Health Affairs, 25, no. 2 (2006): 483 doi: 10.1377/hlthaff.25.2.483 © 2006 by Project HOPE	New Online   Senate Health Reform Bill   Rewarding Providers   Public Option Policy Brief   Health Reform & Abortion   Delivery System Reform

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Narrative Matters

The Nine O’Clock Meeting

LOCATION: TARMAC of the New Orleans International Airport. Action: The U.S. secretary of health and human services and the chief executive officers of the three hospitals still open in the New Orleans area agree to create a forum to rebuild the city’s acute care sector.

The next morning, the U.S. Public Health Service (USPHS) Team, New Orleans, began to coordinate a daily meeting with the leadership of open hospitals, emergency medical services (EMS), military operating in the area, and physicians in the city that came to be known as the "nine o’clock meeting." Soon other health-sector leaders from academic health centers, government, and other entities in the area joined in.

In the next few weeks, health-sector leaders came together—in person or by conference call—at 9 a.m. each day at the USPHS command center, Ochsner Hospital in New Orleans. They worked together and with plenty of straight talk to rebuild the city’s health care sector. The conference call made it possible to include state leadership in Baton Rouge and representatives of isolated hospitals.

The early focus of the nine o’clock meeting was on restoring acute care, including the transport of critically ill or injured patients. This resulted in the resumption of EMS one week after the storm and, shortly afterward, resumption of the 911 call center. The group then was able to move on to developing and coordinating a complex network of emergency transport and treatment that coordinated the complexities and technology of multiple branches of the armed forces and physicians working out of tents.

These morning meetings had the feel of the traditional medical morning report and provided a daily forum for health care leaders to identify a chief complaint, develop a differential diagnosis, and devise a treatment plan. The broad representation allows for quick action—in this case, about a health system rather than an individual patient. One shared result so far, the Greater New Orleans EMS Web site, http://www.gnoems.com, provides unprecedented openness about hospital capacity in the area and a way to widely share system-level information that allows for real-time decision making. Now held weekly, the meetings have become the equivalent of a weekly hospital report for the city of New Orleans.

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