Chapter 09: Weather is Part of the Job: A Near Disaster and Developing Emergency Plans for Floods, Wind, and Hurricanes

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Chapter 09: Weather is Part of the Job: A Near Disaster and Developing Emergency Plans for Floods, Wind, and Hurricanes

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In this segment, Mr. Daigneau explains that serious flooding during the construction of the Alkek Hospital and the Clinical Research Building "was my introduction to rainfall in Houston." He notes that all of the linear accelerators for radiation oncology were in the flood area with only two construction doors holding water back from the equipment. He addressed the deficiency of MD Anderson's emergency plan, creating Hurricane Manager. (In learning about hurricanes he thought, "I need to find another job!) Mr. Daigneau describes the dimensions of this comprehensive emergency plan, how it was drilled, and what it was designed to achieve.

Identifier

DaigneauW_01_20131003_C09

Publication Date

10-3-2013

Publisher

The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

Institutional Processes; The University of Texas MD Anderson Cancer Center; MD Anderson History; MD Anderson Past; Institutional Processes; Discovery and Success; This is MD Anderson; Critical Perspectives on MD Anderson; Building/Transforming the Institution; Growth and/or Change; Obstacles, Challenges; Professional Practice; The Professional at Work; Understanding the Institution

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

Tacey A. Rosolowski, Ph.D:

So tell me about the other challenges of this Three-Building Plan.

William Daigneau, MBA:

Well, what became the LeMaistre Clinic was a pretty straightforward building. The Clinical Research Building, which was pre-Allison, by the way

Tacey A. Rosolowski, Ph.D:

This is Hurricane Allison, for the record.

William Daigneau, MBA:

Tropical storm.

Tacey A. Rosolowski, Ph.D:

Tropical Storm Allison.

William Daigneau, MBA:

Where flooding occurred was not built above flood level at the time, so it was at risk. We later went back and basically created a flood wall around it. At the time, it was pretty" other than that" but it had an animal facility in the basement. So there was a large excavation made for the Clinical Research Building and the Alkek Hospital, and the foundations were being poured. We had a" I can't remember the name of the tropical storm in" by the way, I had come to Anderson in June. In October, we had this enormous rainfall. Flooded what was then just the basement of the Alkek Hospital and the Clinical Research Building. The basements were wide open, and we actually had a storm sewer break and flood the basements. So you say, Well, so what? You flooded the basement of a building that was just under construction, nothing down there yet. It just holds water. You pump it out. Big deal." Well, the problem we had was Radiation Oncology" all the vaults for Radiation Oncology were below grade. The linear accelerators were all in the basement of the old tumor hospital.

Tacey A. Rosolowski, Ph.D:

Oh my gosh.

William Daigneau, MBA:

Well, we had to basically excavate up to that foundation wall to build the new hospital and the Clinical Research Building, so the wall to all of the treatment areas of Radiation Oncology were exposed by the construction. And of course, we were adding Radiation Oncology facilities in the new Alkek, in the basement there. We had poked a few holes into that foundation wall to create the new doorways that would link the two buildings. So here we have a flooded basement, and the only thing holding back the water from our entire radiation oncology area in the hospital were these two construction doors.

Tacey A. Rosolowski, Ph.D:

Oh God.

William Daigneau, MBA:

Oh yeah, it was interesting.

Tacey A. Rosolowski, Ph.D:

I wish the listener could see the look on Mr. Daigneau's face.

William Daigneau, MBA:

Hello, Bill?" Yes?" You better come down here as soon as possible." So it was night. What the heck? So I drove down there, and I could see the water in the" you know" it didn't take long for me to put two and two together. I ran down in the basement, and sure enough, there are our physical plant crews. They're sandbagging. They've got pumps. They're trying to keep the water out of the radiation oncology suite. We had damage down there, but luckily nothing that completely shut us down until we got the water pumped out. But that was my introduction to rainfall in Houston and how much water could accumulate very quickly.

Tacey A. Rosolowski, Ph.D:

When did" ? You said that Tropical Storm Allison had not come yet. When did it get on your radar that these big storms and that weather in general was really a factor and it had to be anticipated in buildings?

