East Cooper Medical Center in Mount Pleasant, SC, is not far from water in any direction. In fact, when Hurricane Florence was threatening, the hospital, which sees 15,000-18,000 patients a year in its ED, seemed particularly vulnerable.

“We immediately set up our incident command center. That in and of itself activates our ‘code disaster,’ which basically puts people on alert that they need to [get ready] and make preparations for their families,” explains Tracy Hunter, SPHR, SHRM-SCP, emergency commander and chief human resources officer. “That Monday [Sept. 10] is when we started having a discussion. The governor was issuing an evacuation order. By Tuesday, we had all of our elective cases canceled.”

Administrators reduced the facility’s patient census to a minimum and arranged to house staff for the duration of the storm emergency, but they also appealed to the state for an exemption to the mandatory evacuation order.

“The primary reason was so that we would be able to shelter in place at the hospital ... and keep our ED open,” Hunter says. An exemption also would enable the hospital to continue to care for its inpatients, thereby avoiding the arduous process of transferring them to other facilities.

Eventually, the state granted the exemption, and in the end the hospital escaped any significant impact from Florence.

“The storm hit about 50 miles north of us, so we were very lucky,” Hunter notes. However, the near miss provided the hospital with an opportunity to exercise all its emergency plans to find out what worked well and what did not.

“A lot of times we struggle with communications because there is always that one person who doesn’t like to get an email or doesn’t like to get a text message, but we had multiple modes of communication that went to the staff so that they were involved every step of the way,” observes Theresa Lynn, RN, BSN, CNE, director of the ED. “We were very prepared, and I think that showed in our set up of the incident command.” What did not work as well was the emergency plan for staffing the hospital’s designated response and recovery team. “We activated [the team] on Thursday [Sept. 13] at 7 p.m. That meant if [a member of that team] worked Monday, Tuesday, and Wednesday nights, [he or she] also worked Thursday night, Friday night, and Saturday night, which has [the person] on six 12-hour shifts working consecutively,” Lynn shares.

Concurrently, other hospital employees were short a shift that week. Those employees had to take paid time off to receive payment for that period, a problem that did not go over well with staff. “Emotions were high, and that contributed to our opportunity to rethink that approach,” Lynn notes. Following the storm emergency, leadership sent out a survey to staff to inquire about how the hospital could have handled the situation better. Employees also discussed the issue at a staff meeting, Lynn says.

“Staff [members] were able to provide some good, constructive feedback. For the next disaster, we will probably alter our plans so that those teams are a little bit more fluid and we can manage it a little bit better.”

Aside from the staffing issue, administrators were pleased with how well their emergency plans were executed. “We had just had some retraining in our incident command structure and it worked extremely well,” Lynn reports. “People were very responsive and they were aware of their roles and responsibilities during a disaster. I think that is why it went so smoothly.”


  • Tracy Hunter, SPHR, SHRM-SCP, Emergency Commander and Chief Human Resources Officer, East Cooper Medical Center, Mount Pleasant, SC. Phone: (843) 881-0100.
  • Theresa Lynn, RN, BSN, CNE, Director, Emergency Department, East Cooper Medical Center, Mount Pleasant, SC. Phone: (843) 461-6100.