Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 4
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Ryan, Benjamin J. Franklin, Richard C. Burkle, Frederick M. Watt, Kerrianne Aitken, Peter Smith, Erin C. and Leggat, Peter 2016. Defining, Describing, and Categorizing Public Health Infrastructure Priorities for Tropical Cyclone, Flood, Storm, Tornado, and Tsunami-Related Disasters. Disaster Medicine and Public Health Preparedness, Vol. 10, Issue. 04, p. 598.

    Ricci, Karen A. Griffin, Anne R. Heslin, Kevin C. Kranke, Derrick and Dobalian, Aram 2015. Evacuate or Shelter-in-place? The Role of Corporate Memory and Political Environment in Hospital-evacuation Decision Making. Prehospital and Disaster Medicine, Vol. 30, Issue. 03, p. 233.

    Vugrin, Eric D. Verzi, Stephen J. Finley, Patrick D. Turnquist, Mark A. Griffin, Anne R. Ricci, Karen A. and Wyte-Lake, Tamar 2015. Modeling Evacuation of a Hospital without Electric Power. Prehospital and Disaster Medicine, Vol. 30, Issue. 03, p. 279.

    Adalja, Amesh A. Watson, Matthew Bouri, Nidhi Minton, Kathleen Morhard, Ryan C. and Toner, Eric S. 2014. Absorbing Citywide Patient Surge During Hurricane Sandy: A Case Study in Accommodating Multiple Hospital Evacuations. Annals of Emergency Medicine, Vol. 64, Issue. 1, p. 66.


Initial Management of Hospital Evacuations Caused by Hurricane Rita: A Systematic Investigation

  • Erin L. Downey (a1), Knox Andress (a2) and Carl H. Schultz (a3)
  • DOI:
  • Published online: 21 February 2013

Hurricanes remain a major threat to hospitals throughout the world. The authors attempted to identify the planning areas that impact hospital management of evacuations and the challenges faced when sheltering-in-place.


This observational, retrospective cohort study examined acute care institutions from one hospital system impacted by Hurricane Rita in 2005. Investigators used a standardized survey instrument and interview process, previously used in the hospital evacuation context, to examine hospitals’ initial internal situational awareness and subsequent decision making that resulted in evacuation due to Hurricane Rita. Participants from each hospital included representatives from senior leadership and clinical and nonclinical staff that comprised the Incident Management Team (IMT). The main measured outcomes were responses to 95 questions contained in the survey.


Seven of ten eligible hospitals participated in the study. All facilities evacuated the sickest patients first. The most significant factors prompting evacuation were the issuing of mandatory evacuation orders, storm dynamics (category, projected path, storm surge), and loss of regional communications. Hospitals that sheltered-in-place experienced staff shortages, interruptions to electrical power, and loss of water supplies. Three fully-evacuated institutions experienced understaffing of 40%-60%, and four hospitals sustained depressed staffing levels for over four weeks. Five hospitals lost electricity for a mean of 4.8 days (range .5-11 days). All facilities continued to receive patients to their Emergency Departments (EDs) while conducting their own evacuation.


Hospital EDs should plan for continuous patient arrival during evacuation. Emergency Operation Plans (EOPs) that anticipate challenges associated with evacuation will help to maximize initial decision making and management during a crisis situation. Hospitals that shelter-in-place face critical shortages and must provide independent patient care for prolonged periods.

DowneyEL, AndressK, SchultzCH. Initial Management of Hospital Evacuations Caused by Hurricane Rita: A Systematic Investigation. Prehosp Disaster Med. 2013;28(3):1-7.

Corresponding author
Correspondence: Erin L. Downey, MPH, ScD Tulane University School of Public Health and Tropical Medicine Department of Health Systems Management 1440 Canal Street New Orleans, LA 70112 USA E-mail
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

5.CS Chavez , B Binder . A hospital as victim and responder: the Sepulveda VA Medical Center and the Northridge Earthquake. J Emerg Med. 1996;14(4):445-454.

6.CH Schultz , KL Koenig , EK Noji . A medical disaster response to reduce immediate mortality following an earthquake. N Engl J Med. 1996;334(7):438-444.

7.E Sternberg , GC Lee , D Huard . Counting crises: US hospital evacuations, 1971-1999. Prehosp Disast Med. 2004;19(2):150-157.

17.CH Schultz , KL Koenig , E Auf der Heide . Benchmarking for hospital evacuation: a critical data collection tool. Prehosp Disast Med. 2005;20(5):331-342.

EL Downey , K Andress , CH Schultz . Initial management of hospital evacuations caused by Hurricane Rita: a systematic investigation. Prehosp Disaster Med. 2013;28(3):1-7

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *