Health announced that Brunswick Medical Center’s emergency department would remain open throughout the storm, but patients wouldn’t be allowed to leave until it was safe for them to do so.

“So, they were still here onsite waiting out the storm with us,” Allen said.

Allen said that because local community pharmacies closed for the storm, some area residents who needed medications sought them from the hospital’s pharmacy. He said the pharmacy closures lasted 3 or 4 days, an unusually long time relative to closures during past weather events.

And he said one of the local shelters was “looking to use us as a resource to provide needed medications for their patients.”

That prompted the staff to examine some of the features in the hospital’s EMR system that aren’t used to manage inpatient medication orders.

”We don’t normally fill outpatient prescriptions. But we did figure out a way that we could change some of the fields as we entered the orders so that we could print an outpatient prescription label,” Allen said. “So we were able to provide that.”

The shelter ultimately managed without needing the hospital’s pharmacy to handle prescriptions. But Allen said his staff used the newfound EMR capability to fill about 140 outpatient prescriptions.

Allen said there was uncertainty about whether the medical center’s wholesaler, McKesson Corp., would be able to replenish medication stocks that were running low in the days after the storm.

The wholesaler had shipped medications from Virginia to Brunswick County, but the driver couldn’t get to the hospital itself.

“He was on the other side of the flooding. Basically, he was on the next island over,” Allen explained.

So with the help of local law enforcement, the medications were transferred from the delivery truck at the edge of the water to a tactical vehicle, which was able to cross the flooded area. The medications were then loaded into a van and pickup truck for delivery to the medical center and to Dosher Memorial Hospital in Southport.

Allen said Dosher’s pharmacy director, Lisa Narron, had contacted the local sheriff’s department for help arranging the medication transfer.

“It’s nice to have some local folks going through the same things with us,” he said. “We know each other, and we can support each other even if we’re not part of the same system.”

When it wasn’t certain that the wholesaler’s shipment would reach the hospital, Novant Health’s system pharmacy and supply chain teams arranged to have a secondary order delivered.

“They had figured out a way to get to us by going down into South Carolina and . . . coming back up to bypass the flooding. So they had found about a 300-mile loop that got them to us,” Allen said.

“They also surprised us and shipped us an entire tote of food and snacks and fruit for our team members,” Allen said.

He said the hospital’s generator came on during a brief loss of power, and air conditioning and hot water remained available throughout the storm. The food services staff had stocked up on supplies before the storm and was able to feed everyone onsite.

During their off hours, he said, the staff watched football, worked on puzzles, and played cornhole, and administrators circulated through the rest areas with trays of snacks for their colleagues.

Cots were set up in conference rooms and other areas in the hospital so staff could sleep.

“While the day shift was working, the night shift was sleeping,” he said. “And then they would switch places—kind of like on a ship.”

Allen said that most of the pharmacy team’s homes had some water damage but nothing major, although one staffer remained isolated at home 6 days after the storm hit.

He said Hurricane Florence was among the most destructive storms he’s witnessed in the area over the past 25 years.

[This news story appears in the November 15, 2018, issue of AJHP.]