Crisis Mode—Emergency Management and Response

Transcript

Narrator

The future of project management is changing fast. On Projectified™ with PMI, we’ll help you stay on top of the trends and see what’s really ahead for the profession—and your career. 

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Stephen W. Maye

Hello, I'm Stephen Maye, and this is Projectified™ with PMI. I'm here with my co-host, Tegan Jones, and in this episode we're talking about emergency management—a topic that’s always important, but has become even more urgent in recent years.

We’re seeing that natural disasters are intensifying. Urban population density continues to increase. And with a growing sense of resource scarcity, political tensions are on the rise. And the type of crisis that requires a massive humanitarian response is becoming more frequent, which is putting a huge strain on the government agencies and NGOs that are supposed to respond. 

Tegan Jones

Right, because disasters that are more intense and more frequent are, of course, more expensive. The global insurance company Aon actually tracks the cost of natural disasters every year, and it found that 2017 was the costliest year on record for weather-related disasters. Around the world, events like hurricanes and floods generated 344 billion U.S. dollars in economic losses last year.

Stephen W. Maye

It’s hard to imagine that much money, let alone losing that much money. It’s basically the GDP of a mid-sized country—say, Denmark, South Africa or Singapore. Just wiped out.

Tegan Jones

Yeah, and it’s not like these costs are just a little bit higher than they used to be. The 2017 losses from natural disasters were almost double the losses that were seen, on average, between the years 2000 and 2016.

And what that really means for organizations is they just can’t keep doing things the way that they’ve always been done.  

Stephen W. Maye

And that has huge implications for recovery projects. So, if you’re rebuilding from scratch after a hurricane or an earthquake, you’d want to make sure whatever you build next will be able to withstand more—stronger winds, higher waves, whatever’s going to be thrown at you.

Tegan Jones

And that’s what a lot of organizations have done here in New Orleans, where I live, in the aftermath of Hurricane Katrina. And one of these organizations, Southeast Louisiana Veterans Health Care System, was actually the winner of the 2018 PMI® Project of the Year Award. So I got a chance to visit this new, massive medical facility that the Department of Veterans Affairs had to rebuild after the storm. 

Stephen W. Maye

That's a highly competitive award. So what do you think made this project so special? Why do you think this is project of the year?

Tegan Jones

So, that’s really for the judges to say, but I think that one of the things that most impressed me was that resiliency element that you mentioned a little bit earlier. They made sure that all of the mission critical equipment—so HVAC, elevator systems, all of that stuff—was placed at least 20 feet, or 6 meters, above sea level. And that’s so the hospital can keep functioning during and immediately after a crisis, rather than people trying to provide medical care in a hot parking lot, which is what really happened after Hurricane Katrina. 

Stephen W. Maye

And I’m sure that decision is going to save a lot of lives one day. We'll hear more about this project a little later in a special segment that showcases the project of the year winner. We'll hear from four members of the medical facility team who will explain a bit about what it took to rebuild this billion-U.S.-dollar facility. 

Tegan Jones

I really do love this story. I have such hometown pride. But I’m also really interested to hear from Victor Orellana Acuña, an architect and PMP who until recently was the deputy national director for the National Emergency Office for the country of Chile. And he was in that role in 2015 when an earthquake triggered a tsunami off the coast of the country. So he has a lot of first-hand experience with what it takes to manage the immediate aftermath of an emergency.

Stephen W. Maye

So, the VA team will talk about building more resilient projects, Victor will talk about emergency response and our first guest will talk about reducing risk in the face of a disaster or a crisis. Mahamoudou Guimbayara works for CARE Mali. He’s the emergency team leader of the Development Food Assistance Program. So he’s dealing with a different kind of disaster—food scarcity and starvation. 

Although this type of crisis is a bit more predictable than something like an earthquake or hurricane, I think the problems that need to be solved and the risks that need to be managed are really pretty similar.

Tegan Jones

Right. It's not just about delivering food to people who need it—although that in and of itself is a huge logistical task. It's also about helping people find ways to recover and reassess after the crisis has passed. So let's hear how his team does it.

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Tegan Jones

CARE International is one of the largest humanitarian aid organizations in the world. It leads development and anti-poverty projects in 94 countries, including the Republic of Mali in West Africa. Mahamoudou Guimbayara, an emergency team leader for CARE Mali, describes the situation on the ground.

Mahamoudou Guimbayara

The country of Mali is classified as a high-risk country by CARE International following the country's political-military crisis in 2012. Today, it can be said that the politico-military crisis has become more complex because of crime, terrorism and inter-communal conflict, especially in the center of the country.

Tegan Jones

The country is also facing a food crisis that’s been exacerbated by extreme weather events like floods and droughts. So one of CARE Mali’s primary goals is to increase food security.

Mahamoudou Guimbayara

The program in which I work is one of CARE's long-term programs called "Harande." Harande means “food security” in Fulani, and Fulani is one of the local languages in Mali here. It’s funded by USAID's Office of Food for Peace, whose overall goal is to improve nutrition and income security in 290 communities by 2020. 

