Preparing for Extreme Heat: 6 Best Practices for Hospitals

About six years ago, Phoenix-based Valleywise Health decided to revamp its approach to heat-related illnesses. The health system wanted to address an increase in ailments linked to rising temperatures.

“We saw a precipitous rise in heat-related illness,” said Jeffrey Stowell, M.D., an emergency medicine clinician at Valleywise Health. “Those numbers were going up by the hundreds each year.”

Subsequently, in 2021, the health system began updating its practices for managing acute heat-related illness, shifting from more passive cooling methods (e.g., ice packs and fans) to cold water immersion, which lowers body temperature much more rapidly.

Valleywise is far from the only health system contending with a growing volume of patients affected by high temperatures. Hot days are becoming more common: In 2025, every state in the continental U.S. (aside from Michigan, Wisconsin, Illinois, Ohio, Indiana and Vermont) hit triple digits by August 7, according to Accuweather. As the heat intensifies, so do the illnesses and injuries caused by scorching temperatures, resulting in a greater need for medical assistance.

Climbing Temperatures Create Health Hazards

During heat waves, healthcare providers see surges in patients with heat-related ailments, such as heat stroke and exhaustion. At University Medical Center of Southern Nevada (UMC) in Las Vegas, where temperatures can reach and remain in the triple digits for days, some patients come in with severe heat stroke and even burns from contact with hot pavement, said Ketan Patel, M.D., medical director and vice chief of the department of emergency medicine at UMC.

He also notes that rising temperatures often lead to higher rates of medical events like heart attacks and strokes, because heat exacerbates pre-existing health conditions.

“Most of the data shows us, medically, that heat acts as a stress test for some people,” he said.

Preventing and Treating Heat-Related Illness: 6 Tips for Hospitals

With temperatures climbing, extreme heat and its harmful health effects are a growing problem. Hospitals and health systems across the nation are rising to the challenge. Here are recommendations to help providers mitigate the impact of extreme heat.

1 | Know your region and be proactive.

Prepare for periods of extreme heat, especially if you’re located in an area prone to high temperatures. Patel advises, “Be proactive rather than reactive.”

Ensuring your hospital or health system is ready for dangerously high temps can involve coordinating care and aligning policies, procedures and best practices. It can also include initiatives like the UMC Lions Burn Care Center’s annual flip-flop drive, which aims to prevent burns from contact with hot pavement by collecting and distributing protective footwear.

“We hold an annual flip-flop donation drive within the organization, and the winning department receives lunch,” said Diane Knapp, assistant chief nursing officer at UMC. “The flip flops are then given to patients, families and anyone in need.”

UMC also hands out backpacks full of supplies that prevent heat-related injuries, such as visors, sunscreen and lip balm. “We focus on children, the elderly and the underserved population,” Knapp said.

2 | Educate the public on how to stay healthy during high heat.

Before temperatures climb to dangerous levels, it helps to educate the public as much as possible about cooling measures, the dangers of pavement burns, the symptoms of heat-related illness and when and how to seek treatment.

“We try to do as much education as possible,” Knapp said. She notes that UMC has a severe weather incident response guide that covers strategies for keeping patients and their families (as well as hospital staff) safe during periods of high heat. Guidelines include staying in cool areas or not leaving home during the hottest hours of the day. Other recommendations include avoiding unnecessary exertion and, if possible, not spending time in cars, when temperatures peak. The medical center also has water available at each entrance for anyone who needs it.

UMC also educates people about how quickly pavement burns can happen.

“It doesn't take long, less than a few seconds, for them to get a second- or third-degree pavement burn,” Knapp said. “Unfortunately, a lot of individuals do not realize that, and they go outside with their bare feet.”

Community partnerships can bolster education efforts. For example, UMC partners with organizations such as local school districts, the Clark County Office of Emergency Management, the Southern Nevada Health District and the Office of Military Medicine.

Valleywise also leverages community partnerships. “We try to work with public health, putting the word out there as much as we can: Summer’s coming, anticipate the heat,” Stowell said.

He also noted that they partner with organizations that focus on substance use, since it’s common for intoxicated individuals to experience heat stroke.

