Hospital evacuations due to disasters in the United States in the twenty-first century
DOI:
https://doi.org/10.5055/ajdm.2020.0351Keywords:
disasters, hospitals, hospital evacuations, natural disasters, man-made disasters, humankind disastersAbstract
Hospitals, which care for some of the most vulnerable individuals, have been impacted by disasters in the past and are likely to be affected by future disasters. Yet data on hospital evacuations are infrequent and outdated, at best. This goal of this study was to determine the characteristics and frequency of disasters in the United States that have resulted in hospital evacuations by an appraisal of the literature from 2000 to 2017. There were 158 hospital evacuations in the United States over 18 years. The states with the highest number of evacuations were Florida (N = 39), California (N = 30), and. Texas (N = 15). The reason for the evacuation was “natural” in 114 (72.2 percent), made-man “intentional” 14 (8.9 percent), and man-made “unintentional” or technological related to internal hospital infrastructure 30 (19 percent).The most common natural threats were hurricanes (N = 65) (57 percent), wildfires (N = 21) (18.4 percent), floods (N = 10) (8.8 percent), and storms (N = 8) (7 percent). Bombs/ bomb threats were the most common reason (N = 8) (57.1 percent) for a hospital evacuation resulting from a manmade intentional disaster, followed by armed gunman (N = 4) (28.6 percent). The most frequent infrastructure problems included hospital fires/smoke (N = 9) (30 percent), and chemical fumes (N = 7) (23.3 percent). Of those that reported the duration and number of evacuees, 30 percent of evacuations lasted over 24 h and the number of evacuees was >100 in over half (55.2 percent) the evacuations. This information regarding hospital evacuations should allow hospital administrators, disaster planners, and others to better prepare for disasters that result in the need for hospital evacuation.References
Landesman LY, Burke RV: Types of disasters and their consequence. In: Landesman LY, Burke RV (eds.): Landsman’s Public Health Management of Disasters, The Practice Guide. 4th ed. Chap 1. Washington, DC: Alpha Press, 2017: 1-31.
Gluckman WA, Weinstein ES, Conlon KM, et al.: Health care facility hazard and vulnerability analysis. In: Ciottone GR (ed.): Ciottone’s Disaster Medicine. 2nd ed. Chap 23. Cambridge, United Kingdom: Cambridge University Press, 2016: 136-142.
Katz R, Banaski JA, Jr: Natural disasters and humanitarian response. In: Katz R, Banaski JA, Jr. (eds): Essentials of Public Health Preparedness and Emergency Management. 2nd ed. Chap 8. Burlington, New Jercy: Jones & Bartlett Learning, 2019: 121-133.
Palmieri TL, Tessone A, Haik J: Burn disaster management: Planning and resource needs. In: Ciottone GR (ed.): Ciottone’s Disaster Medicine. 2nd ed. Chap 30. Cambridge, United Kingdom: Cambridge University Press, 2016: 491-499.
Aschkenasy M, Cranmer H: Global disaster response. In: Ciottone GR (ed.): Ciottone’s Disaster Medicine. 2nd ed. Chap 18. Cambridge, UK: Cambridge University Press, 2016: 105-110.
VandenBerg SL, Davidson SL, Scott B: Preparation for mass casualty incidents. Crit Care Nurs N Am. 2015; 27(2): 157-166.
Brusentsev V, Vroman W: Disasters in the United States: Frequency, costs, and compensation; 2017. Kalamazoo, Michigan: W.E. Upjohn Institute for Employment Research. Available at https://doi.org/10.17848/9780880995245. Accessed July 20, 2019.
Leraning J, Guha-Sapir D: Natural disasters, armed conflict, and public health. N Engl J Med. 2013; 369: 1836-1842.
Schultz CH, Koenig KL: Disaster preparedness. In: Walls RM, Hockberger RS, Gausche-Hill M, et al. (eds.): Rosen’s Emergency Medicine. 9th ed. Chap 192. Philadelphia, Pennsylvania: Elsevier, 2018: 2406-2417.
Wolf SJ, Bebarta VS, Bonnett CJ, et al.: Blast injuries. Lancet. 2009; 374: 405-415.
Roser M, Nagdy M, Ritchie H: Terrorism. Our World in Data. Available at https://ourworldindata.org/terrorism. Accessed July 20, 2019.
