Lessons Learned

The Pulse event caused most of those outside the organization to correctly focus on the immediate clinical response. The associated work, however, continued for days, weeks and months. Some of this work was created by how the outside world responded to the tragedy. In many ways, it became an all-consuming set of reactions that the team managed with precision and grace.


One of my first examples of the outside world’s actions occurred early that Sunday morning when Orlando Health’s Director of Emergency Preparedness, Eric Alberts, looked at me and said that a gentleman had driven his pickup truck from Indiana and was placing 49 wooden crosses on the ORMC campus representing the individuals who had been killed. Eric asked, “Are we going to allow this?” My answer, “Yes.” The continued outpouring of gifts and kind gestures grew exponentially. Pallets of water, flowers, cards, banners, paintings, handmade blankets, gifts and pizzas – hundreds of pizzas! I will never forget after the initial pizza delivery, a law enforcement leader asking me if we should distribute the pizzas or not. Since it was early in the timing of the Pulse event, it wasn’t yet understood how far- reaching the terror act was. The officer’s concern was that the pizzas might have been purposefully contaminated to cause harm to our staff. What decision should be made?


All of the gifts were thoughtful, especially the banners from other healthcare systems. These signed banners with well wishes and encouragement were of great support for our team and sincerely appreciated. The plethora of other gifts raised questions of who should manage, receive, distribute and determine if these items were safe for staff and patients.  Some of those who made donations had expectations of exactly how their gift should be used and how they would like to be recognized for their gift. Orlando Health’s guest services and community relations teams jumped in and took responsibility for all of this and several other unique and essential activities.


Having celebrity anchors from every major news organization camped on the front lawn of one of our hospitals was something I never anticipated. Understanding that the events of the day were events that the entire world felt and experienced was an awakening and important level-setting point for me. Clearly, this was not a local story. We were in the middle of a U.S. presidential race. Anything one of our team said or did might be used as a political statement given the many potential issues that could be associated with this shooting. This fact was constantly on my mind. I am blessed and fortunate that our team focused our message where it needed to be: the organization’s response and the clinical status of patients. This world event caused elected officials ranging from city commissioners to the President of the United States to draw close to the patients under our care. That same draw brought Hollywood stars and major league athletes with the desire to visit and do their part to help. While these gestures were well meaning, it was additional work for the team to manage. They did a wonderful job ensuring that this activity did not affect the clinical care of our patients.


With law enforcement, elected officials, Hollywood stars and athletes plus reporters attempting to sneak into the hospital and every imaginable gift piling up, it was important that we continued to be in charge of our facility and honor our responsibility for the care and safety of patients, team members and physicians. An essential lesson for us was to “own what you own” and ensure everything that happened on our campus was controlled by us and not others. That’s not to say we didn’t desire to work with every party, but our top priority was the care and healing of the victims of the tragedy. No greater place was this ownership true for Orlando Health than in identifying each of the victims and connecting them to their loved ones. This is an area where Orlando Health’s persistence and diligence enabled  families to connect us with their loved ones hours and potentially days sooner than would have occurred had we not taken  a leadership position.


Eventually, the focus of the event turned to economics. Orlando Health spent millions of dollars in preparation, planning and responding to this horrific event. However, the health system was not reimbursed by the federal government, state government or Pulse funds raised for the victims. The organization did receive wonderful support from friends of our Orlando Health Foundation who understood the amazing response of our team members and physicians. These gifts, however, didn’t come close to the organization’s expenditures. Our decision to write off the patient bills of the victims was a conscious choice.  We reasoned that these individuals were part of the worst mass shooting to date in the U.S., and in our judgment, didn’t need the additional burden of the cost of their care. I did receive complaints from people who historically had received care at an Orlando Health facility and were requesting their bills be forgiven as well.   


An extremely important area for me was taking care of those who care for others. The mental trauma of an event like this on individuals cannot be understated. I believe Orlando Health did an excellent job in this area, offering hourly counseling starting that Sunday morning at 7:00 am. More than 2,000 team members and physicians decided to participate in this service. It continues to be available 18 months later and will need to continue going forward. One of the greatest issues Orlando Health team members faced was the feeling of guilt. Team members who were not on site physically wanted to be here to help. All would have come running if called. In truth, each of them was here, because the organization is an accumulation of each person’s expertise, skill and the systems and processes they helped design. I am convinced that the outcomes of the event would have been the same if the tragedy had occurred any other day. Every Orlando Health team member and physician was a part of the outstanding response.