"The Department of Homeland Security lists 19 groups of sectors as Critical Infrastructure Key Resources (CIKR) such as Water, Emergency Services, and Healthcare and Public Health (HPH). Protection of those interdependent sectors is of vital interest for the country in the event of disaster. Hospital infrastructure systems are basic HPH elements of the CIKR. Local hospitals deliver essential routine healthcare services as well as serving as frontline responders during non-routine disaster events. Currently, hospitals generally extend their routine healthcare activities for external community disaster preparedness and response services. This extension takes the form of coordination with other responders within the community. Under this condition, determining the hospital's role in the community disaster response is critical. This thesis evaluates the current external performance of a hospital in response to a community disaster and the degree of integration of hospitals with the community system during and after a disaster. Case studies of two hospitals in Western New York State, one a rural institution sample and the other an urban institution sample, are conducted with data collected through program review and structured interviews of the hospitals' staff and the Emergency Management Officers of each community and analyzed using context analysis. The analysis shows that rural hospitals are more critical to community recovery than urban centers; communication both internal and external to the hospital is key to effectiveness; and emergency planning is actually only a small part of response."--Abstract.

Health systems and assets are a large part of the critical infrastructure of any community and are vital not only for the safety and well-being of its citizens, but also for the economic vitality, quality of life, and livelihood of the entire community. As part of its ongoing mission to foster dialogue among stakeholders and to confront the challenges inherent in ensuring the nation's health security, the Institute of Medicine (IOM) Forum on Medical and Public Health Preparedness for Catastrophic Events sponsored a town hall session at the 2012 Public Health Preparedness Summit. This event took place February 21-24 in Anaheim, California. In this session sponsored by the IOM, the focus of discussion was sustaining health care delivery beyond the initial response to a disaster and facilitating the full long-term recovery of the local health care delivery systems. Many elements required for recovery are also fundamental to the day-to-day operations of these systems. Investing in improved health care delivery systems, both financially and through collaborative capacity building, can enhance economic development and growth before a disaster, and also prove instrumental in sustaining services and recovering after a disaster. Post-Incident Recovery Considerations of the Health Care Service Delivery Infrastructure serves as a summary of the session and explains the value of regional capacity building; the importance of interagency, intergovernmental, and public-private collaboration; and the significant role that health care coalitions can play in ensuring resilient communities and national health security.

This book highlights the vulnerability of healthcare buildings in the context of climate change-triggered extreme weather events (EWEs) and the case for mitigation. With a concise discussion on climate change and its consequences in the form of such events, a cost model and equations that register losses and help quantify them are then presented. The model can be used to estimate the significant potential loss that might occur during an EWE and help healthcare facilities prepare for them. The book analyses cases of major EWEs in India over the last two decades and collates the data available into various categories. Through this research the authors have developed a framework which assists healthcare facilities with a detailed calculation of value losses, both tangible and intangible. The framework can be used to assess the impacts on healthcare buildings in terms of disruption of services so that appropriate decisions related to the resilience in healthcare planning can be taken into consideration. Thus, the book is useful for directing planning and design processes aimed at continuity of service and building resilience to perform in the face of natural disaster and extreme weather. The purpose of this book is to prompt facilities planners and healthcare facilities to prepare to respond to EWEs through the planning and design process in a rational manner. Built infrastructure professionals such as architects and engineers, policy makers, and academics with an interest in disasters, risk and climate change will all find this book to be key reading.

