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3205MED Healthcare Systems Question: Discuss about the Healthcare Systems. In this process, plans are developed so that the people are sent to the safest places in the shortest time. The benchmark evacuation time is established for different hazards and conditions. Answer: Introduction  Emergency evacuation refers to the urgent escape of people from the disaster area. It refers to the immediate escape of the people from areas which suffer from imminent threat to the lives of the people or to their property. The planning process is significant in the emergency evacuation. In this process, plans are developed so that the people are sent to the safest places in the shortest time. The benchmark evacuation time is established for different hazards and conditions. Different benchmarks can be established with the help of best practices, regulations and simulation. In the proper evacuation planning, the organization should use number of exits and technologies to ensure that there is complete and full evacuation. It is important that proper planning follows evacuation as a disorganized emergency evacuation can result in confusion, injury and damage to the people present in the disaster. It is important to consider different factors while designing an evacuation plan. It includes evaluation of different conditions under which the evacuation plan must be triggered, conditions under which evaluation is essential, establishing different designations and authorities who can control the evacuation plan. The evacuation plan must include different routes and exits which can be used for the same purpose. Other than that, it should also include the evaluation procedures for the employees and visitors, especially people who are suffering from disabilities or who do not speak English.   There is a different place where natural disaster can take place and also create an impact on business and administration. In case of evacuation, management of institutions need to develop effective planning and also make sure to manage crisis.  In the case of hospital’s concern for administration is to help clinics clients. In the case of natural disaster, management have two choices whether to stay evacuated from the place. The present report is based on a case study on North Shore—-LIJ’ and Hurricane Sandy. It highlighted on a different area of emergency and explains different ways of evacuation.   Description  The present case study is based on the practice of evacuated or stay. In the USA, different weather conditions appeared so for the institutions and other people it is essential to make decisions how to control the circumstances. In the hospitals, there are also certain problems in case of a storm. The patients are the main concern for the hospital’s administration. In the worst weather condition, it becomes difficult for hospitals management to evacuate or stay. For hospitals, it becomes difficult to make decisions to transfer all patients from the hospitals or find shelter to hide.  The emergency evacuation is highly challenging in hospital or healthcare settings. The patients are already in the vulnerable conditions and sometimes, unable to transport or travel themselves. Therefore, it is important to design a proper evacuation plan which takes into consideration different conditions required in the evacuation of people. The core problem for the hospitals is that transferring patients to another place can be costly, labor-intensive and logistics nightmare. The transportation of the patients require that they are provided same treatment conditions to while they are commuted to different hospitals. If hospitals leave patients in the clinics then they may lose their life and also psychologically harm them. The track and intensity of a hurricane are notoriously difficult to predict and there is no certainty about the risk any given storm posses. Therefore, predication and forecasting is also challenging for the organization. In the case of a storm the hospital management gets clear noticed before many days about the storm forecasts and landfall.  In the hurricanes, hospitals can also loose power and it can negatively impact on the building and the infrastructure of the organization. In   August 2011,   Hurricane Irene bore down on the East Coast. Forecasters and public officials warned that it can create harm to coastal communities. The North Shore-Long Island Jewish Hospitals has 15 hospitals chain across the coastal area and New York City. The administration of hospital decided to evacuate and move 947 patients to other further inland. However, there were no such consequences appear. Through this incident, administration becomes aware how to handle situations and way in which they can evacuate. Fourteen months later, On October 26, 2012, a massive storm which is called Sandy was moving towards the New York City. The North Shore LIJ officials again need to decide whether evacuated or deicide stayed.  The main person who was in-charge during this problem is Romagnoli, who had a lot of experiences in case of emergency. He brought preparedness and crisis management in the hospital’s system when he joined in 2001. He had also build operation center, taught crisis management skills to employees and another individual who are working in hospitals. Irene, who appeared in 2011, give confidence to administration and crisis management to build confidence upon evacuation practice. The experience with Irene helps to Romagnoli to make effective decisions and also how much they should rely on the forecast for making crucial decisions. It can be recommended that the organization should focus on analyzing different risks properly. It should also focus on making appropriate plans so that the organization can effectively manage the evacuation procedures. Discussion There are different types of weather disaster appeared such as hurricane, earthquake, industrial accident or terrorist attack. It can create harm to the hospital in a bad manner and also its patients. The major challenges for a hospital in evacuation are logistics management, labor resources and providing medical facility to all patients during the evacuation.  