William Daigneau, MBA:

When you read my job description" my original job description" there was a title in there which I laughingly look at now. It was called hurricane manager." Well, living up in New York" well, now we know, though, but at the time, I didn't know anything about hurricanes. I'd worked out in Colorado. There are no hurricanes out there. So what's hurricane manager mean? So I talked to our head of Environmental Health and Safety. He said, Oh, don't worry. I'll take care of everything in a hurricane. You just need to show up and make decisions." Now I see a flooded basement and how close we came to a major disaster, and I'm thinking" you know" this was October, so hurricane season was just about over for that year. But I said to myself, I need to learn more about this stuff." So in the spring of every year they have these classes that are offered by the state and county on emergency preparedness for hurricanes. I said, Well, I'll go to one of them to tell me a little bit about what these storms are like and what I can expect, etc." So I went to one. It scared the heck out of me. I came out of that course thinking, Oh my God, I need to find another job." (laughs) This is what stuck in my mind. I recited it for eighteen years at MD Anderson. The wind is the problem, obviously. It can tear things up pretty bad, cause a lot of collateral damage, which they do. But you can board up your buildings. If the roof isn't gone, you can get back into operation. What hurricanes bring is what's called storm surges, where they push the water from the Gulf or the ocean inland" twenty-some foot storm surges" a wall of water twenty feet high, coming in ashore. So in Houston, what does that mean? That means all the bayous drain toward the Gulf. Well, if the Gulf has twenty feet of water" a wall of twenty feet of water" what's going to happen to the bayous? They're actually going to reverse flow. They're going to try and drain the Gulf. Well, we're sitting there on Brays Bayou, and there's Buffalo Bayou downtown. So Texas Medical Center, on two sides of it, has two major bayous, all of them now, in a hurricane, flowing backwards.

Tacey A. Rosolowski, Ph.D:

Toward the [Texas] Medical Center.

William Daigneau, MBA:

Toward the Medical Center. So in my first year, I became" after having my October experience, all of a sudden I realized our fear was not wind; it was flood, and the flooding could cause serious damage that would require weeks and months to repair.

Tacey A. Rosolowski, Ph.D:

Now, MD Anderson had or did not have any kind of set plan to deal with this kind of thing? What was the situation at the time?

William Daigneau, MBA:

Well, that caused me to look into what our emergency plan was. So one of my new goals was this was in serious deficiency. Me just showing up to make decisions? Oh no, no, no. This was not going to work. So at the time, this was before" the years before the incident command center approach, which we now have, by the way. But one thing I became convinced of was we needed to create a calling tree to get people here that can tell us what to do with some of this medical equipment. The animal facilities" we need the veterinarians on site. You know, if the animal facilities are flooding, well, I have no idea what to do. And we had radiation sources in the basement. If they're flooded" and me and the Environmental Health and Safety director, as much as he did know at the time, there's a lot of stuff we have no idea about. So I said, We're getting a group of people together here, because I have no idea about this stuff." So to make a long story short, we created this" at the time" we paid money, actually, to create these booklets, which were basically instructions and what to do in case of a hurricane. We expanded the fire safety and a whole bunch of things. And to this day, they still have the flip books, but that was the beginning of the flip books. We hired a company to basically put everything down in writing. This is what you do, this is what I do, etc. Then in" his name was Earl Jansen. Earl left and went to work for the University of Texas at Austin, so I had to hire a new Environmental Health and Safety person. Her name was Linda Lee, and she came in, and at the time, the incident command center approach was being recommended by FEMA and other agencies. It had grown out of the military" how to deal with emergencies, shootings, whatever. So one of the things Linda Lee put together for us, and did an excellent job, was she created the whole incident command center. And the second thing that she asked me about was should we drill this? I said, Yeah, we should drill it." We started drilling" doing actual drills. So over the years, the whole emergency plan evolved into what was a haphazard, Lord-help-us-if-anything-befalls-us situation to one of" and we got to test it out. You know, we were able to test it out, the whole incident command center on Allison, Rita. Katrina didn't hit us, but it was in the Gulf. Anytime a storm is in the Gulf, we go on alert. So we were able to test it out on a number of actual things that happened. And finally [Hurricane] Ike" Ike, which really did"

Tacey A. Rosolowski, Ph.D:

Tell me how it works.

William Daigneau, MBA:

Well, the innovation of the incident command center is" which I think is quite good" goes back to bringing together a group of people, all specialists in their field, and getting them in the same room to take control of an emergency. So you have a facilities person there, you have Information Technology, you have Finance, you have Purchasing people there, you have the head of the hospital. You have people not so much by title but knowledge sitting in the room. I guess Steve Stuyck [Oral History Interview] is now retired.

Tacey A. Rosolowski, Ph.D:

Yeah, Public Affairs.

