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Hospital Evacuation and Shelter-in-Place: Who Is Responsible for Decision-Making?

Published online by Cambridge University Press:  20 May 2016

Meghan D. McGinty Open the ORCID record for Meghan D. McGinty [Opens in a new window] ,
Thomas A. Burke ,
Daniel J. Barnett ,
Katherine C. Smith ,
Beth Resnick  and
Lainie Rutkow
Meghan D. McGinty*
Affiliation:
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Thomas A. Burke
Affiliation:
US Environmental Protection Agency, Washington, DC
Daniel J. Barnett
Affiliation:
Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Katherine C. Smith
Affiliation:
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Beth Resnick
Affiliation:
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Lainie Rutkow
Affiliation:
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
*
Correspondence and reprint requests to Meghan D. McGinty, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Room 429, Baltimore, MD 21205 (e-mail: mmcginty@jhu.edu)
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Abstract

Objective

During natural disasters, hospital evacuation may be necessary to ensure patient safety and care. We aimed to examine perceptions of stakeholders involved in these decisions throughout the Mid-Atlantic region of the United States during Hurricane Sandy in October 2012.

Methods

Semistructured interviews were conducted from March 2014 to February 2015 to characterize stakeholders’ perceptions about authority and responsibility for acute care hospital evacuation/shelter-in-place decision-making in Delaware, Maryland, New Jersey, and New York during Hurricane Sandy. Interviews were recorded, transcribed, and thematically analyzed using a framework approach.

Results

We interviewed 42 individuals from 32 organizations. Hospital executives from all states reported having authority and responsibility for evacuation/shelter-in-place decision-making. In New York and Maryland, government officials stated that they could order hospital evacuation, whereas officials in Delaware and New Jersey said the government lacked enforcement capacity and therefore could not mandate evacuation.

Conclusions

Among government officials, perceived authority for hospital evacuation/shelter-in-place decision-making was viewed as a prerequisite to ordering evacuation. When both hospital executives and government officials perceive themselves to possess decision-making authority, there is the potential for inaction. Future work should examine whether a single entity bearing ultimate responsibility or regional emergency response coalitions would improve decision-making. (Disaster Med Public Health Preparedness. 2016;10:320–324)

Keywords

hospital evacuationhospital shelter-in-placeorganizational decision-makingemergency preparednessdisasters
Type
Brief Reports
Information
Disaster Medicine and Public Health Preparedness , Volume 10 , Special Issue 3: Superstorm Sandy , June 2016 , pp. 320 - 324
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2016 

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Footnotes

Thomas A. Burke contributed to this work prior to his tenure at the US Environmental Protection Agency (EPA). The views expressed are his own and do not necessarily reflect the policy positions of the EPA. While working on this research, Thomas A. Burke was affiliated with the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

References

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