Rebuilding Emergency Care After Hurricane Sandy

Abstract

A freestanding, 911-receiving emergency department was implemented at Bellevue Hospital Center during the recovery efforts after Hurricane Sandy to compensate for the increased volume experienced at nearby hospitals. Because inpatient services at several hospitals remained closed for months, emergency volume increased significantly. Thus, in collaboration with the New York State Department of Health and other partners, the Health and Hospitals Corporation and Bellevue Hospital Center opened a freestanding emergency department without on-site inpatient care. The successful operation of this facility hinged on key partnerships with emergency medical services and nearby hospitals. Also essential was the establishment of an emergency critical care ward and a system to monitor emergency department utilization at affected hospitals. The results of this experience, we believe, can provide a model for future efforts to rebuild emergency care capacity after a natural disaster such as Hurricane Sandy. (Disaster Med Public Health Preparedness. 2014;0:1-4).

Redistribution of Emergency Department Patients After Disaster-Related Closures of a Public Versus Private Hospital in New York City

“…However, from prior studies, we found that the closest ED to the hospitals that closed (Beth Israel) was limited in its capacity to serve the overwhelming needs of displaced patients, and some of those patients who were not able to receive care at the nearest facility were forced to travel further for care. 7,29 Patients with private insurance went to nearby EDs in proportions predicted by the proximity of the open EDs to their address of residence. However, a significant number of public patients who did not go to the closest ED preferentially accessed other public hospitals, thus bypassing closer private hospitals.…”

“…We calculated the proportion of these redistributed patients that the other NYC EDs received after Hurricane Sandy on October 30th, 2012, and prior to the reopening of a 911-receiving, freestanding ED at Bellevue on December 24th, 2012. 7…”

“…6 These 2 hospitals serve very different patient populations that were both challenged by the loss of their usual source for hospital-based care. 7 These closures added additional stress to the health management of many individuals already affected by the disaster. 8 Having survived the flood waters, nearby open hospitals were overwhelmed with emergency department (ED) volume from the facilities that closed.…”

Prehospital Indicators for Disaster Preparedness and Response: New York City Emergency Medical Services in Hurricane Sandy

“…We previously demonstrated that reestablishing pre-storm level care at Bellevue normalized ED volumes at nearby hospitals. 8 In the present study, we observed the significant effect that a major safety net, academic medical center can have on surrounding prehospital transports, particularly in light of the fact that rapidly reopening NYP/LMH did not decrease the prehospital burden on the other hospitals surrounding Bellevue. Municipalities and disaster planners should carefully consider the potential for "disproportionate impact" from loss of certain hospital assets or capabilities, associated with the importance of the demographics, socioeconomic status, and disease burdens of the hospital population and function.…”

Acute post-disaster medical needs of patients with diabetes: emergency department use in New York City by diabetic adults after Hurricane Sandy

“…1 In New York City alone, 305 000 homes were destroyed, and the city sustained 19 billion dollars in damage including to critical health facilities and infrastructure. 2 There were 159 deaths; of which, 72 were directly attributed to the storm and 87 were indirectly due to the storm's impact, ie, extended power outages which led to hypothermia, falls in the dark by the elderly, or carbon monoxide poisoning from improperly used generators and cooking devices.…”