In a storm, administrations get clear idea and number of days to overcome with situations. Earthquakes and tornadoes are unanticipated events so management did not receive any prior notice, but for this storm, hospitals have little time to evacuate. In the case of evacuation, hospitals have two types of evacuations internal and external. In the external evacuation, patients are moved to the outside of hospitals or any external area. On the other hand in the internal evacuation, they transfer patients to a safe place in hospitals. In the case of crisis, national security also follows the evacuation protocols which focuses on the immediate response of staff. Each staff members has his set roles and responsibility in case of such crisis and maintains communication with each other. The challenge in evacuation is weighing the risks. During the operations of a healthcare organization, different risks are faced. It is important to evaluate all these risks and design a healthcare plan in consideration to all the risks. The evaluation plan must be able to respond to all the risks identified in the analysis section. In the case of fire and earthquake decision are straightforward.  In the case of a hurricane, hospitals need to find the probability of a hazard that storm would hit or not because it is all about minimizing risks.  In addition, while transferring patients from the one place to another place one should gain information about the speed of the wind. In case of hurricanes, wind speed can be reached to 45mph so hospital needs to take decisions before making any type of evacuation process. The challenges which are faced by the hospital are to take care to the emotional and psychological level to patients. In such crisis, due to lack of resources and medical facilities, clients may face problems and also they become they can lose their mental ability.  In the 2011, Irene give hospital’s administration clear confidence that they can handle any type of problems. The plan which was set by the director of emergency planning and preparation was effectively worked. However, when official’s evacuation plan was tested, it did not work effectively and Romagnoli fails to provide help to get everyone one out of hospitals. Therefore, it was important to make adequate changes in the evacuation plan so that the organization can efficiently and properly evacuate all the employees and the patients of the hospital. The management of hospitals becomes frustrated from the false and inappropriate information. Management could not make any decisions. The organization should focus on managing information in an appropriate manner so that it can design an effective evacuation procedure for the employees as well as the patient. In order to overcome the above situation, there are different types of strategies which are developed by hospital’s management. According to Wang, Cheng and You (2016), in the case of such natural crisis, external evacuation and internal evacuation both can be selected. In the case of external evacuation, the management can use the logistics management, there are different hospitals cases where the management use different resources for maintaining logistics management. In the management, hospitals can use an ambulance and commandeered vehicles.  Through this, they can transfer all patients from one place to another place. In addition, management can also use any other resources such as helicopters for inland of patients. For the evacuation, hospital also use different resources and system. North Shore—-LIJ’ has a system which is used in the emergency case. The hospitals in the year of 1997 used emergency preparedness as part of the emergency. Federal government develops a standard method for managing emergencies and communities’ response.  The ICS provides clear guidelines to hospitals structure and also help administration for planning logistics, finance and operations units. While transferring the patients from one hospital to another, patient’s safety is more critical.  Along with this, other main concern for the hospitals is to collect information correctly and also evaluate the strength of hurricanes.  In this situation,   North Shore—-LIJ’ also need to develop their own system and weather predictions so they can collect clear information and make effective preparation for solving problems.   The hospital can also coordinate with the government.  In such type of crisis, the government makes effective roles for the hospitals to overcome any types of problems and maintain their resources. The government also needs to provide help to private hospitals so they can take corrective action at the time of evacuation. Recommendations  In the above case study, the hospital made a successful attempt of evacuation. However, there are certain other ways which can also use during the emergency crisis (Thiede and Brown, 2013). In the hospital crisis, there are certain areas which need to be improved so, next time, the crisis can be solved effectively. Following are future recommendations: At the time of evacuation, the management is making focus only on transferring patients from one place to another place. There are many other patients in hospitals which are suffering from such evacuation because they were not getting enough resources and medical facilities. So, in the future, if such types of events occur management need to focus on strong leadership and also they should set roles and responsibility of each individual. The emergency plan which was developed by emergency authority needs to involve all individual in decisions making process and also should help each other. Resources such as medicine and medical equipment all should be arranged in an effective manner so no harm can be generated to patients. Another recommendation for the hospital is that they should hire certified health care professional which are solely trained for handling emergency area in the hospital.  