Quantifying the performance of healthcare facilities in disasters: A multi-hazard approach

In recent years, many disasters have occurred that resulted in damage to critical healthcare facilities. The 2011 Christchurch and 2010 Bío-Bío earthquakes, Hurricanes Sandy and Katrina, and tornadoes in Joplin, MO and Moore, OK all resulted in severe damage to local hospitals, putting great strain on the healthcare systems of these regions. In order to improve the resilience of facilities like these, decision makers first need ways to quantify their performance due to extreme loading from natural hazards, both predictively and retrospectively. This paper demonstrates a framework for quantifying and predicting the loss, recovery, and resilience of healthcare facilities in various natural-disaster scenarios. This multi-hazard, multi-disciplinary framework consists of three main parts: the use of historical data collected using a survey tool designed to assess the service loss and recovery of health-care facilities, fault-tree analysis for estimating service loss, and application of metrics used to quantify the resilience of individual healthcare facilities based on functional and capacity losses. The utility of the second and third parts of this framework is tested through a pair of case studies of hospitals subjected to an earthquake and a hurricane respectively. For each case study, the service losses and recovery of hospitals are hind-casted based on the physical damage sustained and available resources at the hospital. The predicted service losses are compared with empirical service losses collected from reconnaissance data, news media, and other sources. Resilience is also measured for both the empirical and predicted cases, and the results are compared for each facility.