TY - JOUR
T1 - Lessons Learned From Hurricane Maria in Puerto Rico
T2 - Practical Measures to Mitigate the Impact of a Catastrophic Natural Disaster on Radiation Oncology Patients
AU - Gay, Hiram A.
AU - Santiago, Roberto
AU - Gil, Betty
AU - Remedios, Carlos
AU - Montes, Pedro J.
AU - López-Araujo, Javier
AU - Chévere, Carlos M.
AU - Imbert, Winston S.
AU - White, Julia
AU - Arthur, Douglas W.
AU - Horton, Janet K.
AU - Jagsi, Reshma
AU - Rabinovich, Rachel
AU - Beriwal, Sushil
AU - Viswanathan, Akila
AU - Erickson, Beth A.
AU - Rengan, Ramesh
AU - Palma, David
AU - Loo, Billy W.
AU - Kavanaugh, James A.
AU - Bradley, Jeff
AU - Yom, Sue S.
AU - Harari, Paul M.
AU - Lee Burnett, Omer
N1 - Publisher Copyright:
© 2019 The Authors
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Purpose: Although the wind, rain, and flooding of Hurricane Maria in Puerto Rico abated shortly after its landfall on September 20, 2017, the disruption of the electrical, communications, transportation, and medical infrastructure of the island was unprecedented in scope and caused lasting harm for many months afterward. A compilation of recommendations from radiation oncologists who were in Puerto Rico during the disaster, and from a panel of American Society for Radiation Oncology (ASTRO) cancer experts was created. Methods and materials: Radiation oncologists throughout Puerto Rico collaborated and improvised to continue treating patients in the immediate aftermath of the storm and as routine clinical operations were restored gradually. Empirical lessons from the experience of radiation therapy administration in this profoundly altered context of limited resources, impaired communication, and inadequate transportation were organized into a recommended template, applicable to any radiation oncology practice. ASTRO disease-site experts provided evidence-guidelines for mitigating the impact of a 2- to 3-week interruption in radiation therapy. Results: Practical measures to mitigate the medical impact of a disaster are summarized within the framework of “Prepare, Communicate, Operate, Compensate.” Specific measures include the development of an emergency operations plan tailored to specific circumstances, prospective coordination with other radiation oncology clinics before a disaster, ongoing communications with emergency management organizations, and routine practice of alternate methods to disseminate information among providers and patients. Conclusions: These recommendations serve as a starting point to assist any radiation oncology practice in becoming more resiliently prepared for a local or regional disruption from any cause. Disease-site experts provide evidence-based guidelines on how to mitigate the impact of a 2- to 3-week interruption in radiation therapy for lung, head and neck, uterine cervix, breast, and prostate cancers through altered fractionation or dose escalation.
AB - Purpose: Although the wind, rain, and flooding of Hurricane Maria in Puerto Rico abated shortly after its landfall on September 20, 2017, the disruption of the electrical, communications, transportation, and medical infrastructure of the island was unprecedented in scope and caused lasting harm for many months afterward. A compilation of recommendations from radiation oncologists who were in Puerto Rico during the disaster, and from a panel of American Society for Radiation Oncology (ASTRO) cancer experts was created. Methods and materials: Radiation oncologists throughout Puerto Rico collaborated and improvised to continue treating patients in the immediate aftermath of the storm and as routine clinical operations were restored gradually. Empirical lessons from the experience of radiation therapy administration in this profoundly altered context of limited resources, impaired communication, and inadequate transportation were organized into a recommended template, applicable to any radiation oncology practice. ASTRO disease-site experts provided evidence-guidelines for mitigating the impact of a 2- to 3-week interruption in radiation therapy. Results: Practical measures to mitigate the medical impact of a disaster are summarized within the framework of “Prepare, Communicate, Operate, Compensate.” Specific measures include the development of an emergency operations plan tailored to specific circumstances, prospective coordination with other radiation oncology clinics before a disaster, ongoing communications with emergency management organizations, and routine practice of alternate methods to disseminate information among providers and patients. Conclusions: These recommendations serve as a starting point to assist any radiation oncology practice in becoming more resiliently prepared for a local or regional disruption from any cause. Disease-site experts provide evidence-based guidelines on how to mitigate the impact of a 2- to 3-week interruption in radiation therapy for lung, head and neck, uterine cervix, breast, and prostate cancers through altered fractionation or dose escalation.
UR - http://www.scopus.com/inward/record.url?scp=85065773145&partnerID=8YFLogxK
U2 - 10.1016/j.prro.2019.03.007
DO - 10.1016/j.prro.2019.03.007
M3 - Article
C2 - 30999000
AN - SCOPUS:85065773145
SN - 1879-8500
VL - 9
SP - 305
EP - 321
JO - Practical Radiation Oncology
JF - Practical Radiation Oncology
IS - 5
ER -