Bemelman M: Is there a threat towards medical institutions, and what to do? Chirurgia (Bucuresti). 2017: 112(5):627-629.
Smith ER, Shapiro GL, Callaway DW: Integrated response to terrorist attacks. In: Ciottone GR (ed): Ciottone’s Disaster Medicine. 2nd ed. Chap 66. Cambridge, United Kingdom: Cambridge University Press, 2016: 407-415.
Ardalan A, Schnelle DD: Introduction to natural disasters. In: Ciottone GR (ed): Ciottone’s Disaster Medicine. 2nd ed. Chap 93. Cambridge, United Kingdom: Cambridge University Press, 2016: 566-568.
Watts N, Amann M, Ayeb-Karlsson S, et al.: The Lancet countdown on health and climate change: From 25 years of inaction to a global transformation for public health. Lancet. 2018; 391(10120): 581-630.
Matthew RA, Agius JL: Climate change. In: Koenig KL, Schultz CH (eds): Koenig and Schultz’s Disaster Medicine Comprehensive Principles and Practice. 2nd ed. Chap 4. Cambridge, United Kingdom: Cambridge University Press, 2016: 52-58.
Ghazali DA, Guericolas M, Thys F, et al.: Climate change impacts on disaster and emergency medicine focusing on mitigation disruptive effects: An international perspective. Int J Environ Res Public Health. 2018; 15: 1379-1392.
Wuthisuthimethawee P: Disaster and climate change. In: Ciottone GR (ed): Ciottone’s Disaster Medicine. 2nd ed. Chap 8. Cambridge, United Kingdom: Cambridge University Press, 2016: 47-52.
Bowles DC, Butler CD, Morisetti N: Climate change, conflict and health. J R Soc Med. 2015; 108(10): 390-395.
Fast facts on U.S. hospitals: American Hospital Association, 2019. Available at https://www.aha.org/statistics/fast-facts-us-hospitals. Accessed July 20, 2019.
Mace SE, Doyle CJ, Askew K, et al.: Planning considerations for persons with access and functional needs in a disaster—Part 3: Medical CMIST and recommendations. AJDM. 2018; 13(3): 207-220.
Gray BH, Hebert K: After Katrina. Hospitals in Hurricane Katrina Challenges facing custodial institutions in a disaster. The Urban Institute. 2006. Available at https://www.urban.org/sites/default/files/publication/50896/411348-Hospitals-in-Hurricane-Katrina.PDF. Accessed July 20, 2019.
Kaiser Health News: Two New Orleans hospitals declared “unsalvageable” because of damage from Hurricane Katrina. Kaiser health news June 11, 2009. Available at https://khn.org/morningbreakout/dr00033005/. Accessed July 20, 2019.
Brevard SR, Weintraub SL, Aiken JB, et al.: Analysis of disaster response plans and the aftermath of Hurricane Katrina: Lessons from a level I trauma center. J Trauma. 2008; 65: 1126-1132.
Butuman V, Narang-Ghosh J: Stranded with the patients: A nephrologist’s remembrances of Hurricane Katrina. Am J Med Sci. 2006; 332(5): 255-258.
Check E. Left behind. Nature. 2005; 437: 467.
Leder HA, Rivera P: Six days in Charity Hospital: Two doctors’ ordeal in Hurricane Katrina. Compr Ther. 2006; 32(1): 2-9.
Teperman S: Hurricane Sandy and the greater New York health care system. J Trauma Acute Care. 2013; 749(6): 1401-1410.
Powell T, Hanfling D, Gostin LO: Emergency preparedness and public health the lessons of Hurricane Sandy. JAMA. 2012; 308(24): 2569-2570.
Rosenblatt K: Nurses fleeing fast moving Camp Fire scramble to save patients—and themselves. NBC News. November 11, 2018. Available at https://www.nbcnews.com/news/us-news/nurses-fleeingfast-moving-camp-fire-scramble-save-patients-themselves-n934961. Accessed July 20, 2019.
Shagets FW: Thoughts on the May 2011 Joplin, Missouri tornado. South Med J. 2013; 106(1):113-114.
Sternberg E, Lee GC, Huard D: Counting crises: US hospital evacuations 1971-1999. Prehospital Disaster Med. 2004; 19(2): 150-157.
