Summary: Prior disasters directly inform planning and implementation for subsequent disasters. The Louisiana State University New Orleans Emergency Medicine Residency has planned and implemented a hurricane response protocol, “Code Grey,” for multiple storms. Hurricane Ida made landfall as a Category 4 Hurricane in 2021, followed by Hurricane Francine, a Category 2 Hurricane, in 2024. Hurricane Ida exposed multiple areas for improvement in the Code Grey protocol. Following Ida, given post-storm discussions and resident feedback, an after-action report was created. These identified areas of improvement include the following: (1) resident Code Grey assignments and scheduling, (2) timing of Code Grey activation, (3) expectations for those who evacuate and coordination for safe return into the city, and (4) communication from program leadership. The details of Francine’s planning and protocol were a direct response to those identified areas of improvement. Since Ida, protocols at both the hospital and residency levels have been updated to reflect lessons learned. Assignments for the 2024 Hurricane season included updated rules for pregnant residents and those currently on vacation or off service rotations. Direct resident communication began earlier and more frequently, continuing throughout the storm and beyond. This allowed residents to decide whether to evacuate or shelter in place and prepare for their specific assignments/roles during the storm. Communication included program recommendations on preparation, safety, and expectations, as well as Code Grey timelines and planning. Additionally, a Hurricane Handbook was created for incoming interns and current residents to help familiarize them with personal hurricane preparation, storm safety, and explicit evacuation guidelines. These guidelines include the distance to travel from the city, methods of travel, and expectations of when and how to return. While in turn, Francine exposed further areas of improvement and will inform future responses, lessons learned from Ida improved Code Grey preparation and implementation for current residents.
Woodbridge et al. (Sun,) studied this question.