Hospitals canceled elective surgery, stocked up on food and other supplies and prepared to move their most fragile patients as Tropical Storm Gustav approached the Gulf of Mexico on Thursday.

Officials said they were much better prepared for disaster than they were three years ago, when Hurricane Katrina hit.

At least 140 patients died in hospitals and nursing homes after Katrina made landfall on Aug. 29, 2005. Officials have said most were frail even before suffering the stress of sweltering heat caused by power outages when many backup generators located at ground level flooded. Some hospitals also lost their plumbing and had no running water or working toilets.

Supplies at the public hospital run by Louisiana State University included "many thousands of gallons of water" and lots of buckets in case the water system stops working, said Dr. Cathi Fontenot, medical director and interim CEO.

She said the hospital is sending about 50 psychiatric patients to the state mental hospital in Pineville, and about a dozen high-risk and intensive care patients to other hospitals.

But, like most of the hospitals in the area, it was keeping most patients and the doctors, nurses and other people needed to care for them. In a major change from previous hurricanes, none of the hospitals will take in staffers' families or pets if an evacuation is ordered.

"We have enough nonperishable food for 1,000 people -- that would include employees as well as providers and patients -- for up to a week," Fontenot said. The hospital also stocked up on medicine and 10,000 gallons of diesel.

The Ochsner Health System, which has five hospitals in the New Orleans area, is keeping the three largest open, spokeswoman Katherine Voss said. Those three hospitals held just under 590 patients Thursday, with 48 in the other two.

The system also asked for blood donations Thursday and Friday, because donations usually drop before a hurricane and stay low for a while afterward.

Some of the hospitals already had wells for drinking and cooling water; Children's Hospital New Orleans and Tulane University Hospital & Clinic added them after Katrina.

Children's Hospital also added a helipad and more underground diesel tanks, spokesman Brian Landry said. "We have 80,000 gallons of diesel in the ground" -- enough to power backup generators for 28 days, he said.

Tulane's hospital, which flooded in Katrina, now has better flood protection, bigger fuel tanks and water-cooled generators housed in waterproof enclosures, CEO and Dr. Bob Lynch said. Other generators are on the parking garage's top floor to be safe from flooding, he said.

So many people were trying to use their phones at once after Hurricane Katrina that voice communication was almost impossible. Some doctors used text messaging to get out word of the city's medical woes.

Tulane now has satellite, land, radio and cellular phone systems, Lynch said. "We've got a lot of ways to communicate. We won't be cut off."

East Jefferson General Hospital was built "coming out of Hurricane Betsy" in 1965, so the emergency department and many other vital areas are on the second floor or higher, spokesman Keith Darcey said. But he said the buildings are better fortified and some electrical systems are higher than they had been.

Most of the hospitals canceled elective surgery.

Touro Infirmary hadn't done so at midday Thursday, but many patients had canceled on their own, spokeswoman Christine Albert said. "I think people are evacuating and taking it really seriously" -- at least making serious plans, she said.