Hospital disaster management’s understanding of built environment impacts on healthcare services during extreme weather events

The purpose of this paper is to explore the extent to which hospital disaster planners and managers understand the role of built infrastructure in delivering effective healthcare services during extreme weather events (EWEs). There is substantial evidence to indicate that many hospitals are vulnerable to EWEs. This is alarming given community reliance on hospitals during times of natural disaster and the predicted increase in the frequency and intensity of EWEs.

In this paper, resilience and learning theories are combined to produce a new conceptual model which illustrates how hospital disaster managers learn about the relationship between health outcomes and built infrastructure during EWEs to build future hospital resilience. In this paper, the first part of the conceptual model, concerning the development of disaster management plans is explored and refined using a thematic content analysis of 14 Australian hospitals’ disaster plans and supplementary plans.

The findings indicate high variability of understanding about the role of built facilities in health outcomes during an EWE. There appears to be a widespread and highly questionable assumption in the health disaster planning community that hospital built infrastructure is highly resilient to EWEs. This means that many hospitals will not be unaware of the risks that their buildings pose in the delivery of healthcare services to the community during an EWE and how to manage those risks effectively.

The theoretical framework presented in this paper provides new insights which will enable hospital infrastructure resilience to be better integrated into health service disaster risk planning and preparedness. The findings can help hospital disaster managers learn about and adapt their built environment to changing healthcare needs during EWEs.

By integrating learning and resilience theories in a built environment context, this paper provides new insights, both theoretical and practical, into the important role of hospital infrastructure in planning for EWEs.