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The job description she accepted when she became Chief Operating Officer (COO) of Tulane Medical Center did indicate that hurricane preparedness and planning were of utmost importance, but it didn’t specifically state what to do if something like Hurricane Katrina, the third strongest hurricane ever recorded making landfall, came into the picture. In August of 2005, Kim Ryan rewrote the manual on a minute-by-minute basis during the most incredible disaster to hit New Orleans.
Today, life is far simpler by comparison; Snellville, GA isn’t in the path of a hurricane, but each lesson learned prepared Kim for leading and expanding a local hospital in meeting the demands and opportunities of helping patients in a rapidly changing medical environment.
For the Rochester, NY native, lessons in caregiving began at Albany State alongside her twin sister, Kathy, where they both attended nursing school. “I had a desire to attend William and Mary to major in chemistry, but nursing school was part of a bigger plan for me.” That bigger plan included starting her career in ICU. “There is something about the complexity of a patient in the ICU that completely fascinated me.” For her master’s level classes, Kim chose critical care sciences, working as an emergency room nurse while attending graduate school. Both of these assignments would shape her vision in hospital administration and the role of the nurse in all aspects of patient care. “As a nurse, I was part of a team that worked together to solve medical mysteries and figure out the best way to optimize the health of the patient,” says Kim.
Working as an ER nurse, having to share life and death news with family members is a difficult thing to do; however, she learned that it was much more therapeutic for her to remain calm and compassionate instead of “breaking down” with them. From years in the ER, Kim realized this was a strong character trait that would serve her well throughout her career. “As nurses, we have the privilege of being with patients and their families at their most vulnerable times,” says Kim.
After six years as an ER nurse, Kim left Rochester and accepted a position as an Administrator for the Medical Center’s Children’s Hospital in Macon, Georgia. Seven years later, Tulane Medical Center in New Orleans recruited Kim to be the Administrator for their Children’s Hospital. After two years, the CEO asked Kim to move into the Chief Nursing Officer (CNO), , for Tulane and of course, she accepted. Kim soon realized that her real desire was to be a CEO. “I talked to the Division President and shared my desire and he guided me to the Chief Operating Officer (COO) position first. After spending four years as the CNO, she was offered the position of COO for Tulane Medical Center.
Kim was training her replacement for the CNO position while she transitioned to her new role as COO at Tulane when one the biggest challenges of her life, personal and professional, entered the Gulf of Mexico and was named Katrina. Strong leadership was the crucial component in the days that came before, and most especial after Hurricane Katrina struck New Orleans. “We knew we had to be prepared for caring for our critically ill patients and for anyone needing care after the hurricane struck.”
There could be no way for Kim and her staff, or anyone else in the country to even fathom the extent to which Katrina would impact the area. Kim began her leadership by opening the Command Center just after an 8 am meeting at the Tulane campus on Saturday, August 28th, 2005. “I came out of the meeting and received an update from the National Hurricane Center that showed the storm had moved west and increased in intensity and was heading directly for New Orleans. “We called in essential personnel and they began to arrive early Sunday morning.”
The team immediately made one huge decision which had an impact on the outcome and survival of their patients. They began to cohort all patients on life support to one location. This group included neonatal, pediatric and adult critically ill patients on ventilators, and two patients (one adult and one child) waiting for heart transplants dependent upon heart pumps. They began to set up and utilize small gas powered generators to support those electrical loads. “George Jameson, Director of Plant Operations, came up with this idea, stating that if we could calculate the electrical loads, he could make the generators work,” says Kim. “His brilliant idea would save the lives of our critically ill patients.” With the generators vented through the atrium and an almost endless supply of gasoline from all the cars in the parking decks, George and his crew managed to keep power supplied to the critical machinery.