Dhanoa T, Fuller H, Herechuk B, et al.: Response to a serious flood. The St. Joesph’s Healthcare experience. Healthcare Q. 2014; 17(4): 58-62.
Milstein A: Hospital responses to acute-onset disasters: a review. Prehospital and Disaster Med. 2000; 15(1): 32-45.
Burgess JL: Hospital evacuations due to hazardous materials incidents. Am J Emerg Med. 1999; 179(1): 50-52.
Hendrickson RG, Horowitz BZ: Disaster preparedness. In: Tintinalli JE, Stapczynski JS, Yealy DM, et al. (eds.). Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. 8th ed. New York: McGraw Hill; 2016, 23-29.
Grey BH, Hebert K: After Katrina. Hospitals in Hurricane Katrina. Challenges facing custodial institutions in a disaster. Washington, DC: The Urban Institute, 2006.
Faussett R, Fink S, Haag M: Hospitals pummeled by Hurricane Michael scramble to evacuate patients. The New York Times. October 11, 2018. Available at: https://www.nytimes.com/2018/10/11/us/hurricane-michael-hospitals-damage-florida.html. Accessed January 13, 2020.
Fink S: Hurricane Katrina: After the flood. The Guardian. 2014. Available at https://www.theguardian.com/world/2014/feb/07/hurricane-katrina-after-the-flood. Accessed January 13, 2020.
Mace SE, Sharieff G, Bern A, et al.: Pediatric issues in disaster management—Part 2: Evacuation centers and family separation/ reunification. Am J Disaster Med. 2010; 5(3): 149-161.
Fink S: The deadly choices at Memorial. The New York Times. 2009. Available at https://www.nytimes.com/2009/08/30/magazine/30doctors.html. Accessed January 13, 2020.
Downey, EL, Andress K, Schultz CH: External factors impacting hospital evacuations caused by Hurricane Rita: The role of situational awareness. Prehosp Disaster Med. 2013; 28(3): 264-271.
Butterfield S: Hospitals and hurricanes. Advice on disaster preparation from physicians who’ve been there. ACP Hospitalist. 2016. Available at https://acphospitalist.org/archives/2016/07/disaster-preparation.htm. Accessed January 13, 2020.
McGinty MD, Burke TA, Resnick B, et al.: Decision processes and determinants of hospital evacuation and shelter-in-place during Hurricane Sandy. J Pub Health Manage Pract. 2017: 23(1): 29-36.
Igarashi Y, Tagami T, Hagiwara J, et al.: Long-term outcomes of patients evacuated from hospitals near the Fukushima Daiichi Nuclear Power Plant after the Great East Japan earthquake. Plos One. 2018; 13(4): 1-12.
Horswell C, Hegstrom E: Exodus weighs heavily in death toll: 107. Evacuation: lessons come at a high cost: 107 lives. Houston Chronicle. 2005. Available at https://www.chron.com/news/hurricanes/article/Exodus-weighs-heavily-in-death-toll-107-1502590.php. Accessed January 13, 2020.
Associated Press: Bus carrying 24 elderly evacuees burns: 24 dead. Fire engulfs vehicle carrying seniors carrying seniors from Houston-area nursing home. NBCNews.com. 2005. Available at http://www.nbcnews.com/id/9449949/ns/us_news-katrina_the_long_road_back/t/bus-carrying-elderly-evacuees-burns-dead/#.Xh4OVn9KiJA. Accessed January 13, 2020.
Tanigawa K, Hosoi Y, Iwasaki Y, et al.: Loss of life after evacuation: Lessons learned from the Fukushima accident. Lancet. 2012; 379(9819): 889-891.
Dosa DM, Grossman N, Wetle T, et al.: To evacuate or not to evacuate: Lessons learned from Louisiana nursing home administrators following Hurricanes Katrina and Rita. J Am Med Dir Assoc. 2007; 8:142-149.
Maja-Schultz T, Swain B: Disabled adults in adult care facilities facing disasters in New York City: An aggregate assessment. Case Manag J. 2012; 13(2): 67-74.
Kawano T, Tsugawa Y, Nishiyama K, et al.: Shelter crowding and increased incidence of acute respiratory infection in evacuees following the Great Eastern Japan Earthquake and tsunami. Epidemiol Infect. 2016; 144(4): 787-795.
