When Hurricane Ian was barreling toward Florida in September 2022, Lee Health System was ready to jump into crisis-control mode.
The hospital was preparing to take in patients from outside its area, Armando Llechu, chief officer of hospital-based care at Lee Health, told attendees of the 2023 Association for Healthcare Foodservice (AHF) Conference in Orlando.
Soon, though, the team's priorities would have to shift as it realized the storm was coming directly their way.
“And while we're always prepared, I don't think any of us anticipated what was really coming. And within hours of us thinking that we were going to serve as a resource for neighboring facilities to the north, it became clear that we had a direct impact coming towards us,” Llechu said in a session called “Hurricane Ian Survival Panel: How Leaders, Staff, and Vendors Can Support Each Other During Crisis.”
The team quickly began to prepare its facilities, sourcing protective equipment and ensuring its older facilities were set up for the storm.
“Before you knew it, the storm had hit the land and then it was kind of like a bad ex-girlfriend that just wouldn't go away,” Llechu joked. “It sat on top of us just like drenching us in rain and wind and it seemed like it would never stop.”
Lee Health is the largest employer in the community, and the only major health system. It accounts for 95% of the hospital beds in Lee County, noted Llechu, meaning during that this time of disaster, the hospitals still had to care for large sums of people. One of the big challenges? Ensuring everybody was fed.
“It's hard. And I don't think anything is harder than feeding those folks," Llechu said. "I think we served about 110,000 meals over the course of a few days with significant infrastructure issues within the community, including no running water to two of our campuses. So, it was a really, really tough time for everyone.”
Gloria Graham, system director for public safety, emergency management and PBX operations for Lee Health, said that the crisis was unlike any she had worked on before, particularly in terms of scale. She recalled the director of emergency management for the state of Florida describing the county as “off the grid” during the days after the storm.
Making the right call
There were a few vital moments when a tough decision had to be made, the team noted from the AHF main stage.
David Reeves, system director of foodservice at Lee Health, said that one of these decisions was whether to bring in emergency food supplies.
“We've got plenty of food, four days plus on hand at any one time, but we needed to bring in much more for this," he said.
Early on, it didn’t look like the hurricane was heading toward Fort Myers, where the health system is located, so some team members were hesitant to bring in the extra supplies. Yet the team ultimately decided to order them.
“So, when the food started arriving on Monday, now all of a sudden it looked like this storm was going to be much more likely to hit us,” he said. “And so, we were much more prepared while others—other colleagues and other organizations—were then scrambling to get the food in Monday for Tuesday.”
Managing resources and misinformation
It quickly became apparent that the team needed to prepare for potentially weeks of crisis control, Reeves said.
This meant water would be critical. Leadership reached out to Pepsi, which delivered a full trailer truck of water. The foodservice team was tasked with feeding large sums of people—patients, caregivers, first response teams and even the National Guard.
The team got help from others in the community. World Central Kitchen, a nonprofit founded by chef Jose Andres, sent food trucks from Miami. The trucks were each equipped to serve 2,000 meals, and the team dispatched one at each hospital campus.
The health system also received help from Mercy Chefs, another nonprofit providing disaster relief. Mercy Chefs set up a kitchen in a local church and began delivering 600 meals twice a day to the hospitals.
Another obstacle the foodservice team had to tackle was addressing misinformation and keeping up morale as rumors about rationing spread around the hospital system.
“One thing that I learned from this is that, you know, you can have your emergency food supply, but you've got to try and find a way to really help feed and energize these caregivers because they're really working hard every day,” said Reeves.
The team agreed that the focus was caring for their people "because they're the ones that are caring for the community," Llechu said. "And I mean, there were hundreds of homes lost by our employees. All of the cars in the parking lot at one of our campuses were completely flooded. And our first job as leaders is to help ease that anxiety and help keep folks calm, so that they can continue to care for others.”
The health system also provided resources for staff members impacted by the hurricane, such as paying deductibles on insurance claims for flooded cars. Workers and leaders took displaced colleagues into their own homes, set up carpools and even established an account with Lyft to provide transportation to and from work for those whose cars weren't drivable.
To properly address the needs of staff, the team used its emergency notification system. It sent out a survey to gather information about who needed housing and other resources and who could help provide those resources for others.
Adapting to challenges
Llechu said one of the biggest surprises came when the hospitals lost water pressure.
“So, what happened is the storm wiped out, basically, Fort Myers Beach. And all of the water lines running to all of those buildings to all of those homes were just open and water was just pouring out into the ocean," he said. "So, there was not sufficient water pressure to run our chillers at the hospital to have running water.”
The state said the hospitals had to evacuate, but more patients were coming in and closing was not possible. In addition, the hospitals had up to 1,800 people with no running water. The team quickly jumped into response mode, using a bucket brigade to bring buckets of water from the water retention ponds to flush toilets. The team also tapped into its sprinkler system to keep patients out of non-temperate environments.
“But the big takeaway was, you know, we all focus so much on our span of control. We all focus so much on the things that we can influence,” said Llechu, “But sometimes we don't spend enough time thinking about the external forces and what that means to us and when we take things for granted like running water.”
The healthcare mentality
Graham noted that one thing that got the health system through the crisis was the healthcare mentality of taking care of each other.
To respond to an immediate crisis, system leadership puts together two teams of volunteers: Team A goes in first as a response team, then Team B comes in later to relieve Team A. It’s a challenge for both teams, whose members must leave their families and home behind during a disaster.
“There was a lot of angst, I will say, especially in some of the leadership of ‘Are people going to sign up on the heels of this major disaster we had?’” Graham said. “And they did. And so, I think it is absolutely a testament to the healthcare sort of genome, if you will.”
This mindset was also apparent throughout the foodservice team. Reeves noted that while employees dealt with personal impact from the disaster, they continued to work to serve others.
“One of our staff members, she started crying and she said, ‘First, my home; now, my car. I have nothing left anymore,’” Reeves said. “You know, 15 minutes later after we were talking with her, she's back delivering trays to patients. It was unbelievable, the selflessness that people have to take care of patients. And we took care of one another.”