On Sunday, Mayor Ray Nagin announced his decision to utilize the Superdome for the medically fragile homebound citizens from all over New Orleans. That evening, Kim was visited by the head of EMS and an employee of the Office of Homeland Security. They asked if she could provide them space so that Disaster Medical Assistance Teams (DMAT), could set up two mobile hospitals at Tulane to receive some of the most fragile of these Superdome citizens. Once the hospitals were set up and the doctors, nurses, and medical supplies were in place, a call would be placed to the Superdome and the medically fragile citizens would be transferred. Kim agreed to this plan.
Twenty minutes later, 58 medically fragile citizens arrived by bus from the Superdome, each with a companion. No DMAT hospitals, physicians, nurses, or supplies ever arrived. Kim’s daughter, Cheryl, provided medical care to this group of citizens for the next several days.
At landfall early Monday morning, Tulane Medical Center housed 120 patients plus the 58 from the Superdome. Of those, 11 patients were on ventilators, they had another 11 pediatric patients and 11 neonatal patients and the two patients on heart pumps who were all dependent upon electricity for their survival.
With the horror stories coming in from the news outlets by the minute, the rest of the world knew far more than Kim and her hospital team. “We didn’t use our electricity to run the television or radio,” says Kim. “We had no idea what was transpiring around us, which turned out to be a good thing.” Because they were unaware of the extent of the damage and the subsequent rising water (from the multiple levee breaches), they didn’t have the chance to panic. “We took one thing at a time and made our decisions as the problems presented themselves.”
The problem of communication had thrown some curves toward Tulane Medical’s Command Center in the form of extra patients, but it was a pediatric patient who helped to improve communication. At that time, texting was not utilized like it is today. So, it was helpful when a ten-year-old patient offered his demonstration of “texting” to all the nurses and physicians in the Command Center.
By Monday evening, the worst was thought to be over. The storm had moved to the north and the hospital had only modest damage. Monday night, the Command Center was visited by a member of the Security Department who announced that there was flooding in the streets. The water was rising at an alarming rate. Kim assessed the situation and immediately determined that a total facility evacuation was needed. She awoke the Chief Executive Officer and informed him of the developments. Monday night as the waters continued to rise, Jim Montgomery, the CEO used a land line and spent thirty minutes and finally was able to get a call to Acadian Air Ambulance – asking for their assistance in a total facility evacuation.
Montgomery was also able to contact HCA, Tulane’s parent company in Nashville. They immediately began to charter what turned out to be 26 helicopters to take over the evacuation Wednesday.
The next decision that was needed was to determine the order of patient evacuation. Physician and nurse leaders assessed all patients and decided to evacuate all the critically ill patients FIRST. Following these would be all neonatal and pediatric non critical patients. Last would be all stable adult patients.
Next came the logistics of this massive helicopter rescue effort, which would have been overwhelming except that the team Kim had in place proved capable of making exceptionally effective decisions. Determining where to land the helicopters became a major obstacle. There were two parking decks at Tulane, however, there was no knowledge if they would hold under the weight of a helicopter. “We had no one on our team who could make that determination.” Again, just like the texting issue, the answer came from outside the Command Center. The father of one of the pediatric patients told the directors that he was a Blackhawk Helicopter Pilot and that he would assess the parking decks. He presented the hospital with the safest option saying, “I would feel comfortable landing a black hawk helicopter on this deck.”
The helicopters began to arrive as the massive operation of moving some of the sickest patients in New Orleans from the atrium to the second floor and then up to the roof of the parking garage in stifling heat, among raw sewage and within the confines of the 7 flights of stairs. The first helicopter arrived Tuesday late morning. Kim worked all day Tuesday and most of Wednesday coordinating the evacuation from the Command Center. By Wednesday afternoon, the majority of the critically ill patients had been transported by helicopter to sister hospitals in Louisiana and Texas.
