Hospital as a Critical Infrastructure in the Community Disaster Response System

The Department of Homeland Security lists 19 groups of sectors as Critical Infrastructure Key Resources (CIKR) such as Water, Emergency Services, and Healthcare and Public Health (HPH). Protection of those interdependent sectors is of vital interest for the country in the event of disaster.;Hospital infrastructure systems are basic HPH elements of the CIKR. Local hospitals deliver essential routine healthcare services as well as serving as frontline responders during non-routine disaster events. Currently, hospitals generally extend their routine healthcare activities for external community disaster preparedness and response services. This extension takes the form of coordination with other responders within the community. Under this condition, determining the hospital's role in the community disaster response is critical. This thesis evaluates the current external performance of a hospital in response to a community disaster and the degree of integration of hospitals with the community system during and after a disaster. Case studies of two hospitals in Western New York State, one a rural institution sample and the other an urban institution sample, are conducted with data collected through program review and structured interviews of the hospitals' staff and the Emergency Management Officers of each community and analyzed using context analysis. The analysis shows that rural hospitals are more critical to community recovery than urban centers; communication both internal and external to the hospital is key to effectiveness; and emergency planning is actually only a small part of response.