Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-25T06:57:54.212Z Has data issue: false hasContentIssue false

New York City's Healthcare Transportation during a Disaster: A Preparedness Framework for a Wicked Problem

Published online by Cambridge University Press:  28 June 2012

Ernest Sternberg*
Affiliation:
Department of Urban and Regional Planning, University at Buffalo, State University of New York, Buffalo, New York, USA
George C. Lee
Affiliation:
Department of Civil, Structural, and Environmental Engineering, University at Buffalo, State University of New York, Buffalo, New York, USA
*
Hayes Hall, South Campus Buffalo, NY 14214USA E-mail: [email protected]

Abstract

During a disaster, victims with varied morbidities are located at incident sites, while healthcare facilities with varied healthcare resources are distributed elsewhere. Transportation serves an essential equilibrating role: it helps balance the patients' need for care with the supply of care. Studying the special case of New York City, this article sets out the healthcare transportation components as: (1) incident morbidity; (2) transportation assets; and (3) healthcare capacity. The relationship between these three components raises an assignment problem: the management of healthcare transportation within a dynamic and partly unpredictable incident-transportation-healthcare nexus, under urban disruption. While the routine dispatch problem can be tackled through better geographic allocation software and technical algorithms, the disaster assignment problem must be confronted through real-time, mutual adjustment between institutions. This article outlines institutional alternatives for managing the assignment problem and calls for further research on the merits of alternative institutional models.