Kawano T, Hasegawa K, Hiroko W, et al.: Infectious disease frequency among evacuees at shelters after the Great Eastern Japan Earthquake and tsunami: A retrospective study. Disaster Med Public Health Prep. 2014; 8(1): 58-64.
American College of Emergency Physicians: Emergency Department Crowding: High Impact Solutions. Dallas, Texas, 2016. Available at https://www.acep.org/globalassets/sites/acep/media/crowding/empc_crowding-ip_092016.pdf. Accessed January 13, 2020.
Schafermeyer R, Asplin BR: Hospital and emergency department crowding in the United States. Emerg Med (Fremantle). 2003; 15(1): 22-27.
Statista: Number of natural disasters in the United States in 2017, by type. Available at https://www.statista.com/statistics/216819/natural-disasters-in-the-united-states/. Accessed July 20, 2019.
Facts + Statistics: U.S. catastrophes. Insurance Information Institute. Available at https://www.iii.org/fact-statistic/facts-statistics-us-catastrophes. Accessed July 20, 2019.
Sigma (Swiss Institute): Natural catastrophes and man-made disasters in 2017: A year of record breaking losses. Available at https://reliefweb.int/sites/reliefweb.int/files/resources/sigma1_2018_en.pdf. Accessed July 20, 2019.
NIFC: Wildland fire fatalities by year. Available at https://www.nifc.gov/safety/safety_documents/Fatalities-by-Year.pdf. Accessed July 20, 2019.
King DD, Beebe CE, Suchomel JL, et al.: A closer look at U.S. health care infrastructure. Health Facilities. 2018. Available at https://www.hfmmagazine.com/articles/3239-a-closer-look-at-infrastructure. Accessed July 20, 2019.
Kelen GD, Carlett CL, Kubit JG, et al.: Hospital-based shootings in the United States: 2000 to 2011. Ann Emerg Med. 2012; 60(6): 790-798.
Rege A: 17 fatal hospital shootings since 2002. Becker’s Hospital Review. 2018. Available at https://www.beckershospitalreview.com/population-health/17-fatal-hospital-shootings-since-2002.html. Accessed July 20, 2019.
Chicagotribune: Chicago attack among worst hospital shootings in U.S. in two decades. Available at http://www.chicagotribune.com/news/breaking/ct-fatal-hospital-shootings-in-us-20181120-story.html. Accessed July 20, 2019.
De Cauwer H, Somville F, Sabbe M, et al.: Hospitals: Soft targets for terrorism? Prehospital Disaster Med. 2017: 32(1): 94-100.
Minemeyer P: Joint commission issues update to its guidelines for emergency management. 2017. Fiercehealthcare. Available at https://www.fiercehealthcare.com/ambulatory-care/joint-commission-cms-rule-emergency-management-guidelines. Accessed Juanuary 13, 2020.
Hicks J, Glick R: A meta-analysis of hospital evacuations: Overcoming barriers to effective planning. J Healthcare Risk Manage. 2015; 34(3): 26-36.
Cocanour CS, Allen SJ, Mazabob J, et al.: Lessons learned from the evacuation or an urban teaching hospital. Arch Surg. 2002; 137(10): 1141-1145.
Evans M, Carlson J, Ban P, et al.: Left in the dark. Modern healthcare 2012; 42: 1/8.
Beam A: California hospitals question 2030 earthquake standards. Associated Press. 2019. Available at https://apnews.com/ee92215e72c04b41947d2be418a5c944. Accessed January 13, 2020.
Sexton C: Building improvements eyed in Florida to withstand hurricanes. The news Service of Florida. 2019. Available at https://www.wptv.com/news/state/building-improvements-eyed-in-floridato-withstand-hurricanes. Accessed January 13, 2020.
FEMA: Floodwall protected Our Lady of Lourdes Hospital during Tropical Storm Lee. 2011. Available at https://www.fema.gov/news-release/2011/10/13/floodwall-protected-our-lady-lourdes-hospital-during-tropical-storm-lee. Accessed January 13, 2020.
Published
How to Cite
Issue
Section
License
Copyright 2007-2023, Weston Medical Publishing, LLC
All Rights Reserved
