Leone Ryan M, Salway R James, Silvestri David M, Iavicoli Laura G
Ryan M. Leone, MSc, is a Medical Student, Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, and a Visiting Scholar, National Center for Disaster Medicine and Public Health, Uniformed Services University, Bethesda, MD. R. James Salway, MD, MSc, is an Assistant Professor of Emergency Medicine, Weill Cornell School of Medicine, New York, NY. David M. Silvestri, MD, MBA, MHS, is Assistant Vice President of Emergency Management, NYC Health + Hospitals, New York, NY. Laura G. Iavicoli, MD, MBA, is a Professor of Emergency Medicine, Icahn School of Medicine at Mount Sinai, and Chief Medical Officer, NYC Health + Hospitals/Elmhurst; both in New York, NY.
Health Secur. 2025 Mar-Apr;23(2):116-123. doi: 10.1089/hs.2024.0095. Epub 2025 Mar 3.
Labor actions by healthcare workers are increasing in frequency and quantity, particularly throughout the United States. Regardless of their cause and size, these strikes could disrupt normal hospital operations and impact patient access to care, quality of care, and costs. Strikes resemble other large-scale incidents like natural disasters, pandemics, or terrorist attacks by shrinking a hospital's capacity to care for patients, forcing hospitals to pursue logistically complicated actions such as finding replacement providers, and impacting nearby facilities due to patient offloading. In contrast to these incidents, however, strikes are unique because they come with advance notice, reduce capacity by precise amounts with predictable provider losses, occur during defined periods, and do not necessarily increase demand for patient care. To maximize efficiency and minimize disruption in response to strikes, hospitals must properly plan ahead and successfully execute their plans. In this article, we recount the experience of a 2023 resident strike at NYC Health + Hospitals/Elmhurst in New York City and describe 6 core strategies that the facility implemented to maintain quality care: strike aversion and planning, increasing coverage, decreasing demand, internal and external messaging, external partnerships, and demobilization. We also provide a planning template that other hospitals can use to prepare for and respond to healthcare provider strikes. The information in this article was first presented as a poster, "Healthcare Labor Action Preparedness and Response" at the Preparedness Summit, March 25-28, 2024, in Cleveland, Ohio.
医护人员的罢工行动在频率和数量上都在增加，尤其是在美国各地。无论罢工的原因和规模如何，这些罢工都可能扰乱医院的正常运营，并影响患者获得医疗服务的机会、医疗质量和成本。罢工类似于自然灾害、大流行或恐怖袭击等其他大规模事件，会削弱医院照顾患者的能力，迫使医院采取后勤复杂的行动，如寻找替代医护人员，并因患者分流而影响附近的医疗机构。然而，与这些事件不同的是，罢工的独特之处在于它们会提前通知，会因可预测的医护人员流失而精确减少医疗服务能力，会在特定时期发生，而且不一定会增加对患者护理的需求。为了在应对罢工时有更高的效率并将干扰降至最低，医院必须提前做好妥善规划并成功执行计划。在本文中，我们讲述了2023年纽约市卫生 + 医院/埃尔姆赫斯特分院住院医师罢工的经历，并描述了该机构为维持优质护理而实施的6项核心策略：罢工预防与规划、增加覆盖范围、减少需求、内部和外部信息传达、外部合作以及复员。我们还提供了一个规划模板，其他医院可以用来为医护人员罢工做准备并做出应对。本文中的信息最初是作为一张海报《医疗行业劳工行动的准备与应对》，于2024年3月25日至28日在俄亥俄州克利夫兰市举行的应急准备峰会上展示的。
