Contact NAPAEmail info@NAPAanesthesia.com

Call 516.945.3333

Mailing Address:

North American Partners in Anesthesia

68 South Service Road, Suite 350

Melville, NY 11747

*HFMA staff and volunteers determined that Anesthesia DepartmentManagement has met specific criteria developed under the HFMAPeer Review Process. HFMA does not endorse or guarantee the use of this service.

About North American Partners in AnesthesiaFounded in 1986, North American Partners in Anesthesia (NAPA) is the leading single specialty anesthesia and perioperative managementcompany in the United States. NAPA is comprised of the mostrespected clinical staff, providing thousands of patients with superiorand attentive care. The company is known for partnering with hospitalsand other health care facilities across the nation to provide anesthesiaservices and perioperative leadership that maximize operating roomperformance, enhance revenue, and demonstrate consistent patientand surgeon satisfaction ratings.

NAPAanesthesia.com

Government officials issued dire warnings to millions ofresidents, businesses and health care facilities along theentire East Coast of the United States in late October2012 to prepare for an imminent hurricane dubbed,“Superstorm Sandy.” Hurricane Sandy was second onlyto Hurricane Katrina, which hit the Gulf Coast in 2005, asthe costliest hurricane for property damage. Sandycaused an estimated $75 billion in destruction accordingto the National Hurricane Center.

The hurricane and subsequent flooding and storm surgecaused 72 deaths in eight states, primarily in New York(48) and New Jersey (12). Lower Manhattan, StatenIsland and Long Island in New York and beach townsalong the entire New Jersey coast were particularly hardhit by the storm. Millions were without shelter and powerfor weeks and even months. The storm forced theclosure and evacuation of hospitals, nursing homes andhealth care facilities for a prolonged period of time.

Our Unmatched Anesthesia Experience. Your OR’s Advantage.

While many hospitals and health facilities, especially in

New Jersey and New York, evacuated in advance of

Hurricane Sandy — others were caught off guard.

NAPA’s ongoing commitment to emergency preparedness

demonstrates the importance of comprehensive crisis

management, as evidenced by the magnitude of the

2012 storm.

NAPA’s staff cared for evacuated patients and provided

for staffing shortages before, during and after the event.

In addition, many physicians and clinicians became

displaced from hospitals that were flooded or shut down

indefinitely. NAPA expedited and extended clinical

privileges to displaced medical staff at its facilities that

were unaffected by the storm or to hospitals that were

fully operational and accepting patient evacuees.

“During Sandy, it was relatively easy

to triage from the command center and

send messages to 1,500 people. I could

communicate with every NAPA employee

with one stroke. The hospitals’ chiefs

created customized contact lists to use

for their hospital-specific messaging.

Those lists were downloaded into the

emergency communication system before

Hurricane Sandy. We were confident that

we were effectively communicating with

our entire staff throughout the event.”

– JOHN DI CAPUA, MD

SITUATION

“There is no greater time that we, as

medical professionals, have to put on

our white coats as when there’s an

emergency or natural disaster.”

– JOHN DI CAPUA, MD

Deputy CEO and Chief Medical Officer for North American

Partners in Anesthesia (NAPA), Melville, New York

TWO | HURRICANE SANDY THREE |

NAPA offers solutions to meet every health care

organization’s ability to manage and provide a secure

and safe environment when tested with shortages and

displaced staff during natural disasters, terrorism or

other unexpected traumatic events. Advanced planning

puts emphasis on several core practices that any

hospital or health facility can emulate and implement,

as needed.

As the nation’s largest single specialty anesthesia and

perioperative management company, NAPA provides

personnel to its client hospitals — no matter what the

circumstances.

NAPA’S SOLUTIONS

For example, a year before Superstorm Sandy,

Dr. Di Capua directed NAPA’s emergency operations

during Hurricane Irene which hit the East Coast in late

August 2011. NAPA provided 100 percent medical

coverage to storm-affected facilities and at regional

hospitals temporarily accepting transferred patients,

particularly if any of the hospitals’ staff were unable to

get to work. NAPA’s approach during Irene was to

use administrative staff to make phone calls to essential

staff — a time consuming and less-than-optimal

process. After the storm, NAPA’s leaders identified areas

that needed significant improvement, especially with

communications, and worked throughout the year to

upgrade its systems before the next major event.

