Abstract
BackgroundAdequate hospital staffing during and after a disaster is critical to meet increased health care demands and to ensure continuity of care and patient safety. However, when a disaster occurs, staff may become both victim and responder, decreasing their ability and willingness to report for work. This qualitative study assessed the personal and professional challenges that affected staff decisions to report to work following a natural disaster and examined the role of management in addressing staff needs and concerns.MethodsSemi-structured interviews were conducted with individuals who filled key management roles in the United States Department of Veterans Affairs New York Harbor Healthcare System’s response to Superstorm Sandy and during the facility’s initial recovery phase. All interviews were audio recorded and transcribed. Three major themes were identified: 1) Barriers to reporting (“Barriers”), 2) Facilitators to reporting (“Facilitators”), and 3) Responses to staff needs and concerns (“Responses”). Atlas.ti 7.1.6 software program was used for the management and analysis of the transcripts.ResultsResults indicated that staff encountered several barriers that impeded their ability to report to work at mobile vans at the temporarily nonoperational Manhattan campus or at two other VA facilities in Brooklyn and the Bronx in the initial post-Sandy period including transportation problems, personal property damage, and communication issues. In addition, we found evidence of facilitators to reporting as expressed through descriptions of professional duty. Our findings also revealed that management was aware of the challenges that staff was facing and made efforts to reduce barriers and accommodate staff affected by the storm.ConclusionsDuring and after a disaster event, hospital staff is often confronted with challenges that affect decisions to report for work and perform effectively under potentially harsh conditions. This study examined barriers and facilitators that hospital staff encountered following a major natural disaster from the management perspective. Insights gained from this study can be used to inform future disaster planning and preparedness efforts, and help ensure that there is adequate staffing to mount an effective response when a disaster occurs, and to recover from its aftermath.
Highlights
Adequate hospital staffing during and after a disaster is critical to meet increased health care demands and to ensure continuity of care and patient safety
Having adequate staffing during and after a disaster is critical to hospital surge capacity, i.e., a hospital’s ability to “expand quickly beyond normal services” to meet increased health care demands [1], and to ensure continuity of care and patient safety [2,3,4,5]
We examine the impact of personal and professional challenges on staff response and recovery efforts, using qualitative data from interviews with individuals who filled key management roles in the United States Department of Veterans Affairs (VA) during Superstorm Sandy (“Sandy”) - the most devastating natural disaster ever to hit NYC and the second-costliest hurricane in U.S history - which made landfall on the New York/New Jersey area on October 29, 2012 [19,20,21]
Summary
Adequate hospital staffing during and after a disaster is critical to meet increased health care demands and to ensure continuity of care and patient safety. When a disaster occurs, staff may become both victim and responder, decreasing their ability and willingness to report for work. Having adequate staffing during and after a disaster is critical to hospital surge capacity, i.e., a hospital’s ability to “expand quickly beyond normal services” to meet increased health care demands [1], and to ensure continuity of care and patient safety [2,3,4,5]. Additional factors shown to influence decisions to report include perceived emergency preparedness of the organization, perceived importance of one’s role during a disaster, and the strength of an individual’s sense of professional duty [11,12,13,14,15,16]. Prior experience with disasters has been shown to influence hospital evacuation and disaster response decisions [14, 17]
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