Jiang Lynn, Tedeschi Christopher M
Emergency Medicine Residency Program, New York Presbyterian Hospital, New York, New York.
Department of Emergency Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.
J Emerg Manag. 2020 Sep/Oct;18(5):383-398. doi: 10.5055/jem.2020.0487.
In late 2012, Hurricane Sandy struck the eastern United States. Healthcare infrastructure in New York City-including long-term care facilities (LTCFs)-was affected significantly. The authors examined the impact of the storm on LTCFs 2 years after the event, using a qualitative approach consisting of a semistructured interview focused on preparedness and response. Important insights regarding preparedness and response may be lost by quantitative analysis or outcome measurement alone. During Sandy, individuals at LTCFs experienced the event in important subjective ways that, in aggregate, could lead to valuable insights about how facilities might mitigate future risks. The authors used data from a semistructured interview to generate hypotheses regarding the preparation and response of LTCFs. The interview tool was designed to help develop theories to explain why LTCF staff and administrators experienced the event in the way they did, and to use that data to inform future policy and research.
Representatives from LTCFs located in a heavily affected area of New York City were approached for participation in a semistructured interview. Interviews were digitally recorded and transcribed. Recurrent themes were coded based on time period (before, during, or after the storm) and content. A grounded theory approach was used to identify important themes related to the participants' experiences.
A total of 21 interviews were conducted. Several overarching themes were identified, including a perception that facilities had not prepared for an event of such magnitude, of inefficient communication and logistics during evacuation, and of lack of easily identifiable or appropriate resources after the event. Access to electrical power emerged as a key identifier of recovery for most facilities. The experience had a substantial psychological impact on LTCF staff regardless of whether they evacuated or sheltered in place during the storm.
Representatives from LTCFs affected by Sandy experienced the preparation, response, and recovery phases of the event with a unique perspective. Their insights offer evidence which can be used to generate testable hypothesis regarding similar events in the future, and can inform policy makers and facility administrators alike as they prepare for extreme weather events in similar settings. Results specifically suggest that LTCFs develop plans which carefully address the unique qualities of extreme weather events, including communication with local officials, evacuation and transfer needs in geographic areas with multiple facilities, and plans for the safe transfer of residents. Emergency managers at LTCFs should consider electrical power needs with the understanding that in extreme weather events, power failures can be more protracted than in other types of emergencies.
2012年末，飓风桑迪袭击了美国东部。纽约市的医疗基础设施，包括长期护理机构（LTCF），受到了重大影响。作者在事件发生两年后，采用定性方法，通过聚焦于准备和应对的半结构化访谈，研究了风暴对长期护理机构的影响。仅通过定量分析或结果测量可能会遗漏有关准备和应对的重要见解。在桑迪飓风期间，长期护理机构的人员以重要的主观方式经历了该事件，总体而言，这可能会产生有关机构如何减轻未来风险的宝贵见解。作者使用半结构化访谈的数据来生成关于长期护理机构准备和应对的假设。访谈工具旨在帮助形成理论，以解释长期护理机构的工作人员和管理人员为何以他们那样的方式经历该事件，并利用这些数据为未来的政策和研究提供信息。
与位于纽约市重灾区的长期护理机构代表联系，邀请他们参与半结构化访谈。访谈进行了数字录音和转录。反复出现的主题根据时间段（风暴前、期间或之后）和内容进行编码。采用扎根理论方法来确定与参与者经历相关的重要主题。
共进行了21次访谈。确定了几个总体主题，包括认为机构没有为如此规模的事件做好准备、疏散期间沟通和后勤效率低下以及事件发生后缺乏易于识别或合适的资源。对于大多数机构而言，电力供应成为恢复的关键指标。无论他们在风暴期间是撤离还是就地避难，这段经历都对长期护理机构的工作人员产生了重大的心理影响。
受桑迪飓风影响的长期护理机构代表以独特的视角经历了事件的准备、应对和恢复阶段。他们的见解提供了证据，可用于生成关于未来类似事件的可检验假设，并能在政策制定者和机构管理人员为类似环境中的极端天气事件做准备时为他们提供参考。结果特别表明，长期护理机构应制定计划，认真应对极端天气事件的独特性质，包括与当地官员的沟通、多机构地区的疏散和转移需求以及居民安全转移计划。长期护理机构的应急管理人员应考虑电力需求，并认识到在极端天气事件中，停电可能比其他类型的紧急情况持续时间更长。
