Evacuating a Tertiary Care Hospital before Superstorm Sandy

The past 30 years have brought a steady increase in the number of hospitals and nursing homes that have evacuated because of hurricanes, tornadoes, and floods. The human and financial costs of a poorly executed evacuation are potentially significant. Nevertheless, there is limited research within and outside the US Department of Veterans Affairs (VA) on this topic. We used an in-depth, case study approach to examine the successful, pre-emptive evacuations of the New York Harbor Healthcare System (NYHHS) Manhattan VA hospital in anticipation of Hurricane Irene and “Superstorm” Sandy. The evacuation of the NYHHS Manhattan VA hospital provided a unique opportunity to closely examine the process of evacuating a large, urban, tertiary care medical center due to two separate events.

We conducted 29 key informant interviews with hospital and regional VA staff who participated in the evacuation, or who responded to the incoming surge of patients at other VA hospitals within the area. Interviews identified factors that influenced decisions to evacuate before both hurricanes; we also examined how disaster preparedness planning and exercises impacted the two evacuations. In addition, we created a “process map” outlining the operational components of hospital evacuation, and identified key decision points. The findinhomelessgs from this project have broad applicability beyond VA facilities.

With more than 150 hospitals across the nation, the possibility of a disaster forcing the closure of a VA hospital is a potential risk every year. Since 2005, two VA hospitals have been destroyed, and a third VA hospital was rendered unusable for many months. We apply the knowledge gained from this study to our work on evacuation for both VA and non-VA organizations.