Tegan Jones

While CARE Mali can’t prevent extreme weather events from damaging crops, it can predict and plan for the fallout of a food shortage. But to step up it’s emergency response skills, the team needed to better understand how to mitigate risks before, during and after a crisis.

So last June, Mahamoudou received training from the PMI Educational Foundation, or PMIEF, on disaster risk reduction.   

Mahamoudou Guimbayara

Good preparation and planning can save lives, reduce the impact of disaster, and help people rebuild faster. This involves identifying potential emergencies and ensuring that appropriate arrangements are made in anticipation of a crisis.

The use of the risk management approach learning during the PMI training helped the team a lot in the planification of the activities, notably the identification of the probable risks which could hinder the good realization of the activities. The risks identified are classified according to their nature as avoidance, transference, mitigation and acceptance. Under this process, a mitigation plan is drawn up for potential risks.

Tegan Jones

The PMIEF training also showed CARE Mali how to conduct rapid needs assessments, which helps the team respond faster and more effectively in emergency situations. 

Mahamoudou Guimbayara

For each activity, it is important to know who is responsible for its successful implementation and who should contribute to it and when the activity should be carried out. 

Tegan Jones

But the work doesn’t end when the crisis is over. Smart project planning helps CARE Mali drive reconstruction after a disaster—and move communities towards long-term sustainable development. 

Mahamoudou Guimbayara

By integrating disaster risk reduction approach and emergency preparedness plans into its long-term development program, CARE helps communities build resilience and create sustainable methods of disaster preparedness and response. This then reduces the vulnerability of the community to future emergencies. 

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Tegan Jones

Mahamoudou mentioned the training he received from the PMI Educational Foundation, and that’s actually how we heard about his work. So I'd recommend that anyone who really liked his story go to www.pmief.org to read case studies about other disaster management or humanitarian organizations who have done really great work after receiving one of the foundation's grants.

Stephen W. Maye

Disaster management training also helped our next guest rethink how projects should be run in an emergency situation. Victor Orellana Acuña is the former deputy national director of Chile's National Emergency Office. He discusses how communities can increase their capacity to respond and save lives in a crisis. 

Tegan Jones

Great, let’s hear what he has to say.

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Victor Orellana Acuña

Hello, I am Victor Orellana from Chile. I am architect and I work a lot of time in the government sector. I was the deputy national director of the National Emergency Office of Chile.

In countries like such as Chile, the majority of public services and critical infrastructure are managed by private companies, but supervised by the public sector through concession contracts. It is very important that these contracts ensure an adequate level of service. In this way, we avoid the cascade effects that can generate a collapse of the entire service system, making recovery and reconstruction more and more expensive and slower. One of the most interesting exercises we have done in Chile is to establish a common map where we can visualize the different capacities of each sector and company, and also define the critical points that can be affected by a disaster to quickly organize the protection and recovery. 

In this sense, disaster response and recovery processes can be much better when there are standardized codes and ways of working that allows us to manage a common language in difficult times where many lives might be in danger. I think it's very important that public and private organizations that participate in post-disaster processes cultivate and develop these codes early and determine a corporate standard of project management to better fulfill their mission.

In this way, we can move quickly to generate networks of organizations ready to respond to emergency and better recover damaged areas. This is essential when disasters cross the borders of the countries and become regional or global problems, but also when more and more international aid is needed to help the affected countries. I think there is a very broad space to include the tools of the project management to reinforce the capacity of the communities to respond in the most critical hours after an emergency.

I had the opportunity to form a task force that worked to the PMIEF in 2012 in the construction of methodologies for project disaster management. The most important thing was to understand that project management framework was too big to work in the area of a disaster. So we have to first to simplify the framework and to select what kind of tools and what kind of knowledge we can take to create a more simplified model to act in disaster moment, helped by the project management tools.

In emergency times, when many, many lives are in danger, we have to move very quickly with people that we don't know. So we have to have many common tools and codes. The project management is a very efficient language to move quickly inside the emergency committees. The tools that the project management gives to the professionals and the local government or inside the communities or inside the government agencies is a resource that make more easier the movement inside this net of collaboration when the emergency is developing.

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Stephen W. Maye

Being able to move quickly while still knowing exactly where you need to focus your efforts makes a huge difference in a situation where every hour counts. And I think a lot of teams can relate to this idea of simplifying and adapting your processes so that they work in a fast-paced environment. 

Tegan Jones

Especially when something goes wrong, it’s really helpful to understand how to streamline schedules and rethink priorities so that you’re able to handle that setback.

That’s something the team from Southeast Louisiana Veterans Health Care System had to do pretty regularly when they were rebuilding the new medical center in New Orleans. It was a one-billion-U.S.-dollar project that took over 10 years to complete, so they definitely had to contend with a lot of big issues along the way. But the team was still able to open the facility on time with everything the medical staff needed to provide the best possible care for veterans. 

Stephen W. Maye

And they did all of that in the post-Katrina environment, which had to be incredibly difficult. In that kind of crisis situation, a lot of the systems and supply chains that we normally rely on simply shut down. 

Tegan Jones

It’s definitely a tough job, which is why I’m glad we got the chance to hear directly from the project team that made it happen. Let’s start with Fernando Rivera, the director of the medical center, who paints a picture of how things were operating right before the storm.

