On August 29, 2005, Hurricane Katrina passed east of New Orleans, Louisiana, USA and resulted in widespread flooding when the levees protecting the city failed [Taylor, 2007]. The functioning of medical schools within the city were disrupted, due to damage to their educational and research facilities and their hospitals; loss of transportation and civil services; loss of utilities; lack or food and clean water; and general displacement of the population, including faculty and students. The responses of the medical schools and of the LCME to the aftermath of Hurricane Katrina is an illustration of how the accreditation system intervened during an acute emergency affecting the short-term functioning of these medical schools.
What the Medical Schools Did
There were two medical schools and their associated teaching hospitals that were affected by Hurricane Katrina. The specific steps taken by each medical school were based on the individual school characteristics, but the strategies were similar and resulted in quick responses and timely resolution.
The Louisiana State University School of Medicine – New Orleans (LSU-NO) evacuated students, administrators, and faculty to Baton Rouge, an existing organizational component of the medical school and an existing educational site for medical students that is located outside the region of storm damage. Education for students in the pre-clerkship (basic science) phase of the curriculum began by the end of September 2005. A temporary faculty research infrastructure was created through shared resources with LSU faculty at the Baton Rouge site and faculty at other institutions. New housing for faculty and students was organized. Renovations at the New Orleans campus were sufficiently complete to allow the basic science portions of the curriculum to resume within about nine months. [Hollier, 2006; Wikipedia, 2017]
Tulane University School of Medicine relocated its pre-clerkship students and teaching staff to the Baylor College of Medicine in Houston, Texas. Students in the clinical years did their clerkships at teaching hospitals associated with several Texas medical schools. Students and faculty returned to New Orleans during 2006 [Wikipedia 2016].
In summary, both medical schools re-located administrators and faculty to temporary facilities outside New Orleans so that they could continue to provide the medical education program. Those facilities were either within the medical school system (LSU-NO) or external to it (Tulane). Much of the medical education program of each school returned to New Orleans within the year.
What the LCME Did
LCME records describe that information was collected from both New Orleans medical schools during the year following Hurricane Katrina. The requested information focused on the availability of resources to implement the medical education program during the emergency, including such things as access to educational and clinical facilities, availability of medical school faculty to teach the program’s students, and access of students to a wide range of student services. The need to have these resources available to all students is codified in accreditation standards.
The LCME follow-up included both a request for written information and on-site review. A written report on the move to Baton Rouge was requested from LSU-NO by the end of November 2005. This was followed by an additional written report in May 2006 and an on-site visit to Baton Rouge in September 2006. Similarly, the Tulane School of Medicine clinical teaching sites in Texas were visited in November 2005, a written report from the school was due in May 2006, and an on-site visit to the New Orleans campus was conducted in August 2006. Each of the written and survey visit reports were reviewed by the LCME to ensure that compliance with relevant accreditation standards was being maintained.
A Medical School’s Perspective on the LCME’s Actions
To obtain a school’s perspective on the role accreditors can play under difficult circumstances, the authors interviewed Dr. N. Kevin Krane, who served as vice dean for academic affairs at Tulane University School of Medicine at the time Hurricane Katrina struck, and was a central figure in the coordination of the school’s response to the emergency. Dr. Krane stated: "The LCME was very helpful in making sure that in the process of responding we protected the integrity of the curriculum for the benefit of the students. They gave us the parameters by which to operate under the special circumstances. It was important to know that our actions would be supported. The LCME’s flexibility gave us the authority to move forward. Without the flexibility, we would have had to shut down the program."
Dr. Krane noted that early and frequent communication between the program and the LCME was essential. His recommendation for accreditors with programs in the midst of an emergency circumstance is to for the accreditor to reach out early, asking it can support the needs of the program. "Communication is essential, so that everyone is on the same page, and the accreditor isn’t seen by the program as an inflexible barrier, and the program isn’t viewed by the accreditor as taking unreasonable actions."