title: Pandemic influenza and critical infrastructure dependencies: possible impact on hospitals.
abstract: Hospitals will be particularly challenged when pandemic influenza spreads. Within the health sector in general, existing pandemic plans focus on health interventions to control outbreaks. The critical relationship between the health sector and other sectors is not well understood and addressed. Hospitals depend on critical infrastructure external to the organisation itself. Existing plans do not adequately consider the complexity and interdependency of systems upon which hospitals rely. The failure of one such system can trigger a failure of another, causing cascading breakdowns. Health is only one of the many systems that struggle at maximum capacity during "normal" times, as current business models operate with no or minimal "excess" staff and have become irreducible operations. This makes interconnected systems highly vulnerable to acute disruptions, such as a pandemic. Companies use continuity plans and highly regulated business continuity management to overcome process interruptions. This methodology can be applied to hospitals to minimise the impact of a pandemic.
authors.affiliation: National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children's Hospital at Westmead and the University of Sydney, Sydney, NSW, Australia.
authors.forename: Ralf L
authors.initials: RL
authors.lastname: Itzwerth
authors.forename: C Raina
authors.initials: CR
authors.lastname: Macintyre
authors.forename: Smita
authors.initials: S
authors.lastname: Shah
authors.forename: Aileen J
authors.initials: AJ
authors.lastname: Plant
mesh_terms: D001315:Australia / Q000453:epidemiology; D003153:Community Health Services / Q000458:organization & administration*; D003159:Community-Institutional Relations; D004189:Disaster Planning / Q000458:organization & administration*; D004196:Disease Outbreaks / Q000517:prevention & control*; D006739:Hospital Administration; D006779:Hospitals, Public / Q000458:organization & administration*; D006801:Humans; D007251:Influenza, Human / Q000453:epidemiology* / Q000628:therapy*; D011785:Quality Assurance, Health Care