One year later: A case study examining a community hospital’s administrative response to a debris flow

Ann Gianola, Steven A. Fellows


Santa Barbara, California was first impacted by the Thomas Fire in December 2017 only to be devastated by the Montecito Debris Flow less than two weeks later. Cottage Health, a not-for-profit health system that provides advanced tertiary and quaternary medical care for patients throughout the Central Coast of California, was at the forefront of first responders to those directly impacted by the debris flow. Santa Barbara Cottage Hospital (“SBCH”) (located 6 miles from the flow) treated 18 trauma patients, two first-responders, and 1 additional emergency patient later in the day, while Goleta Valley Cottage Hospital (“GVCH”) (located 12 miles from the flow) treated seven patients. Flooding and debris from the storm forced the closure of Highway 101 in both directions north and south for thirteen days. Highway 101 is the only major thoroughfare from Santa Barbara to Los Angeles and forced Cottage Health to implement an internal “travel agency,” in order to support Cottage Health clinicians to get to and from the two hospitals. The internal “travel agency” arranged transportation via planes, boats, vans and trains. In addition, the agency arranged accommodations utilizing local hotels, and an empty patient care unit in GVCH. Employees and board members opened up their homes to respond to more than 4,000 transportation and 900 overnight accommodation requests. Immediately following the disaster, licensed Cottage Health clinicians implemented a How We Heal: Trauma and Anxiety Support Group series to serve all Santa Barbara residents. The series is composed of How We Heal: Process Group, How We Heal: Skill Building/Seeking Safety Group and How We Heal: Survivor Group and one year later, continues to serve the community.

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Journal of Hospital Administration

ISSN 1927-6990(Print)   ISSN 1927-7008(Online)

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