IMPLEMENTATION

Emergency Preparedness

• INVEST IN STATE-OF-THE-ART

COMMUNICATIONS TECHNOLOGY

Advanced planning includes investing in technology

that rapidly and efficiently reaches everyone involved.

Months before Hurricane Sandy, NAPA re-evaluated

its approach to emergency communications by

investing in a geographically-based, high-speed

notification system. The new system features multi-

faceted global capabilities, similar to those used by

many school districts and municipalities across

the country. It streamlines and alleviates many labor

intensive manual processes while quickly

disseminating messages. NAPA’s anesthesia chiefs

trained on the new system months before

Superstorm Sandy hit.

• VOLUNTEER AT EMERGENCY

OPERATIONS CENTERS (EOC)

NAPA’s anesthesiologists and clinical staff actively

support every involved hospital’s EOC team. Staff

provided back up to the hospital’s chief medical

officer or executive director for any type of support,

such as answering telephones, helping solve

unforeseen problems, allowing for breaks and rest

and providing general assistance throughout the

entire event.

• PREPARE AT HOME AND IN THE WORKPLACE

At NAPA, clinical staff and administrators are

accountable for not only participating in emergency

training and safety protocols at work sites, but also

applying these tactics to their own personal home

and family lives. NAPA’s senior leadership and medical

and administrative staff are expected to prepare their

personal circumstances in advance — well before

disaster strikes — to safely get to work, take

responsibility, care for patients and perform their duties.

• PLAN FOR EARLY ARRIVAL

During Sandy, NAPA’s staff prepared to stay at

assigned hospitals for the duration of the event.

Many arrived earlier than needed or before their active

duty. The staff came well-prepared with personal

items to use between shifts and to get rest or sleep.

• DEPLOY STAFF FOR MANY ROLES

As trained emergency response professionals,

anesthesiologists and CRNAs can adapt to any

clinical situation — not only the operating room.

NAPA notified hospitals located in the storm’s path

or in flood zones to access its staff for more than

anesthesia-related purposes. NAPA directed its

staff to respond to shortages of medical staff

wherever they were needed — the intensive care unit,

as house physicians overseeing patient floors, for

pain management issues or in the emergency room.

With the applications of lessons learned from Hurricane Irene, NAPA worked on improvements

and better solutions in several key areas prior to Hurricane Sandy.

FOUR | HURRICANE SANDY FIVE |

RESULTSNAPA’s executive and clinical leadership attend mandatory meetings during the year to

brainstorm and strategize on quality improvement, including emergency management.

After Hurricane Sandy, NAPA’s senior management met to make adjustments to continue

to improve emergency protocol for future incidents. These include:

• NAPA deployed more than 1,000 anesthesiologists,

nurse anesthetists and clinicians and over 225

administrative staff to 38 hospitals and health care

facilities throughout states in the Middle Atlantic

and New England regions.

• Clinical and administrative staff were ready and in

place before the storm hit, minimizing shortages and

optimizing patient and staff safety measures.

FUTURE PlanningLessons Learned &

• The new global communications system that NAPA

purchased and implemented after Hurricane Irene in

2011 reached thousands of people with specific,

up-to-the-minute messaging sent to land lines,

cellular phones, computers, fax machines and pagers

in the form of voice messages, texts and emails.

• Backup NAPA staff worked with the EOC team at

each affected hospital, in addition to the staff working

at central command.

As the nation’s largest single specialty anesthesia

and perioperative management company,

NAPA provides personnel to its client hospitals —

no matter what the circumstances. • Instructing NAPA’s Human Resources Department

to reserve large blocks of hotel rooms near

hospitals, well in advance of a storm, to better

accommodate staff.

• Providing NAPA staff that are minimally affected or

unaffected during an emergency with credit cards

or other purchasing mechanisms to buy items in

short supply, such as generators, to help staff and

others in storm-affected areas.

• Devising a distribution system for NAPA-purchased

emergency supplies, if needed, that is more

streamlined and efficient prior to a major disaster

or event.

SIX | HURRICANE SANDY SEVEN |