Optimization-based decision support to assist in logistics planning for hospital evacuations


  • Roger Glick MS, MBA
  • Douglas R. Bish, PhD
  • Esra Agca, PhD(c)




hospital evacuation planning, emergency response logistics, optimization, decision support


The evacuation of the hospital is a very complex process and evacuation planning is an important part of a hospital’s emergency management plan. There are numerous factors that affect the evacuation plan including the nature of threat, availability of resources and staff, the characteristics of the evacuee population, and risk to patients and staff. The safety and health of patients is of fundamental importance, but safely moving patients to alternative care facilities while under threat is a very challenging task. This article describes the logistical issues and complexities involved in planning and execution of hospital evacuations. Furthermore, this article provides examples of how optimization-based decision support tools can help evacuation planners to better plan for complex evacuations by providing real-world solutions to various evacuation scenarios.

Author Biographies

Roger Glick MS, MBA

Carilion Clinic, Roanoke, Virginia; Department of Basic Science, Virginia Tech Carilion School of Medicine, Roanoke, Virginia; Department of Pediatrics, Virginia Tech Carilion School of Medicine, Roanoke, Virginia

Douglas R. Bish, PhD

Grado Department of Industrial and Systems Engineering (0118), Virginia Tech, Blacksburg, Virginia

Esra Agca, PhD(c)

Grado Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, Virginia


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

Schultz CH, Koenig KL, Lewis RJ: Implications of hospital evacuation after the Northridge, California, earthquake. N Engl J Med. 2003; 348(14): 1349-1355.

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

Government Accountability Office: Disaster Preparedness Limitations in Federal Evacuation Assistance for Health Facilities Should be Addressed. Available at http://www.gao.gov/new.items/d06826.pdf. Accessed February 15, 2012.

Bagaria J, Heggie C, Abrahams J, et al.: Evacuation and sheltering of hospitals in emergencies: A review of international experience. Prehosp Disaster Med. 2009; 24(5): 461-467.

Gray BH, Hebert K: Hospitals in Hurricane Katrina: Challenges facing custodial institutions in a disaster. J Health Care Poor Underserved. 2007; 18(2): 283-298.

Sternberg E, Lee GC: New York City’s healthcare transportation during disaster: A preparedness framework for a wicked problem. Prehosp Disaster Med. 2009; 24(2): 95-107.

Maxwell C: Hospital organizational response to the nuclear accident at Three Mile Island: Implications for future-oriented disaster planning. Am J Publ Health. 1982; 72(3): 275-279.

Cocanour CS, Allen SJ, Mazabob J, et al.: Lessons learned from the evacuation of an urban teaching hospital. Arch Surg. 2002; 137(10): 1141-1145.

Han LD, Yuan F, Urbanik T: What is an effective evacuation operation? J Urban Plan Dev. 2007; 133(1): 3-8.

Tayfur E, Taaffe K: A model for allocating resources during hospital evacuations. Comput Ind Eng. 2009; 57(4): 1313-1323.

Bish DR, Agca E, Glick R: Decision support for hospital evacuation and emergency response. Ann Oper Res. 2011 (in press), DOI: 10.1007/s10479-011-0943-y.



How to Cite

Glick MS, MBA, R., D. R. Bish, PhD, and E. Agca, PhD(c). “Optimization-Based Decision Support to Assist in Logistics Planning for Hospital Evacuations”. Journal of Emergency Management, vol. 11, no. 4, Feb. 2017, pp. 261-70, doi:10.5055/jem.2013.0142.