NO

VEM

BER

/DEC

EMB

ER 2

015

18

Typically, this column highlights the outstanding efforts of one individual who works tirelessly behind the scenes

to bring excellence to his or her organization. But, sometimes an entire team goes above and beyond to meet challenges head on. That was the case in early-October when record rainfall combined with extreme tides to wreak havoc across much of South Carolina. Historic flooding threatened to dis-rupt patient care, but the team at Intramed Plus came to-gether to prevent that.

“Everyone working together in crisis mode is what made things work,” reflects Gail Caulder, RPh, Pharmacy Manag-er, at Intramed Plus in Charleston. “There were some close calls, but we were fortunate to get through it with every-one safe and no interruptions in service.”

“We have a good community and a top-notch team,” adds Account Executive/Hospital Liaison Camille Hilton. “Every-one knows they need to pull together in times like this, and they did.”

Preparation“We knew the storm was coming and took several steps to prepare,” recalls Caulder. “Living in a coastal area—and many of us having seen Hurricane Hugo—we know how important it is to be prepared,” she adds.

“Several days prior, Vanessa York, our primary Patient Inventory Coordinator, made calls to patients in the areas likely to be affected to find out if they planned to evacuate, where they planned to go, and ensure that we had current contact information for them,” she explains. “She’s been with Intramed for 18-years so she knew what needed to be done.”

At the same time, York and Pharmacy Technicians Tanya Capleton and Liz Braitsch were asking patients to inventory their supplies and medications with the goal of ensuring they were equipped well into the next week. “Patients on inotro-pic therapy are always our first concern, and all of the ones currently on service happen to live in rural areas making them more difficult to reach,” explains Caulder. Most patients were supplied through mid-week in advance of the flood.

Then the pharmacy crew—Caulder and Glenda Owens, RPh, Staff Pharmacist—worked through the patient sched-

Intramed Plus Employees Come Together to Maintain Patient Service Through Historic FloodingBy Jeannie Counce

ule in anticipation of the weekend weather. “We had one patient who was scheduled for home-start parenteral nu-trition (PN) on Friday,” recalls Caulder. “We were worried about the timing, but she really wanted to do it,” she says, noting that the key to success would be ensuring that pa-tient labs were drawn and tested at the appropriate time to assess the therapy’s effectiveness and check for signs of adverse events.

To ensure coverage, a pharmacist worked daily through the weekend, coordinating with weekend on-call nurse, Lynn Asbury, RN. “Communication is so important as things start to develop on the ground,” explains Hilton. “It’s critical to continue checking in and adjusting.”

Rainfall—And Flooding The rains, which began on Thursday, October 1st, contin-ued through the weekend. By Sunday, approximately 20 inches had fallen in the state’s Midland and Lowcountry regions, recalls Hilton. Rivers, streams, and estuaries over-flowed their banks—particularly near the coast, which

Lynn Asbury, RN (left) who was the call nurse the weekend of the storm and Patient Inventory Coordinator Vanessa York (right) remained in close touch with patients and the Intramed Plus team throughout the rains and flooding.

NO

VEM

BER

/DEC

EMB

ER 2

015

19

is dotted with islands, marshes and waterways. Flash floods stranded residents in their homes, swept away cars, and made roads impassable throughout the middle and southern part of the state.

“The lunar cycle complicated matters when a full moon created a ‘king tide,’ or especially high tide, two days after the rain began,” Hil-ton explains. With waterways crest-ing and nowhere for the water to go, dams—36 in all—began breeching, causing more flooding. By the time it was over seven people were killed, more than 40 home rescues were made, and more than 300 roads and bridges, including portions of I-90 and I-26, were closed.

“The roads presented the biggest challenge,” recalls Caulder, noting that most of the area still had pow-er. “On Monday, none of our veteran nurses were able to get to the office. Holding down the fort were a part-time nurse and a just recently hired nurse,” she explains, adding that Mary McKeown, RN (part-time) and

Dale Donnelly, RN (new hire) really stepped up during the crisis.

