1. Super Storm Sandy 2012 Robin Haag Coney Island Hospital Infection Control Department

3. We Need a Favor Park Slope Armory Medical Needs Shelter 200 beds Rockaway LTC Facilities Evacuated Nursing Homes Group Homes Assisted Living NYCDOH MH Concerned Diarrhea outbreak Non medical shelter

4. Park Slope Armory

6. Where To Begin? Infection Control 101 Limited capacity patients Sanitary Conditions Personal Hygiene Hand Hygiene Bathrooms Food Safety Spacing of Cots Non medical volunteers Infection Control 102 Medical Care Rounds Identifying the ill Isolation Patient Rights Staff Safety Donations Clothing Bed bugs

7. Personal Hygiene Limited capacity patients Limited to no privacy Incontinent patients No showers Hourly bathroom cleaning Cleaning products Sinks Designated sinks as bathtubs Hand hygiene Bathroom Monitors

8. Food Safety Conflicting information Food handling Temperature Gloves/Aprons/Nets No refrigeration Patients Staff Multiple sources Erratic delivery Food Lines Hand hygiene Eating on cots

9. General Safety LTC Staff Volunteers Orientation Competing agency agendas DOH HHC FEMA DMAT Communication Joint rounding Meetings Patient separation Facility Cots Behavioral health Medically ill Donations Stock variation Cleaning and hygiene Clothing Itching rounds Pet therapy

10. Wellness

11. Back at the Ranch Losses Main Hospital Building including Operating Rooms, Labor & Delivery, Laboratory, Radiological, Outpatient, Pharmaceutical and Food Services Emergency Department (Adult, Pediatric and Behavioral Health) Tower Building (Inpatient Services) Hammett Pavilion (Behavioral Health Inpatient/Outpatient) Power Plant and Engineering Services FDNY-EMS Battalion Station and Repair Facilities All Administrative Buildings including Human Resources, Financial and Administrative (clinical and non-clinical support) Services Ida G. Israel Community Health Center totally destroyed

12. Utility Losses Approximately 250 different mechanical systems including: Electrical distribution Fuel, water, oxygen, medical gas and air pumps Ejector pumps for storm drainage Communications systems failure (primary, secondary and tertiary systems) Primary IT and security network equipment

13. Main Building

14. Ida Israel

15. That Does Not Kill Us……..

16. Before and After

17. Preparing for the Future Long term solutions are required to avoid future evacuations Perimeter of campus needs to be protected from 3 nearby waterways Emergency Department and all critical support services including imaging equipment must be moved from 1 st Floor and repositioned to a new structure Placement of critical hospital systems (medical gases, oxygen, air pumps), electrical and mechanical systems must be at significantly higher levels Replace pumps and motors with submarine type electrical cabling and submersible pumps