IceStorm 98 Study

Mr. Barnett is responsible for the overall administration of all non-clinical aspects of Kingston Psychiatric Hospital

Mr. Barnett was not certain as to the date when it occurred to him that the Ice Storm was a major event. He thought it was the "first night" but was unclear whether that was the Wednesday or the Thursday. He recalled: that it was a few hours into the storm, that the power was starting to go out, that he was in town, that he came because he had been called with staff saying that the hospital would have to get ready to receive some people and that it was long before any state of emergency was declared.

Mr. Barnett's staff consulted him on meeting the needs of people who KPH had placed in community accommodation in Seeley's Bay. "My response to the staff was 'Do what you think is right!' not knowing that that was such a loaded answer because it led to a whole pile of things happening, that in the fullness of time, became a series of right things to do. But at that point in time, it was not being done as a result of any declaration of a disaster or anything like that." It was hours after that when he realized that it was something serious and widespread, beyond anything that had ever been contemplated.

Given that many staff were unable to make it in to work, Mr. Barnett said that the only thing left to be done was to take the people you have and try not to operate out of a crisis but rather out of a positive mode. His approach was to treat the KPH campus as a place to come if you are in need to get through the storm and its aftermath. He decided that "we will receive you as if you were a camper, not a patient, not somebody in distress but someone who is coming for relief" and that KPH would rely on whatever staff and community people might want to help with "Camp KPH". "We did not go in search of operating in accordance with the policies and procedures of a hospital under the Public Hospitals Act. We didn't register people as patients. We just received them as guests. at CAMP KPH."

The second thing that KPH did was recognize that the situation was so far reaching that wherever their employees called home, they were all facing personal crises of some kind. Consequently, the KPH administration decided to leave it to the judgment of each employee to prioritize what he or she needed to do to meet the crisis that was facing him or her personally. Whether they came to work as scheduled or stayed at home to support their family and or community was something that the hospital wanted to respect. So KPH did not declare a crisis or disaster or do a "fan-out" which would have required calling in employees in a prescribed manner. Their task was to "run the camp and keep the hospital going."

Mr. Barnett was emphatic that "There was no plan. for this kind of event. I don't know how you could plan for this kind of event. You could do some things that would make you stronger should this ever repeat itself but the handling of the event would probably play-out the same way next time. I see no reason for it to be different. Stay as relaxed as you can and be as flexible as you can and respect the decisions that people are making under very trying times to do the best they can for their family, for their employer and for their neighbour.

What have they learned? "We learned from the bottom-up how to establish and run a hostel. We learned how to do it better than we did it at first and at the end of the day we received all kinds of accolades on how well we did it." He recalled that they learned how to run a hostel independently and as a tripartite operation with the Salvation Army and the Red Cross. They learned how to fill the gaps for other groups who offer refuge. And they learned how to "force communication" when communication wasn't well set-up. and to facilitate it in a way that allowed for people to remain positive rather than being made to feel that they had fallen short. Mr. Barnett said that KPH was able to draw upon the individual strengths of its staff and the strengths of its campus "to provide for the community what so few others were able to provide".

By "forced communication" Mr. Barnett explained that "at times there didn't seem to be any communication because everybody was doing the best they could with where they were at. So you really didn't know the ins and outs about every staff member and why they were making certain decisions and you didn't really have the opportunity to follow it up. You didn't really know the roles people were playing with their agencies to provide relief so you really didn't understand sometimes what was being asked of you and what wasn't being asked of you. One moment you would be asked to do this and you would get ready; then you'd be asked to stand down and you wouldn't understand what was going on. So at some point in time you would have to. go to the location, pull the people around the table and say 'Let's talk!' because it wasn't happening the other way. It was bits and pieces of things happening. You would force the people to take the time (to communicate)." Things then made more sense and he knew more about where the need was greatest and the role was best in helping all of the agencies to come together.

For an extended period of time, KPH was unable to communicate with their superiors at the Ministry of Health in Toronto. Barnett noted that "We managed. We had some freedoms that way and we exercised them. And we weren't criticised at the end of the day." In responding to the needs in the best way that they could, employees took pride in discovering that they could do things that they didn't know that they could do. Moreover, they were proud, knowing that they did the right things well for people in distress.

Was there any early communication from the Ministry of Health warning about the difficulties being experienced in Cornwall or Brockville? Mr. Barnett said: "There was nothing to alert us that we were about to experience the Quebec experience." Some messages were received when Hawkesbury and Brockville were struck by the storm. However, the messages were not taken as warnings. It was felt that "It was just a storm and we've had ice storms before and they've come and they've gone. And we've always had alternate power here. reliable alternate power."

