An ice storm did not keep Mt Carmel Medical Equipment from achieving a near flawless accreditation survey. In fact, it may have helped.

Gary L. Miller

Mt Carmel Medical Equipment top executive Gary L. Miller thought he was in trouble the morning of his scheduled Joint Commission on Accreditation of Healthcare Organizations (JCAHO) survey. Mt Carmel’s scheduled surveyor was called away on a personal emergency and JCAHO alerted the Pittsburg, Kan, oxygen and HME provider that a substitute surveyor would arrive from Seattle the following day, January 30.

Unfortunately, Mt Carmel had prepared using an outline the original surveyor had developed on her own. “It was not a standard JCAHO procedural protocol,” Miller says. “We knew the substitute would have her own outline—how similar it would be to the first one was anybody’s guess. And there wouldn’t be time to find out before she got here. We were just going to have to wing it and hope that our original preparations would be sufficient to get us through the survey process.”

But if Miller thought he was in trouble then, he was about to find out the meaning of trouble with a capital T. Television news reports were warning of a particularly nasty cold front en route to the area. “They told us to expect icing overnight,” Miller says. “Only the next morning, we woke up to not just icing, but severe icing. In fact, it was an ice storm.”

Crisis Response
The cold front bearing that storm stalled above Crawford County. Because it lingered, it lashed the area with freezing rain for most of the night, allowing massive amounts of ice to build up on trees. The weight of the ice felled limbs and sometimes even entire trees. As the timbers plummeted, they often took down with them nearby power lines already sagging beneath an unusually thick coating of ice. Consequently, the county suffered major electrical outages.

“Our office was in total darkness,” Miller says. “We couldn’t even operate our computer system.”

That meant serious problems where the JCAHO survey was concerned. But far worse was the fact that Mt Carmel Medical Equipment now faced an area-wide crisis to which it would have to respond—a response that would demand pulling out all the stops.

“Our first responsibility was to assess the status of our high-risk patients, those who were using any kind of electrically operated device at home, such as a concentrator or a pulse oximeter, and provide interventions as necessary to ensure the safety of those patients,” Miller says.

Without access to the main computer system, it was difficult to figure out who those patients were and where they were located. That information had to be pieced together from patient data in the possession of each Mt Carmel Medical Equipment delivery driver. The drivers, Miller explains, carry battery-operated handheld computers in which are loaded patient names, addresses, and liter-flow information.

Even then, many patients had to be looked in on by driving to their homes rather than simply contacting them by phone. “Land-line telephone service was unaffected by the ice storm,” Miller says. “Cellular, however, was marginal because most of the transmission towers lost power. And those people whose only phone at home was the cordless type were unable to communicate with the outside world since cordless phones have a base unit that operates on electricity.”

An “Ice” Place to Visit
When the JCAHO substitute surveyor showed up at Mt Carmel Medical Equipment later that morning, the company was throbbing with activity as the staff sought to deal with the storm-caused emergency. “I suggested to the surveyor that perhaps she might want to come back another day when things were back to normal,” Miller says. “I told her I didn’t think we could devote to her the attention necessary under these circumstances.”

To Miller’s surprise, the surveyor asked if she could observe his team in action. Miller said yes, confident that what she witnessed would create a good impression.
“We were working from a disaster-response plan we had developed,” he says. “It worked very well for us, even though there was a certain amount of improvisation involved, since the plan was geared toward dealing with the aftermath of a tornado, not an ice storm. With a tornado, the affected area is usually only about a quarter-mile wide and five or six miles long. An ice storm affects an area many, many times larger, but with only a fraction of the physical devastation.”

An element of the plan that was as applicable for an ice storm as a tornado was the coordination of efforts with the medical center as well as with shelters set up by the Red Cross and others.

“We deployed oxygen concentrators and various essential equipment and supplies at the shelters,” Miller says. “There also was a lot of communication between us and our oxygen supplier to make sure we had enough tanks to meet the needs of patients.”

Before it was all over, Mt Carmel made 61 deliveries and went through about 150 oxygen tanks.

Moving Ahead
The ice storm lasted until late in the morning. Repair crews were able to begin restoring electricity to parts of the county by that afternoon.

“The lights came back on for us around 5 o’clock,” Miller says. “Operationally, things began to settle down after the first day, but we considered there to still be an emergency situation until the last of our patients got their electricity back on—for some that was as long as 5 days later.”

Miller can only guess at the extent to which the surveyor’s scoring was influenced by the professionalism she observed during the crisis. All he can say is that despite some parts of the survey being conducted by lantern light, Mt Carmel Medical Equipment passed inspection with flying colors. “No deficiencies were noted by the surveyor, and we were recommended for full accreditation,” he says.

Rich Smith is a contributing writer for Dealer/ Provider.