Hilton, who lives on James Island south of Charleston, couldn’t reach the office either. “I was able to make it to one of the hospitals on the pen-insula and worked from there,” she remembers. After reaching Medi-cal University of South Carolina, she parked in the highest spot possible and stayed there coordinating dis-charges and patient care on the fly with Intramed’s Charleston office for more than 12 hours. She did the same Tuesday and Wednesday.

Nurse Manager Maggie Phillips also worked remotely from her home. Stranded by the closure of I-95, she coordinated with nurses and patients in the field via phone, reporting back to the office. “Thanks to her, nurses were able to reach the home-start PN patient for training and arrange with Home Health to obtain needed labs,” Caulder reports, adding that the patient remains on therapy and is doing fine.

Hilton and Caulder note that coping with the aftermath involved a great deal of communication and problem solving. “It was a team effort, every-one had ideas and input,” observes

Caulder. “You need that to deal with each situation because every situation is different.”

AftermathBy mid-week, as patients’ medication supplies began to dwindle, the oper-ations department shifted into over-drive. But their task was problematic because of the many road and bridge closures. “Normally, our warehouse and delivery team hum along and make sure the right things happen, but they went above and beyond to make sure all the patients got what they needed to remain on therapy,” Caulder recalls. “They understand how important these medications are to the health of our patients.”

Operations Supervisor Kelly New-man and her entire warehouse and delivery staff—Richard Reason, Mike Ray, Ken Little, and Ed Yarnell—act-ed as the nerve center that tracked closures and managed the impossible by finding routes that were workable and safe. They were also in touch with patients to check conditions on the ground. In one particularly hair-rais-ing instance, a patient on continuous antibiotic therapy was in a remote lo-

The operations team kept patients well-supplied during historic flooding. Left to right: Ken Little, Operations Driver; Kelly Newman, Operations Supervisor, and Richard Reason, Operations Driver.  Newly hired Mary McKeown, RN (left)

and Nurse Manager Maggie Phillips, RN (right) juggled road closures and stranded staff to provide clinical cover-age throughout the emergency.

NO

VEM

BER

/DEC

EMB

ER 2

015

20

cation near a river that was isolated by flood and dam issues.

“Police had encouraged this fam-ily to evacuate on Tuesday due to rising water, but they chose to stay,” Caulder explains. “We kept checking with him and his wife, but the roads to his home were impassable most of the week. By Thursday, we were afraid we might have to call the physician to report an interruption in his nafcillin therapy. But, at the last minute a dirt road opened.” The team seized the opportunity and was able to make the delivery safely.

“They certainly rose to the occa-sion,” adds Hilton. “Many of them are fisherman or have lived here their whole lives, so they know how to play the tides,” she explains. “At low tide the water over the roads was at its lowest, so they’d plan around those

windows to reach the hardest-hit ar-eas.” The operations team also stayed in touch with the pharmacy depart-ment so it dispensed the drugs they needed in time to make the windows.

“It’s amazing what people will do for each other,” remarks Hilton, who saw the whole community—and the staff of Intramed—come together to overcome obstacles presented by the weather. “The pharmacists and nurs-es brought fresh coffee and biscuits to the operations folks who were working so hard; people did all they could from wherever they were; and everyone just kept working until the job was done.” Yes, in the midst of a dangerous storm and its aftermath, the power of teamwork and collabo-ration ultimately ensured the safety and high-quality care for Intramed’s home infusion patients.

Photo Credit: Leroy Burnell/The Post and Courier October 4, 2015. Charleston County Rescue workers on Peppercorn Lane Sunday afternoon to help residents get out from the flood in the neighborhood.

Historic flooding in downtown Charleston on October 4, 2015. Three days into the storms roads were im-passable and many buildings took in an at least a foot of standing water.