The Division President then told Kim he needed her for another leadership challenge. He asked that she travel by helicopter from Tulane to the New Orleans airport to set up a command center there. Patients would soon be gone, and the remaining employees, physicians, and family members had to be safely evacuated. This could be accomplished faster by landing at the airport, which hadn’t been flooded. Kim agreed only if her daughter could accompany her. Hearing yes, they both immediately went to the parking deck and awaited transport. When the next helicopter arrived, she and her daughter ran towards it and before getting in, the pilot said, “I’m looking for Kim Ryan.” Kim said, “I’m Kim Ryan.” The pilot handed over a note that simply said, “Your family is safe.” Kim’s twin sister, Kathy, had called the Nursing Supervisor at Lafayette Hospital, two hours from New Orleans, because she heard on the radio that Tulane was taking some of their patients to Lafayette. She told the Supervisor she needed to get communication to Kim. The Supervisor told her that pilots were leaving from Lafayette and going to Tulane. Kathy, also a nurse and Chicago resident, asked if she would write a note to Kim to tell her, “Her family is safe.” How amazing that the helicopter Kim was getting on had THAT special note. The pilot also handed her an American flag – and with tears in her eyes, she took the flag to the Command Center – there was a letter attached to it which said, “This flag is to be hung when the last person leaves the building.” The flag was from an HCA sister hospital in Florida.
During the four days of evacuations, Kim and her team went without sleep, toileted in plastic bags filled with kitty litter (another of George’s survival ideas for which every staff member was grateful), endured swollen and infected feet and heard shots from the street. “We were so thankful for the 25 Tulane University Security Officers who stood guard over us night and day,” says Kim. “They kept us safe so we could concentrate on caring for our patients.”
Kim’s ordeal did not end there. She had already been lulled into a false sense of security when the hurricane had passed and her hospital had come through without much damage. It wasn’t until the flood waters came that the staff knew there was more to come that would test them to the limits. As Kim and her daughter Cheryl landed at the airport, they quickly found that they were not prepared for the chaos that the airport was under. “There was very little security at the airport with unfathomable civil unrest.” Kim took stock of her situation and found an unused storage facility on the tarmac. Inside that storage facility, was a flushing toilet and bottled water. This was just the location to prepare to receive employees from Tulane.
The plan was developed with HCA corporate command center. Buses would be chartered in Lafayette, Louisiana. They would arrive Thursday morning at the New Orleans Airport. Kim and her daughter would watch the people landing by helicopter and identify those from Tulane. They would be escorted to the storage facility, given water, and the opportunity to use the toilet. Their shoes and socks would be removed, feet cleaned and they would then be put on the bus. When the bus was full, it would leave for the return trip to Lafayette and the next bus would arrive.
All day Thursday, the plan went like clockwork. By Thursday night, several hundred employees had been evacuated and bussed to Lafayette. As night fell, however, the chaos inside the airport increased. The security guards that accompanied each bus approached Kim and her daughter and stated that it was no longer safe. They would be leaving to return to Lafayette. At this same time, Kim was approached by a leader from another hospital in New Orleans that had been flooded. He told Kim and her daughter of 150 of his nurses who had been inside the terminal for hours with reports of being raped. He begged to be given the opportunity to get his nurses and utilize the buses to move them to safety. Hearing this, Kim’s daughter Cheryl approached the Security Guards stating, “you will NOT leave, you will give us 5 minutes to go into that terminal and get these nurses out of this horrific environment”. They agreed and Kim, Cheryl and the administrator went inside the terminal and rescued the nurses. Kim made one more phone call to her parent company to ask for transport for these nurses, and they complied. The nurses and Kim’s daughter got on the buses and headed to Lafayette
Kim’s final night at the airport was spent in absolute exhaustion. “My feet were so infected that I found a commercial floor cleaner and made a solution to clean them which burned horribly,” says Kim. “I had given my shoes away because they didn’t fit any more.” Kim found a military guard with a semi-automatic weapon who was standing in the terminal. She asked him if she could sleep at his feet. He said he would watch over her. She slept for a little more than an hour. When she awoke, the National Guard had arrived, triaged the patients left in the terminal and restored order.