William Daigneau, MBA:

Yeah, all your media relations because" you know" the TV channel wants to know what we're doing. Well, somebody put that together. Right now I'm worried about the flooding, so the media people would put that together. So you bring everybody into a room together, which is called the incident command center, and then you have the incident commander. Now, at the time that I left, the incident commander was the head of the hospital, which is Dr. [Thomas] Burke. If he was incapacitated, if fell to me, which I was never really comfortable with, but" you know" but I had the medical officer in the room with me, so medical decisions. And head of nursing was in the room with you. But the whole idea is you bring these core groups together, create the command center. You have your incident commander who makes decisions. But basically all the people in the room together during the emergency are there basically to manage their aspect of the emergency. So for example, when are we going to close the clinics? Well, we have the head of the clinical operations there. So in this case, it was Gerard Colman. So Gerard would say, Well, for us to close the clinics we have to give this much notice." He knew that because he knew about the scheduling, the patients coming in, etc. You can't wait until a patient leaves their home or gets off the plane to tell them it's closed, so you need so many hours. So things like that would come up. So he'd advise the incident commander, Well, I need to notify everyone at least 12 hours in advance." And then if the commander said, Okay, let's close it," then it was Gerard's responsibility to actually mobilize his group to call every patient, contact every patient, and let them know that their appointment was canceled, that the clinic would be closed. So that's how the command center works. Issues come up. We have damage. We've got flooding here. It mobilizes people. The incident commander is there to make a decision on what to do, and then all the people who would execute that decision are sitting in the room and have at their command the people and the resources necessary to do it. So it's a nice system. It works well. We've tested it out. We've always come through everything with minimal damage. We're always one of the first hospitals to reopen. Our clinics reopened earlier than almost anybody else, and we were back in business way before" you know" the only thing that governed our ability to get back in business was it was usually getting our employees back to work, because sometimes they were affected by the flooding or damage or whatever. So the thing that really" the plant was never an issue for us to" we shipped in bottled water. We had everything.

Tacey A. Rosolowski, Ph.D:

So laying in supplies was also part of it.

William Daigneau, MBA:

Yeah. I mean, everything" generally, our incident command system worked. We'd drill it twice a year.

Tacey A. Rosolowski, Ph.D:

Oh, really?

William Daigneau, MBA:

Oh yeah. Run everybody" sometimes it was just a paper drill. Sometimes we'd pull everybody into the room. Linda Lee's staff would create this fictional" sometimes it was a bombing. Sometimes it was a fire. Sometimes it was a hurricane. And every time we drilled it, we learned something new about our plan, and it got better and better and better.

Tacey A. Rosolowski, Ph.D:

What about technology and computer systems and all of that?

William Daigneau, MBA:

In terms of the incident command?

Tacey A. Rosolowski, Ph.D:

Yeah.

William Daigneau, MBA:

Oh yeah, communications were always important, both telephone as well as the computer systems.

Tacey A. Rosolowski, Ph.D:

And I'm thinking data security and patient information, security" all of that.

William Daigneau, MBA:

Yeah, we actually had" in the command center, we would close the whole institution, but there were what we called the islands" that were still up and operational, and one was the data centers. Yeah, they were staffed, and they had food supplies there" power bars and microwavable. Yeah, they were fully self-sufficient. But to keep the data centers and the telephone system up and operational"

Tacey A. Rosolowski, Ph.D:

How long did it take to really get the working model of this in place?

William Daigneau, MBA:

It evolved. It evolved. I mean, originally, the concept of" there was a guideline for incident command centers that was created by FEMA, but it misses a lot of the details. And the details became" every year you had to update your departmental emergency plan, which was integrated into the overall institutional plan. And every year we got better. For example, one year we created what was called the emergency plan officers" the EPOs. Those were the people for each department, not necessarily the department head, but they were people in each department that were responsible to create and then update their departmental emergency plan. And they were responsible for communication flow, notification, things like that. They had a list" they still do" they have a list of responsibilities. So one year we thought" you know" because up until then we had relied on department heads. Well, we found out that department heads don't always communicate well with their departments, and they're not always available. But they use a departmental administrator or somebody else that does a lot of that stuff that is available, that does communicate well. So one year we said, We've got to create a core group of people. So we created the emergency plan officer" EPO" and asked every department to name one. And it took" you know" this did not go in place in one year. Every year it got better and got stronger, and every time we had an incident, we would make it better and correct the problem we had, and the drills would reveal deficiencies" unable to contact So-and-So. They didn't respond. Now what do you do? So every year we got better and better at it, and we innovated every year on something that would enhance the program, so it evolved over" yeah.

Tacey A. Rosolowski, Ph.D:

Good wake-up call.

William Daigneau, MBA:

Just about a scary situation to one where we were pretty confident.

Tacey A. Rosolowski, Ph.D:

Right. Make it manageable. Yeah. Wow. Amazing.

William Daigneau, MBA:

All learned.

Tacey A. Rosolowski, Ph.D:

All learned.

William Daigneau, MBA:

All learned from a flooded basement. (laughs)

Chapter 09: Weather is Part of the Job: A Near Disaster and Developing Emergency Plans for Floods, Wind, and Hurricanes

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