At the time of crisis, one should be able to handle all type of emergency and also they should have good knowledge about the evacuation. Through this approach hospital management can manage resources and staffs effectively. In the present evacuation all responsibilities should be handled only by a few people, other staffs were not making a contribution so future hospitals should involve and hire certified employees who can help to manage resources and provide all facilities to all patients. This strategy is also helping to administration to overcome external dependency. Increase communication plan during the emergency. In the time of storm, there was lack of proper communication and also management was unaware about weighing risk associated with the storm. The management becomes frustrated because they were not receiving proper coordination among staff members and also facing problems for developing any plan. So it is recommended that hospital management should make the focus on develop strategies in which they can manage communication effectively an before making any evacuation strategy it is essential to weigh risks because it is possible that storm may be not brought so many consequences. So management does not need to evacuation they can stay in hospitals. The fourth recommendation for these North Shore—-LIJ hospitals is that need to increase backup plans and also try to decrease shift’s lengths. So management needs to make the focus on developing effective planning on the backup plans. At the time of evacuation, plan management had to the faced number of shifts which increased work burden for hospitals. So emergency management should make the focus on developing the emergency backup plans and also make proper communication with other staff members so they can handle the problem of crisis effectively. Lack of government coordination may also create problems for North Shore—-LIJ’. In the time of crisis management faced problems for managing communication with government. Federal does not provide any types of facilities to privately owned hospitals. So management should prepare for emergency itself.  Making communication with a government assistance to administration to overcome with problems and also it helped to them for developing effective communication. The last recommendation for overcoming the crisis is lack of federal budgets. In the privately owned hospitals is that they are highly facing problem in managing budgets in their preparation plan. So the management should also make coordination and also they should make a communication to provide federal budgets. Through which emergency management can manage resources also they can help to patients to overcome problems.  In addition, management also should make the focus on in advance preparation and conduct emergency planning preparation so they help to provide better service to patients and staff members. Conclusion From summing up the present report, it can be concluded that for overcome with natural crisis evacuation consider as the best options. North Shore LIJ hospital, through effective planning and practices easily overcome with threats. By weigh risks and developing coordination among the staff hospital managed evacuation process. The hospitals received 48 hours in advance for preparing emergency. Romagnoli played important role in case of emergency.  However, the hospitals also need to make coordination with the government as well to overcome such problems. References Bowser GC, Cutter SL. Stay or go? Examining decision making and behavior in hurricane evacuations. Environment: Science and Policy for Sustainable Development. 2015 Nov 2;57(6):28-41. Cote DW, McGee TK. An exploration of residents’ intended wildfire evacuation responses in Mt. Lorne, Yukon, Canada. The Forestry Chronicle. 2014 Aug 19; 90(4):498-502. Huang SK, Lindell MK, Prater CS. Who leaves and who stays? A review and statistical meta-analysis of hurricane evacuation studies. Environment and Behavior. 2016 Oct;48(8):991-1029. Lazo JK, Bostrom A, Morss RE, Demuth JL, Lazrus H. Factors affecting hurricane evacuation intentions. Risk analysis. 2015 Oct 1;35(10):1837-57. Medina MA, Moraca JM. Should I stay or should I go? Determinants of evacuation upon flood warning among households in a flood prone area in Bukidnon, Philippines. International Letters of Natural Sciences. 2016;50. Thiede BC, Brown DL. Hurricane Katrina: Who stayed and why?. Population Research and Policy Review. 2013 Dec 1;32(6):803-24. Wang QF, Cheng C, You C. A New Modified Twist Drill Craniostomy Using a Novel Device to Evacuate Chronic Subdural Hematoma. Medicine. 2016 Mar;95(10). Weller SC, Baer R, Prochaska J. Should I Stay or Should I Go? Response to the Hurricane Ike Evacuation Order on the Texas Gulf Coast. Natural Hazards Review. 2016 Mar 21;17(3):04016003. Zhang N, Ni XY, Huang H, Duarte M. Risk-based personal emergency response plan under hazardous gas leakage: Optimal information dissemination and regional evacuation in metropolises. Physica A: Statistical Mechanics and its Applications. 2017 May 1;473:237-50.

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