For hospitals, building resilience around climate change isn’t optional | ViVE 2025

Nashville – Even though he leads an academic medical center that saves lives and engages in critical research, John Couris says with a laugh that his health system may be famous for one feature.

‘We’ve become known for our AquaFence,” says Couris, the president and CEO of Tampa General Hospital.

The hospital utilizes the AquaFence during hurricanes, which are all too common in Florida. The fence is designed to withstand up to 15 feet of storm surge.

“The AquaFence is a great example of innovation,” Couris said, adding. “It's literally and figuratively a moat around our hospitals.”

Couris spoke about planning for weather emergencies during the ViVE digital health conference. He talked about the growing dangers of climate change, and how hospitals and health systems must engage in long-term plans to deal with growing hazards.

“You have to build resiliency around climate change, and what we decided to do was to build a fortress on the water, because we have no other choice,” Couris said.

Couris also said that climate change isn’t just a worry for hospitals on the coast. He pointed to the devastating flooding in western North Carolina from the remnants of Hurricane Helene last fall.

“A lot of people say, ‘Well, yeah, but I don't have to worry about climate change because I'm not on the water.’ Well, ask the poor people from North Carolina who lived in the mountains and their lives, hospitals, businesses, homes, ruined. They’re not on the water. They’re in the mountains.”

“We all have to deal with climate change, and we all have to figure out ways to coexist with what's happening around us with Mother Nature,” he said.

After his presentation, Couris spoke with Chief Healthcare Executive® about preparing for more potent storms and weather events.

• Read more: Tampa General CEO shares advice on planning for emergencies

Even with the development of its AquaFence, Couris said the system is looking to explore ways to contend with even greater storm surge. He said he’s meeting soon with the firm in Norway that developed the fence to discuss the possibility of modifying the fence to withstand storm surges of 20 feet or more.

“Business continuity is incredibly important,” Couris told Chief Healthcare Executive. “Patient safety is the most important thing. Team member, physician safety, is equally as important as patient safety. The fence keeps our business going. It keeps our ability to provide care going. It protects our patients and our team members. So, it's really important. It's not just a fence, it's a strategy.”

Tampa General’s main campus sits on Davis Island in Tampa Bay, and Couris noted that the hospital was built more than a century ago. For those wondering why Tampa General doesn’t simply move its flagship hospital campus, Couris said building a new hospital elsewhere would cost $4 billion to $5 billion. “It’s not realistic,” he said.

A few years ago, the hospital built a power station, situating it more than 30 feet above sea level. He says the $53 million investment in the power station was necessary to ensure resilience, and notes that the plant would cost about $75 million if it had to be constructed today.

“This stuff's expensive,” he said. “But you know what's even more expensive? Not doing something. If you imagine your business getting completely shut down, or a chunk of your business, it would be catastrophic to the people that you care for, and the people that you employ that rely on you for their livelihoods, right? There's a lot at stake.”

Couris urged the audience of healthcare leaders to recognize the gravity of climate change and the need to plan appropriately.

“I tell people, if you think the work that we're talking about is a ‘nice to have’ and not important, not strategic, in today's world with the global warming challenges that we're having, you're wrong. You're wrong. It should be on the table and something every health system and every business should be thinking about strategically. Not because we just have to do it, but it's strategic,” Couris said.

• Read more: Most clinicians want hospitals to act on climate change

Couris said he’s especially worried about the rapid intensification of storms. In Florida, he said it’s been startling to see storms that are Category 1 hurricanes evolve into Category 5 hurricanes within just a few days.

“I've never seen that,” he said. “That's scary, that's worrisome.”

“That's why we have to learn, not just as a healthcare industry, but as a society. We have to learn how to co-exist. We have to learn how to build real resiliency in our infrastructure … how to change processes and systems to respond and recover from the storms. It’s startling.”

• Read more: From hurricanes to wildfires, hospitals must plan for environmental disasters