How Does A Gust of Wind Incapacitate Indian Hospital?

Cheryl Clark, for HealthLeaders Media , June 17, 2009

Starr says that "a lot of patients were pretty angry. They had longer wait times because we had to go back and find everything on paper. It slowed everything down."

Just about everything that could go wrong did go wrong. "Trail of Tears. You can call it that, because that's pretty much what it was," says Starr, a member of Cherokee Nation of Oklahoma.

Starr's investigation into the events this last week led him to other unsettling realizations. He learned that his engineers never connected parts of the hospital's electrical systems to the backup generator because the generator wasn't powerful enough to handle them, especially after a 36,000 square foot ambulatory care center was built two years ago.

"I asked the engineers, why wasn't the computer system on the emergency generator," Starr says. "I was told, 'It's not large enough to handle the work load. I had to take something off.'"

He says in the past he had repeatedly asked his engineers if the generator was hooked up, and was powerful enough, but says he was told that it was adequate.

"I literally want to scream out of frustration," Starr says.

Starr describes a culture of apathy, anger and despair that pervades the attitudes of some of his key employees, many of whom he says knew of the 40-year-old building's fragility but never discussed it with him. Perhaps, he says, after years of disappointment and seeing so many unmet needs from Indian Health Services, they believed the problems would never be fixed. Better to just work with what you've got.

"But we're a healthcare facility, and patients are going to continue to need us regardless of what's going on with the weather," Starr says. Members of the seven tribes in the region that use the hospital "expect things to be here. But if you don't have your system in place, you can't provide the services you're supposed to. It's just infuriating," he says.

Starr, who has been CEO of Indian Hospital in Lawton for almost seven years, is still in a bit of disbelief that practices he didn't know about made his hospital so vulnerable--to an event so mundane as a change in the weather.

But he is encouraged that additional money from the Indian Health Service budget this year will help him buy another more adequate generator. Hopefully it will be big enough to handle the entire hospital.

Even in the next big wind.

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