Hospital Pharmacy services in the aftermath of Hurricane Ian
John A. Armitstead is the System Director of Pharmacy at Lee Health in Fort Myers, Florida. During the past five years, Fort Myers has twice been hit by major hurricanes (Irma in 2017, Ian in 2022), making him possibly the most hurricane-experienced pharmacy director in the United States. In this series of short videos, he describes the preparations that the pharmacy service makes for hurricanes and what happened when hurricane Ian struck on September 28th, 2022.
Preparing the pharmacy service for a hurricane
As System Director of Pharmacy at Lee Health Mr Armitstead is responsible for 400 pharmacy employees in 15 different sites in Lee County in south west Florida. These include five hospitals, a micro-hospital, a home infusion service, a mail order pharmacy and an infusion site pharmacy, all of which deliver care to the citizens of Lee County.
“Every year …. we establish a ‘hurricane pack’ or a wish list of pharmaceuticals that we might need prior to a hurricane from our wholesaler”, says Mr Armitstead. The pack is not ordered until a hurricane is expected. In addition, every employee at Lee Health is assigned to Team A or Team B. Team A staffs the hospitals for the first 48-72 hours and is then relieved by Team B.
First steps for pharmacy when the hurricane hits
Pharmacy managers need to plan for the provision of emergency pharmacy services after the hurricane has passed and must bear in mind that wholesalers may be out of action and transport disrupted. Typically, the medicines in a ‘hurricane pack’ will include tetanus vaccines, antibiotics, analgesics and products for surgical procedures such as intravenous propofol.
Hurricane damage arises from strong winds, heavy rain and, for coastal areas, storm surges. On this occasion the storm surge caused significant damage because south west Florida is not far above sea level. “Twelve of my 400 employees … lost their homes during hurricane Ian from total flooding of their home”, says Mr Armitstead. In addition, 32 employees lost their cars after they had been totally submerged in sea water.
How the pharmacy service responded to hurricane Ian
As a member of ‘Team A’ Mr Armitstead was present in the hospital during the hurricane and set up a command centre to monitor and guide pharmacy services in the other facilities. “Once the hurricane starts to hit, a variety of different events start to occur and you need to adapt your disaster plan with a dose of reality”, he says.
For a period of 48 hours after hurricane Ian, the five hospital outpatient pharmacies were the suppliers of prescriptions for outpatients throughout Lee County, a population of about one million people.
Lessons for pharmacy from hurricane Ian
Reflecting on his experiences during and after hurricane Ian, Mr Armitstead says how proud he is of the dedication and professionalism of his staff for the way in which they responded to the demands of the situation.
The workload in the outpatient pharmacies tripled in the post-hurricane period and at one hospital they converted the retail pharmacy into a drive-through pharmacy to reduce the volume of patients coming into the hospital to collect prescriptions. Mr Armitstead emphasises the importance of having a written emergency plan and of revising it in the light of experience “such that we’ve got a better plan next time”.
Read and watch the full series on our website or on YouTube.