"When the storm hit and the power started going in the city," Mr. Barnett recalled "we made the decision, as early as possible to get off the city system and go right over to our diesel (generator). We basically stayed on (the generator) right through as our gift to the city" by not taxing the city's fragile power supply. "We understood that, at one point, the city was in danger of going 100% out of power. So we did everything to back away from drawing any of their power." Barnett then emphasized how important an independently powered facility like KPH is by describing the role that Brockville Psychiatric Hospital played when the entire City of Brockville found itself with no other powered site.

For the ice storm period, KPH operated two parallel programs, the hospital and Camp KPH. The hospital program was comprised of "bedded" care for those who were in-patients and community outreach for patients resident in the community. (The KPH community outreach workers found themselves and their patients in some high risk situations.) Camp KPH was sub-divided into three shelters. One, located in what was recently a ward, sheltered "people who you had to be medically alert about". A second shelter, located in the Beechgrove building, housed people who came from supervised housing along with the staff who normally worked with them. The third shelter, located in the Penrose building, was a hostel for the public at large.

Was the hospital's emergency plan used? It wasn't opened. "The emergency plans says when something happens you de-camp to. There was no place to de-camp to." The plan did not anticipate this kind of emergency.

Contact with governmental organizations was limited to Emergency Measures Ontario when the tri-partite shelter was being set up and the City of Kingston emergency command centre when it instructed how the KPH shelter would be most helpful.

Something that caused additional anxiety among KPH staff was the "stand-up/stand-down series of notices from long-term facilities. They would call in to KPH saying that they would be bringing large numbers of their frail, elderly residents in for shelter. Then they would not arrive, having found another alternative. There was also the difficulty of trying to reserve cots as people trickled in without registering.

Mr. Barnett expressed his concern that hundreds of frail and elderly people were very vulnerable because there were a whole host of institutions like Extendicare with no back-up. At the outset, there should have been one institution with beds and back-up power designated to receive people needing this level of care, as Hotel Dieu ended up doing. If the "frail elderly" needed to be cared for in any numbers at KPH, it likely would have meant that, as in Brockville, they would have been placed in beds and the in-patients would have had to use cots. Looking into the future, with the number of publicly funded beds being reduced and the number of elderly growing, what are nursing homes doing to protect themselves against similar emergencies in the future?

Additionally, Mr. Barnett observed that KPH and other services discovered that some of the people who came in for shelter that the organizations thought were being well looked after in the community, were living lives whose quality was not anywhere near the standard that was expected. "We heard comments (that) what we were offering them as camp accommodation was so much superior to what they had in real life. They were coming from apartments for the elderly. They were coming from private homes. And we were finding that people's standard of living is dramatically less than we thought it was. We are not alone in the discovery that out there in this great community of Kingston are people who have much less than we would want them to have. They may be our fathers and mothers and uncles and grandparents. They are very quiet about it and very humble about it and somehow existing. How much do we know our community?"

On the subject of back-up capacity, the KPH site has independent gas boilers for heat and a diesel powered electrical generator with more than enough capacity for the site. Mr. Barnett said that ultimately, "the preferred site for the hostel was here and that's why the tri-partite was set-up here at Penrose." Its features were reliable back-up utilities, private and family rooms and enough space to comfortably accommodate people while respecting their dignity. KPH could have accommodated everyone in all of the other shelters in Kingston. The City of Kingston learned that it should take a closer look at the features of the KPH site and how it can be better used in the future.

The camp and family environment of the KPH shelter retained enough structure for health & safety but also featured a relaxed attitude that responded well to whatever came up. For example, no one made the decision that there would be free meals at KPH. It happened that the radio announced that if you haven't had a hot meal, go to KPH. They have hot meals. People started coming for meals. The KPH cafeteria went with the flow to meet the needs of the community. Some staff would bring their families for a meal and this freed staff to perform their job in the hospital. Family members also volunteered many hours to the service of the hostel. "A lot of people put in a lot of hours in a combined effort, without any of them being directed to do it. It was amazing what some people did. I could name names but the heroes were obvious to all of us." Barnett said, contrasting functional power and earned power, a lot of people earned power over their performance during the ice storm. Earned power stays and those who earned power are being recognized by being called upon to do other things. The value of generic, multi-skilled, knowledge workers was demonstrated by the ice storm. The way of the future will be less difficult as a result of the knowledge and power sharing during the storm.

For 60-70% the event, communication with the Ministry of Health and any officials in Toronto was cut. "Nobody panicked, we just did our thing." Eventually the Ministry made contact to say "Hey, you did a great job. Tell me what it was?" A report has now been sent to the Ministry.

Looking back, Mr. Barnett said that he thinks the way things unfolded was the best way to meet the particular challenges of this ice storm. He doubts that classical organizational theory and command structures would work. "You just go with the flow and do the best you can. Empower people. Take some risk with them." Mentor more people to participate. The effective organization was very flat. "It didn't matter who was management or bargaining unit, professional, non-professional, you did whatever had to be done. Now you had to run your hospital the way you would run a hospital but outside of that, when it came to helping so many other people, you just did what you had to do and whoever was able, did."