3 | Implement rapid cooling methods.

When Valleywise transformed its procedures for treating acute heat-related illness, the health system opted to implement cold water immersion based on evidence that it’s the most efficient way to lower a patient’s temperature.

“We found that when comparing it to cooling people in other ways, it was faster, and the outcomes were better,” Stowell said. “The longer you’re hot, the more your body begins to break down.”

After securing the necessary supplies (immersion bags, ice and water) and getting buy-in from providers within the system, Valleywise has now facilitated cold water immersion for all patients with severe heat-related illness. The treatment requires multi-disciplinary teams, including physicians and nurses trained in immersion and capable of handling multiple patients in rapid succession during peak hours on hot days.

The health system has made efforts to educate staff about cold water immersion each year with tools like training videos and step-by-step flow charts. “Now, five or six years in, it’s automatic,” Stowell said.

4 | Coordinate with pre-hospital care providers.

It can also help to reach out to pre-hospital care providers and organizations in your community (e.g., the health department) before the temperatures climb.

“See what you can do to impact patients as early as possible,” Patel said.

Pre-hospital cooling carried out by emergency medical services (EMS) or firefighters can significantly improve outcomes for patients with heat-related illness or injuries. For example, Patel explained that EMS in Las Vegas sometimes needs to spend a while retrieving hikers with heat exposure from remote outdoor locations. If pre-hospital care providers can perform cold water immersion as soon as they transport the patient back to their rig, it can make a big difference.

“Sometimes the most important factor in survival isn’t what I do as an emergency physician when they come to the hospital; it’s what they do before they come to me,” Patel said. “Arming people to act early often goes a long way.”

Similarly, Valleywise has partnered with the Phoenix Fire Department and local EMS to facilitate pre-hospital cold water immersion. In the past year or so, many patients arrive at the hospital already cooled off by EMS or firefighters.

“That’s the hope: that they’ll get them cooled faster, and they’ll have better outcomes,” Stowell said. “We should start to cool patients as soon as possible, not waiting until they get to the hospital.”

Pre-hospital care providers can also assist with educational efforts. UMC hosted an EMS symposium last year, for instance, to enable EMS, firefighters and police officers to spread awareness across the region about how to stay safe during extreme heat.

5 | Focus on prevention, especially for vulnerable groups.

The best way to treat heat-related illness is to prevent it in the first place. Patel recommends encouraging patients to visit their primary care physicians for routine check-ups and generally take care of their health and nutrition. Additionally, people should know how and when to seek medical assistance and shelter during periods of extreme heat.

He also advocates for public education about monitoring and helping those who might not be able to remove themselves from hot environments, such as children, pets and older adults. “Keep an eye on those who are the most vulnerable,” Patel said.

Valleywise includes similar messaging in its public education efforts about watching out for those at higher risk, such as people with chronic conditions or multiple comorbidities.

“For example, if you have a relative with a chronic illness, check on them,” Stowell said. “Make sure their air conditioning is functioning.”

Another strategy that Valleywise uses is identifying at-risk patients early in the season. If someone comes to the hospital for treatment of a heat-related illness less severe than full heat stroke early in the summer, clinicians will not only treat their current condition but also offer information, such as a list of nearby cooling centers.

“We try to predict which patients will have challenges and provide them with resources,” Stowell explained.

6 | Collaborate with other healthcare providers.

After Valleywise successfully implemented cold water immersion, the health system connected with other providers to share the protocol through videos, diagrams and other resources to help them build their own cold water immersion processes.

“This is becoming more common,” Stowell said about extreme heat. “I just hope that we continue to recognize the importance of identifying these patients and treating them.”

For more information on strategies for creating resilient infrastructure and emergency operations to keep hospitals functional during natural disasters like extreme heat, join us for a Leadership Scan this Thursday, June 4 at noon Central time. During this virtual event, sponsored by Howden, hospital executives will share the proactive strategies, systems and cultures their organizations have built to address adversity and foster resiliency. Panelists will highlight the strategies they have employed to protect patients, staff and operations during not only extreme heat but also hurricanes, wildfires, floods and workplace violence. Don't miss out on the discussion — Save your spot now.