Resilience of Healthcare in Disasters: a Systems Approach
Jacques, Caitlin C.
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Healthcare systems have been identified worldwide as critical infrastructure which must continue to function in order for communities to survive natural disasters such as earthquakes, floods, and hurricanes. In a time in which human exposure to natural hazards is increasing, it is therefore crucial that methods be found by which the performance of healthcare in disasters can be clearly evaluated, in a manner that is meaningful to both engineers and stakeholders within the healthcare system. This dissertation presents efforts to develop tools to address this need. It proposes several new methods for examining healthcare performance in terms of resilience, all of which combine expertise from engineering and healthcare disciplines, and demonstrates their application to healthcare facilities in the United States and New Zealand. These tools address the problem of examining the resilience of healthcare systems and facilities in several different ways. The first tool, a new resilience metric which defines the performance of healthcare facilities in terms of the functionality of critical healthcare services, provides a clear system of measurement by which resilience can discussed and compared. The second tool, a detailed fault tree analysis of healthcare services, allows functionality to be accessed in terms of the resources needed to create surge capacity: staff, supplies and equipment, and infrastructure and the built environment. A standardized method for developing this fault tree analysis using guided interviews with healthcare experts is also proposed. The third and final tool, a standardized survey and analysis methodology, allows for the collection of the full data set needed to character a healthcare system at a regional level, for future use in modeling and simulation.