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Fernando Rivera

Over 400,000 residents in the Orleans parish area. Over 1.5 million residents in the metropolitan New Orleans area. A VA hospital that was housing one of the three Nobel Prize winners in the VA in research. Over 500 medical students rotating through the facility, taking care of almost 40,000 active users of the system. And that's, so that's occurring on a Friday. 

And on Monday it's all gone.

[Archival audio of Hurricane Katrina coverage]
Stephen W. Maye

When Hurricane Katrina hit the Gulf Coast in 2005, it devastated New Orleans, leaving a shocking 80 percent of the city under water. Liz Failla, project engineer and coordinator for Southeast Louisiana Veterans Health Care System, remembers the days following the storm.

Liz Failla

It was very hard to see anything good, or to even have any faith in anything positive happening. People were tired, they were hurt, they were struggling.

Stephen W. Maye

But that didn’t stop New Orleans from starting to rebuild. For the Department of Veterans Affairs, or VA, that meant envisioning a replacement medical facility that would care for roughly 40,000 veterans across the Gulf Coast region. 

But before the VA could break ground on the new regional referral center—a facility that would cover 12 city blocks—the team had to win over the local community. 

Liz Failla

Here we are, the big federal government, coming into a neighborhood in a community that has been devastated. People are trying to rebuild their lives, that sort of thing. And there's a lot of skepticism.

Stephen W. Maye

Communication was key—especially when it came to learning what veterans wanted out of the new medical center. Dr. Stephanie Repaskey, the associate director for Southeast Louisiana Veterans Health Care System, explains how simulations helped the team put patients first.

Stephanie Repaskey

We would never open an area without a simulation. What we have learned is there is how you've designed it and you think it'll work, how it works when you walk through it, and then how it works when you put the actual patient into it. And those are not always the same, and you need to be able to adjust.

We actually did 24-hour simulations and we got feedback on meal delivery, meal temperatures, waking people up, noise levels on the unit—which you wouldn't normally think about but when you have a patient laying there who's not feeling well, they'll hear things that you won't necessarily even know that you're being at that volume. So we were able to make those adjustments prior to actually ever bringing in a patient. 

Stephen W. Maye

Those insights were especially helpful in the hospital’s mental health units, where design issues may be less obvious to the untrained eye. 

Stephanie Repaskey

We had an exam room curtain that we had tested with over several hundred people: no issues, everyone liked it, seemed generally generic. And then we went to a mental health group with veterans who suffered from post-traumatic stress disorder, and they immediately said, “That reminds me of barbed wire.”

Stephen W. Maye

Focus groups with military families also helped uncover usability challenges the team had simply missed.

Stephanie Repaskey

I think back to that patient who said, “Can you just lower the mirror so I can see myself?” who's in a wheelchair. And had we not taken the time to get that, we would have missed an opportunity that will impact literally thousands of people. 

At the end of the day, it doesn't matter how beautiful the building is or how wonderful we think it is if our patients don't come and use it. That's really the true measure of whether we are successful or not. 

Stephen W. Maye

But getting the design right was just one step in the process. The project team also had to understand and plan for dependencies across 65 different healthcare services that would roll out on a staggered schedule. Mary Beth Cooper, the associate chief nurse for activation, explains how project managers help the team hit key deadlines even when problems appeared. 

Mary Beth Cooper

If something came up that might derail something for a few weeks or a month, the project managers would keep us on track with moving forward with the other things that we needed to support that area opening anyway.

Stephen W. Maye

For example, smart sequencing helped the team recover when a pipe broke, flooding four floors in the inpatient tower only six weeks before it was set to open. Dr. Repaskey remembers how the team adapted in the face of such a significant setback.

Stephanie Repaskey

We were actually able to shift our schedule to activate floors that were not flooded in lieu of those that had been while the repair work was going on.

Many people would have said, “You're not gonna open on time.” That was about three months before we were supposed to activate the entire tower. We brought the team together, we shifted sequencing, we shifted priorities, and that allowed us to actually open on time with that building.

Stephen W. Maye

The medical center saw its first patient in December of 2016, with additional services coming online through 2018.

Fernando Rivera

This facility has already provided over 500,000 outpatient clinic appointments, over 1,000 surgical procedures, over almost 10,000 bed days of care, and is actively growing its research program.

Stephen W. Maye

The project benefits the greater community as well. Its state-of-the-art research center and medical school partnerships are positioning New Orleans as an up-and-coming bioscience corridor. 

And the hospital has already created 3,000 new jobs. Plus, the new facility was designed to help the city’s residents weather future storms.

Fernando Rivera

Our exterior walls are built to withstand 130 mile-an-hour winds. All of our critical mission systems are at least 20 feet above mid-sea level. The facility is set up to support 1,000 occupants for five days without having the benefit of water or electricity. 

So we are a strategic and national resource in the central Gulf South region—not just for day-to-day health care services for veterans in the region, but for the future innovation of medicine and research, and of course, to be able to support the community and support the region with state-of-the-art technology and health care services in the event of a disaster.

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Narrator

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