Kim was back in place on the tarmac at 6 a.m. Friday morning. There were still 500 people at Tulane, and the helicopters would be landing soon. Buses were due back at 6:30 a.m. When ALL the employees, physicians, and family members were safely on the buses, she was in the last group to get on the bus on Friday evening.
Once she arrived in Lafayette, she had her first shower, was seen by a doctor, received a tetanus shot and antibiotics, and was taken to one of two shelters where HCA had set up food, bedding, spending money, and the opportunity to fly anywhere in the country to meet loved ones. At the shelter, she saw hundreds of Tulane employees and they spent the night together. The next afternoon on Saturday, Kim got on a plane to Atlanta and made connections to Chicago, where her twin sister and entire family awaited her arrival.
HCA did not stop there. All of the Tulane employees displaced by Hurricane Katrina received a paycheck from August through the end of the year. They were told that Tulane would be reopening, however if they chose not to return to New Orleans they were offered the opportunity to work at any other HCA hospital that had a position available.
Kim spent two nights in Chicago with her family, and then flew to Lafayette to begin the daunting task of connecting Tulane’s patients with their doctors and to begin the rebuilding effort. She was back in her office in downtown New Orleans by Thanksgiving. The hospital reopened in a limited capacity on Valentine’s Day 2006 and took almost three years to completely rebuild. Despite the horrific conditions, Tulane Medical Center did not lose a single patient. Kim credits many with the success. “If HCA had not trusted us to make decisions, if we had not had leaders and staff that cared passionately about their patients, we couldn’t have provided the level of care that led to no patient being lost”
Kim’s days at Eastside Medical Center are far less stressful than anything she endured over the days before and after Hurricane Katrina. HCA offered Kim Ryan the Chief Executive Officer position at Eastside Medical Center and she moved to Snellville in 2008 to begin the next chapter in her life.
Opened Loganville Digital Imaging Center in May 2010
Opened Spine Center in November, 2011
December, 2011 – $12M Investment Expansion of the Emergency Department by 20,000 s.f.
• 41 private treatment rooms
• 10 “fast track” rooms for rapid medical evaluation
• 9 Pediatric urgent care rooms staffed by board certified pediatricians
January, 2013 – $55 million, 92,000-square-foot surgical facility that includes an operating suite with advanced robotic equipment and 48 surgical beds, a new state-of-the-art surgical tower. It has two 24-bed floors. It houses all surgical patients from Intensive Care, Progressive Care, and Surgical Care. The tower also has seven new surgical operating suites, including the first Hybrid Operating Suite in the county.
Also in May 2012, partnered with Piedmont Heart and an interventional Cath lab was opened that provides care to patients with coronary artery disease.
The employees use compassion, respect, and teamwork when it comes to providing patients with the best care possible. Eastside is also not afraid of change; instead, they embrace it. It is Ryan’s goal to make Eastside Medical Center the best it can be. She will always be searching for the most recent and up-to-date technology. She welcomes any and all additions that will give people a positive healthcare experience and that will expedite the process of getting patients back to their everyday lives.
October, 2013 – EMC partnered with Marshall Steele and introduced Joint Destinations to the community. It is a comprehensive program that is based on a national best practice model for hip and knee replacements and structured around the fundamental principle of wellness.
Kim is a fellow of the American College of Healthcare Executives, and serves on the Board of Directors for the following organizations:
• Gwinnett Chamber of Commerce
• Georgia Chamber of Commerce Health Care Committee
• Gwinnett Coalition for Health and Human Services
• Gwinnett Tech Foundation
• Four Corners Primary Care Center
Kim was appointed by Governor Deal to serve on the Board of Behavioral Health and Development Disabilities and recently was elected Chair.
For more information about Eastside Medical Center visit http://eastsidemedical.com
For more information about HCA Healthcare visit http://hcahealthcare.com
