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Lessons Learned During Texas' Winter Storm


By Kimberly Persley, MD, President, Texas Ambulatory Surgery Center Society President

For the past year, we have all been dealing with the repercussions of the COVID-19 pandemic. For ambulatory surgery centers (ASC) in particular, this has meant postponing and/or cancelling procedures.

When Texas Ambulatory Surgery Center Society (TASCS) members were polled on the challenges and opportunities presented by the pandemic, it was found that:

  • telemedicine improved communication with patients
  • extra efforts were put into sanitizing
  • leaders felt more prepared for future emergencies

On the other hand, there were worries over personal protective equipment (PPE) shortages, understaffing and finances.

On top of all of this, Texas surgery centers also faced Winter Storm Uri in February 2021. 

Along with freezing temperatures came icy roads, power outages and changes in water supply, ranging from no water or low pressure to burst pipes and boil-water notices. This state of emergency also led, once more, to ASCs having to cancel or postpone procedures.

Since so many were affected by the storm and were working extra hours to get patients rescheduled and centers back open, TASCS postponed its virtual Capitol Day and Infection Control Meeting, shared resources (such as what to do if a center had damage from the storm) and talked with members about what they learned during this time.

ASC Experiences During the Winter Storm
Tammy Stanfield, who is the administrator/director of nursing at North Pines Surgery Center, stated that her facility’s HVAC system does not operate on generator backup power.

“The building was extremely cold when we got a chance to check on it. When the main power goes off and the generator is running, all operations cease once current surgical cases are completed. The building was terminally cleaned prior to resuming cases.”

Additionally, on the topic of generators, one center learned how to treat the diesel fuel that operates its generator, as it turns to gel if left untreated when the temperature goes below 20 degrees. Another center learned to shut generators off when closing for a storm and when extended power outages are expected, as the generators only provide power to complete in-progress procedures only.

Celia Smith, administrator at Houston Premier Surgery Center in The Villages, discussed how frozen and burst plumbing affected daily operations. “The City of Houston's water pressure dropped below 20 pounds per square inch, triggering a water advisory. Our building was impacted by low-to-no water pressure, followed by the water advisory. We consulted with other ASCs, infection control coordinators and the SouthEast Texas Regional Advisory Council (SETRAC) to be sure we were implementing all necessary measures before resuming patient care.”

A final center mentioned scheduling a prep day before reopening, allowing those who could make it in check that everything was in order before resuming business. This included tasks such as:

  • running sterilizers
  • testing generators
  • checking on pipes, water pressure, internet and phone lines (which could be down, even if power is back) 

Since a storm alters the case schedule, the center also reminded everyone how important it is to know what is in stock and ensure that the supplies, instruments and equipment needed for rescheduled procedures are available.   

This year, TASCS has been providing members with even more education and opportunities to collaborate and learn from each other. There are regular virtual town hall events, blog posts, newsletters, polls and social media posts that cover everything from advocacy and accreditation to patient safety and reporting. This information ensures ASCs can keep working to provide high-quality, cost-effective care… in a pandemic, during a winter storm and beyond. 

Kimberley Persley, MD, is President of Texas Ambulatory Surgery Association and Partner, Dallas Endoscopy Center; Texas Digestive Disease Consultants
She studied at University of Texas Southwestern Medical School and Mount Sinai Medical School. Her focus is on Inflammatory Bowel Disease and obesity.