Type
Special Report
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. New York City Office of Emergency Management : New York City Comprehensive Mitigation Plan. New York, 2004.Google Scholar
2. McKinsey and Company: Increasing FDNY's Preparedness. New York, Fire Deptartment of the City of New York,2002.Google Scholar
3. Aufder Heide, E: The importance of evidence-based disaster planning. Ann Emerg Med 2006;47(1):3449.CrossRefGoogle Scholar
4. Health Systems Research: Altered Standards of Care in Mass Casualty Events. US Department of Health and Human Services, Agency for Healthcare Research and Quality, 2005.Google Scholar
5. Barbera, JA, Macintyre, AG, DeAtley, CA: Discussion Paper 2001-15. In Howitt, A, Pangi, RL Countering Terrorism: Dimensions of Preparedness. Cambridge, MA: MIT Press, 2003, pp 283298.Google Scholar
6. American Hospital Association: Cracks in the Foundation: Averting a Crisis in America's Hospitals. Chicago: American Hospital Association, 2002.Google Scholar
7. Burt, CW, McCaig, LF: Staffing, Capacity, and Ambulance Diversion in Emergency Departments: United States, 2003-04. Advance Data from Vital and Health Statistics 2006(376): 112.Google Scholar
8. Arendt, LA, Hess, DB: Hospital Decision Making in the Wake of Katrina: The Case of New Orleans, in Engineering and Organizational Issues Before, During and After Hurricane Katrina. 2006, Buffalo: MCEER, 2006Google Scholar
9. United States, Government Accountability Office, Bascetta CA: Disaster Preparedness: Limitations in Federal Evacuation Assistance for Health Facilities Should be Addressed: Report to Congressional Committees. Washington, DC: Government Accountability Office, 2006.Google Scholar
10. Rodriguez, H, Aguirre, BE: Hurricane Katrina and the healthcare infrastructure: A focus on disaster preparedness, response, and resiliency. Front Health Serv Manag 2006; 23(1):1324.CrossRefGoogle ScholarPubMed
11. Sternberg, E, Lee, GC, Huard, D: Counting Crises: US Hospital Evacuations 1971-1999. Prehospital Disast Med 2004;19(2):150157.CrossRefGoogle ScholarPubMed
12. Bravata, DM, McDonald, K, Owens, DK: Regionalization of Bioterrorism Pre pa redness and Response. In Evidence Report/Technology Assessment. Rockville: Agency for Health Care Research and Quality, 2004.Google Scholar
13. National Cooperative Highway Research Program, et al. : Surface Transportation Security. Volume 10, A Guide to Transportation's Role in Public Health Disasters. Washington, D.C.: Transportation Research Board. 1 v. 2006.Google Scholar
14. Houston, N: Common Issues in Emergency Transportation Operations Preapedness and Response: Results of the FHWA Workshop Series. Washington, DC: US Department of Transportation, Federal Highway Administration, 2007.Google Scholar
15. Hess, DB: Security on buses and trains: Guarding the nation's public transit systems against terrorist attacks. Journal of Security Education 2006;1(4):119132.CrossRefGoogle Scholar
16. Sternberg, E: The urban region as locus of security problems: Toward rese arch and education to safe guard New York and other urban areas from terro rism and disaster. Journal of Applied Security Research 2007;3(1):1124.Google Scholar
17. New York City Department of Health and Mental Hygiene: Pandemic Influenza Preparedness and Response Plan. New York: NYC DOHMH, 2006.Google Scholar
18. Bradt, DA: Site management of health issues in the 2001 World Trade Center disaster. Acad Emerg Med 2003;10(6):650660.CrossRefGoogle ScholarPubMed
19. Hogan, DE, Waeckele, JF, Dire, DJ, Lillibridge, SR: Emergency department impact of the Oklahoma City terrorist bombing. Ann Emerg Med 1999;34(2):160167.CrossRefGoogle ScholarPubMed
20. Smoak, BL, Geiling, JA: Mass Casulaty Events: Lessons Learned. In: Roy, MJ (ed) Physician's Guide to Terrorist Attack. Totowa: Humana Press, 2004, pp 319.Google Scholar
21. Centers for Disease Control and Prevention, N.C.f.I.P.a.C., Division of Injury Response: In a Moment's Notice: Surge Capacity for Terrorist Bombings—Challenges and Proposed Solutions. Atlanta: US Department of Health and Human Services, 2007.Google Scholar
22. US Army Soldier and Biological Chemical Command: Biological Warfare Improved Response Program. n.d. (2002).Google Scholar
23. Bolton, PA: Managing Pedestrians During Evacuation of Metropolitan Areas 2007, US Department of Transportation, Federal Highway Administration.Google Scholar
24. Ercolano, J: Pedestrian disaster preparedness and mass evacuations on foot. The Bike/Ped Professional 2007(2):2.Google Scholar
25. Tierney, KJ, Lindell, MK, Perry, RW: Facing the Unex pected: Disaster Preparedness and Response in the United States. Washington, DC: Joseph Henry Press, 2001, pp xi–306.Google Scholar
26. Transit Cooperative Research Program and National Cooperative Highway Research Program: Guidleines for Transportation Emergency Exercises. Washington, DC: Transportation Research Board, 2006.Google Scholar
27. City of Oklahoma City Document Management Team: Alfred P. Murrah Federal Building Bombing April 19, 1995. Oklahoma City: Fire Protection Publications, 1996.Google Scholar
28. Powell, M: Project Pediatric Preparedness Final Report. Oklahoma City: Terrorism Research Center and Emergency Medical Services Authority, 2005.Google Scholar
29. Steinfeld, E: Evacuation of people with disabilities. Journal of Security Education 2006;1(4):107118.CrossRefGoogle Scholar
30. Continuum Health Partners: Evacuation Planning for Hospitals, Draft Document. New York: New York City Department of Health and Mental Hygiene, 2006.Google Scholar
31. The Institute for Crisis, Disaster and Risk Management, at George Washington University: Emergency Management Principles and Practices for Healthcare Systems. Washington DC: Veterans Health Administration, US Department of Veterans Affairs, 2006.Google Scholar
32. Sternberg, E: Planning for resilience in hospital internal disaster. Prehospital Disast Med 2003;18(4):291300.CrossRefGoogle ScholarPubMed
33. Committee on the Future of Emergency Care in the United States Health System: Emergency Medical Services at the Crossroads. Washington, DC: National Academies Press, 2007.Google Scholar
34. Fire Department of the City of New York: FDNY Strategic Plan 2007–2008. New York: Fire Department of the City of New York, 2007.Google Scholar
35. Hanfling, D, Mayer, TA: Interfacility Transport of Patients from the Urgent Care Setting. In: Edwards, T, Mayer, TA, (eds), Ugent Care Medicine, New York: McGraw-Hill, 2002, 2938.Google Scholar
36. Philips, SJ, Knebel, A (eds): Mass Medical Care with Scarce Resources: A Community Planning Guide. Rockville: Agency for Healthcare Research and Quality, 2007, xiii–166.Google Scholar
37. Post, Buckley, Schuh, and Jernigan Inc: New York Hurricane Evacuation (restudy) Transportation Analysis for New York City: Final Summary Report. NY: US Army Corps of Engineers, 2006.Google Scholar
38. Joint Commission Resources: Infection Issues in the Environment of Care. Oakbrook Terrace: Joint Commission Resources, 2005.Google Scholar
39. New York State Workgroup on Ventilator Allocation in an Influenza Pandemic: All ocation of Ventilators in an Influenza Pandemic: Planning Document—Draft for Public Comment. Albany: New York State Department of Health/New York State Task Force on Life & the Law, 2007.Google Scholar
40. American Medical Association and American Public Health Association: Improving Health System Preparedness for Terrorism and Mass Casualty Events: Recommendations for Action. Chicago and New Orleans: AMA/APHA Linkages Leadership Summit, 2006.Google Scholar
41. Greater New York Hospital Association: Testimony of the Greater New York Hospital Association on New York City Hospitals in the Blackout of 2003: Lessons Learned. New York: New York City Council Committee on Health, 2003Google Scholar
42. Joint Commission on Accreditation of Healthcare Organizations: Surge Hospitals: Providing Safe Care in Emergencies. [Location not specified] Joint Commission Resources, 2006Google Scholar
43. Rittel, HWJ, Webber, MM: Dilemmas in a general theory of planning. Policy Sciences 1973;4(2):155169.CrossRefGoogle Scholar