Weathering the storm
A publication in JAMA Surgery highlights how the UF Health system navigated a nationwide sterile fluid shortage
Jan. 28, 2026 — In late fall 2024, Hurricane Helene — the deadliest strike on the U.S. mainland since Hurricane Katrina — ripped through the Southeast and adversely affected infrastructure across the country, including a Baxter International manufacturing site in North Carolina responsible for half the nation’s supply of sterile intravenous fluids.
When the facility was forced to close due to extensive flooding, health systems across the country grappled with a world where a steady supply of a ubiquitous resource was no longer guaranteed.
A recent publication in JAMA Surgery highlights how the University of Florida Health system’s response to the storm and its aftermath tested an already-rigorous culture of patient safety and data-driven care.
The expert multidisciplinary teams across UF Health and the College of Medicine didn’t just maintain steady operations during this dramatic shortage; they developed new strategies that would shape how the institution manages essential supplies for years to come.
Taking inventory
Tedd Comerford, M.H.A., FAHRMM, CMRP
Critical items like IV fluids were already kept in reserve, said Tedd Comerford, M.H.A., FAHRMM, CMRP, senior vice president for supply chain for UF Health, but the initial challenge was shifting the view to track sterile fluid supplies at a greater level of detail than ever before.
“Our supply was immediately reduced to 40% of what we’d had, and we needed to better understand the impact of that,” he said.
Comerford’s team leveraged UF Health’s inventory systems to develop a detailed way to track sterile fluids beyond anything used previously.
“We had line of sight to every location across the enterprise and every department’s supply rooms,” Comerford said. “We don’t normally maintain such a granular level of detail, but in this case, we knew what they had and what they were using every day.”
Using this data, system leadership plotted a utilization curve that forecast depletion under several conservative scenarios.
“We already had reserve stock when Helene hit,” Comerford said. “We immediately took inventory, considered the systemwide effects of the reduction of supply and determined that conservation could get us through December.”
Getting a clear picture of existing supplies — what was available and how long it would last — was essential in ensuring continued quality of care for all UF Health patients.
Getting buy-in
Tim Morey, M.D.
According to Tim Morey, M.D., chief medical officer for UF Health Shands and senior associate dean for clinical affairs at the UF College of Medicine, one of the most important aspects of the system’s successful response to the crisis was its people.
“We gathered a group of individuals with the right knowledge who were positioned to start dealing with the situation,” he said. “It was the first time we’d opened a systemwide crisis command center. It wasn’t just people from the Gainesville market getting involved in problem-solving; we had people from Central Florida and UF Health St. Johns and Jacksonville all putting their heads together to understand what was going on and how we were going to approach solutions.”
That command center comprised a coordinated, systemwide team of supply chain, pharmacy, perioperative, information services and clinical leaders poised to monitor and conserve resources and adapt workflows — all while maintaining UF Health’s commitment to safe, high-quality patient care.
John Hollingsworth, M.D.
John Hollingsworth, M.D., M.Sc., chief quality officer for the UF Health clinical enterprise, said communication was key to “turning the ship” that is a large academic health system.
“You can’t overcommunicate in these situations,” said Hollingsworth, also a professor in the Department of Urology. “We made sure that everybody at every level was getting the information they needed, in real time, to proactively respond to this crisis.”
System leadership held meetings at all levels, communicating plans and goals with care team members and stakeholders to continuously remind them of the situation and keep them updated on progress.
Hollingsworth said while organizational inertia can be a challenge when implementing large-scale changes, the urgency of the fluid shortage accelerated efforts.
“The crisis taught us that as a collective we’re stronger than any individual entity within the system,” he said. “This was a bidirectional learning process across our entire UF Health system. From our academic medical centers to our to community hospitals, everyone contributed and shared innovations, bringing new ways of thinking about how to adapt to the shortage.”
Transparency in communication and timely updates to care teams also played a large role in ensuring continuity in the approach to the shortage.
“People got on board quickly,” Morey said. “It was important to them that we were able to not only articulate the challenges clearly but also show them exactly how we were approaching solutions. They really stepped up to the plate.”
Patient safety
Getting through the shortage wasn’t simply a matter of reducing sterile fluid utilization. Patient safety remained a top priority.
“At UF Health we pride ourselves on safe, reliable patient care,” Hollingsworth said. “Even though we were reducing sterile fluid utilization by 40%, our priority was not compromising the high level of safety the communities we serve have come to expect. We were able to not only maintain our high levels of patient safety, but we were also able to sustain access to care for our communities.”
Postoperative acute kidney injury, an important metric when considering fluid utilization, showed no increases during the period impacted by the fluid shortage.
The preservation of both critical and noncritical services during the shortage are a testament to the hard work and swift response time of the UF Health system in a time of crisis.
New protocols, safe and effective fluid alternatives and careful attention to systemwide situational awareness all contributed to a 40% decrease in IV bag utilization between September 2024 and January 2025, at which time the nationwide supply began to ramp back up.
Lessons learned
Stephen J Motew, M.D., M.H.A.
Morey said the first and most important lesson learned from the shortage was that everyone has great ideas.
“Our academic health system is full of brilliant minds and talents,” he said. “It was gratifying to be able to open a systemwide command center and leverage that experience.”
Comerford agreed that the shortage was an opportunity to showcase the vision leadership has for UF Health as an integrated health system.
“This was a UF Health clinical enterprise success on behalf of our patients,” he said. “There are no individual heroes in this effort. This was a heroic response by UF Health to a devastating event.”
Comerford said the lessons learned from the shortage, from the quick formation of a command center to the integrated communications and implementation of solutions, has provided a blueprint for how the system can handle future crises.
“Our response to this national shortage underscored the strength of UF Health as an integrated academic health system,” said Stephen J. Motew, M.D., M.H.A., FACS president and system CEO of UF Health. “By working together across disciplines, regions and roles, our teams upheld our mission to provide safe, high-quality care for our patients, even under extraordinary circumstances.”
The necessities created during the shortage have led to long-term changes in UF Health’s approach to sterile fluid usage. While production at the Baxter facility has long since ramped up its operations to pre-hurricane levels, UF Health has continued to leverage several of the conservation measures developed during the crisis.
This doesn’t just translate to savings as less supplies are used; it means patients can be assured of continuity of care even in the event of a similar shortage in the future.
“We don’t want another one to happen,” Comerford said. “But we’re absolutely ready if it does.”
