| Objectives: In 2012 Hurricane Sandy caused flooding, infrastructure and environmental damage, and interruption to public health services. To evaluate the New York State (NYS) public health system response to Hurricane Sandy, this dissertation provides an assessment of staff perceptions from responders representing affected local health departments and the New York State Department of Health.;Methods: A mixed methods approach was used to summarize the Sandy response staff feedback on the strengths and challenges experienced during Sandy and the staff recommendations for public health system preparedness. Qualitative analysis of text from emergency reports, focus groups, interviews and anonymous surveys was performed to sort key words into Public health Preparedness Capabilities using NVivo version 10 (QSR International, Melbourne, Australia). Quantitative analysis of closed ended survey responses was performed using the Statistical Analysis Software (SAS) package, version 9.2 (Cary, NC).;Results: For both local and state health department staff emergency operations coordination and information sharing preparedness capabilities were among the most-cited strengths, challenges, and recommendations. Important strengths included conference calls and other mechanisms for sharing information with partners, evacuation plans, use of staff, volunteers, and existing resources such as vehicles, flexibility with executive orders on vaccination requirements, maintenance of existing surveillance, laboratory, systems, and 'just in time' training.;Under the emergency operations coordination preparedness capability, key recommendations were sharing of situation reports more broadly, development of additional partnerships and memoranda of understanding, and utilizing staff and resources from non-affected regions and agencies.;Under the information sharing preparedness capability, key recommendations were increased communication channels at remote work sites, use of social media, clarifying the data that can be shared under HIPPA regulations, and improved emergency contact information for staff.;Recommendations were also provided for planning (development of interagency plans), training and preparedness (additional training including support staff), flexibility (partnership with unions to explore flexibility in staffing rules and compensation), and roles and responsibilities (clarifying staff roles).;Conclusions: Public health response to weather related disasters can be enhanced by building on existing strengths, seeking staff feedback on challenges, and working to incorporate recommendations for future improvement. |