In the devastation that follows a major disaster, there is a need for multiple sectors to unite and devote new resources to support the rebuilding of infrastructure, the provision of health and social services, the restoration of care delivery systems, and other critical recovery needs. In some cases, billions of dollars from public, private and charitable sources are invested to help communities recover. National rhetoric often characterizes these efforts as a "return to normal." But for many American communities, pre-disaster conditions are far from optimal. Large segments of the U.S. population suffer from preventable health problems, experience inequitable access to services, and rely on overburdened health systems. A return to pre-event conditions in such cases may be short-sighted given the high costs - both economic and social - of poor health. Instead, it is important to understand that the disaster recovery process offers a series of unique and valuable opportunities to improve on the status quo. Capitalizing on these opportunities can advance the long-term health, resilience, and sustainability of communities - thereby better preparing them for future challenges. Healthy, Resilient, and Sustainable Communities After Disasters identifies and recommends recovery practices and novel programs most likely to impact overall community public health and contribute to resiliency for future incidents. This book makes the case that disaster recovery should be guided by a healthy community vision, where health considerations are integrated into all aspects of recovery planning before and after a disaster, and funding streams are leveraged in a coordinated manner and applied to health improvement priorities in order to meet human recovery needs and create healthy built and natural environments. The conceptual framework presented in Healthy, Resilient, and Sustainable Communities After Disasters lays the groundwork to achieve this goal and provides operational guidance for multiple sectors involved in community planning and disaster recovery. Healthy, Resilient, and Sustainable Communities After Disasters calls for actions at multiple levels to facilitate recovery strategies that optimize community health. With a shared healthy community vision, strategic planning that prioritizes health, and coordinated implementation, disaster recovery can result in a communities that are healthier, more livable places for current and future generations to grow and thrive - communities that are better prepared for future adversities.

Today our emergency care system faces an epidemic of crowded emergency departments, patients boarding in hallways waiting to be admitted, and daily ambulance diversions. Hospital-Based Emergency Care addresses the difficulty of balancing the roles of hospital-based emergency and trauma care, not simply urgent and lifesaving care, but also safety net care for uninsured patients, public health surveillance, disaster preparation, and adjunct care in the face of increasing patient volume and limited resources. This new book considers the multiple aspects to the emergency care system in the United States by exploring its strengths, limitations, and future challenges. The wide range of issues covered includes: • The role and impact of the emergency department within the larger hospital and health care system. • Patient flow and information technology. • Workforce issues across multiple disciplines. • Patient safety and the quality and efficiency of emergency care services. • Basic, clinical, and health services research relevant to emergency care. • Special challenges of emergency care in rural settings. Hospital-Based Emergency Care is one of three books in the Future of Emergency Care series. This book will be of particular interest to emergency care providers, professional organizations, and policy makers looking to address the deficiencies in emergency care systems.

Disasters and public health emergencies can stress health care systems to the breaking point and disrupt delivery of vital medical services. During such crises, hospitals and long-term care facilities may be without power; trained staff, ambulances, medical supplies and beds could be in short supply; and alternate care facilities may need to be used. Planning for these situations is necessary to provide the best possible health care during a crisis and, if needed, equitably allocate scarce resources. Crisis Standards of Care: A Toolkit for Indicators and Triggers examines indicators and triggers that guide the implementation of crisis standards of care and provides a discussion toolkit to help stakeholders establish indicators and triggers for their own communities. Together, indicators and triggers help guide operational decision making about providing care during public health and medical emergencies and disasters. Indicators and triggers represent the information and actions taken at specific thresholds that guide incident recognition, response, and recovery. This report discusses indicators and triggers for both a slow onset scenario, such as pandemic influenza, and a no-notice scenario, such as an earthquake. Crisis Standards of Care features discussion toolkits customized to help various stakeholders develop indicators and triggers for their own organizations, agencies, and jurisdictions. The toolkit contains scenarios, key questions, and examples of indicators, triggers, and tactics to help promote discussion. In addition to common elements designed to facilitate integrated planning, the toolkit contains chapters specifically customized for emergency management, public health, emergency medical services, hospital and acute care, and out-of-hospital care.

"This new volume includes Individual Concepts and Events sections that provide information on the general approach to disaster medicine and practical information on specific disasters. You'll also find an exhaustive list of chapters on the conceivable chemical and biologic weapons known today, as well as strategies for the management of future events, or possible scenarios, for which there is no precedent."--BOOK JACKET.