title: Personal and professional challenges confronted by hospital staff following hurricane sandy: a qualitative assessment of management perspectives.
abstract: Adequate hospital staffing during and after a disaster is critical to meet increased health care demands and to ensure continuity of care and patient safety. However, when a disaster occurs, staff may become both victim and responder, decreasing their ability and willingness to report for work. This qualitative study assessed the personal and professional challenges that affected staff decisions to report to work following a natural disaster and examined the role of management in addressing staff needs and concerns.
  
  
  
  Semi-structured interviews were conducted with individuals who filled key management roles in the United States Department of Veterans Affairs New York Harbor Healthcare System's response to Superstorm Sandy and during the facility's initial recovery phase. All interviews were audio recorded and transcribed. Three major themes were identified: 1) Barriers to reporting ("Barriers"), 2) Facilitators to reporting ("Facilitators"), and 3) Responses to staff needs and concerns ("Responses"). Atlas.ti 7.1.6 software program was used for the management and analysis of the transcripts.
  
  
  
  Results indicated that staff encountered several barriers that impeded their ability to report to work at mobile vans at the temporarily nonoperational Manhattan campus or at two other VA facilities in Brooklyn and the Bronx in the initial post-Sandy period including transportation problems, personal property damage, and communication issues. In addition, we found evidence of facilitators to reporting as expressed through descriptions of professional duty. Our findings also revealed that management was aware of the challenges that staff was facing and made efforts to reduce barriers and accommodate staff affected by the storm.
  
  
  
  During and after a disaster event, hospital staff is often confronted with challenges that affect decisions to report for work and perform effectively under potentially harsh conditions. This study examined barriers and facilitators that hospital staff encountered following a major natural disaster from the management perspective. Insights gained from this study can be used to inform future disaster planning and preparedness efforts, and help ensure that there is adequate staffing to mount an effective response when a disaster occurs, and to recover from its aftermath.
authors.affiliation: Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.|US Department of Veterans Affairs, Veterans Emergency Management Evaluation Center (VEMEC), North Hills, CA, USA.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Morris
authors.affiliation: Department of OB/GYN Research, Baystate Medical Center, Springfield, MA, USA.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Ricci
authors.affiliation: US Department of Veterans Affairs, Veterans Emergency Management Evaluation Center (VEMEC), North Hills, CA, USA.
authors.forename: Anne R
authors.initials: AR
authors.lastname: Griffin
authors.affiliation: US Department of Health and Human Services, Center for Delivery, Organization, and Markets (CDOM), Agency for Healthcare Research and Quality, Rockville, MD, USA.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Heslin
authors.affiliation: Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA. aram.dobalian@va.gov.|US Department of Veterans Affairs, Veterans Emergency Management Evaluation Center (VEMEC), North Hills, CA, USA. aram.dobalian@va.gov.|School of Nursing, UCLA, Los Angeles, CA, USA. aram.dobalian@va.gov.
authors.forename: Aram
authors.initials: A
authors.lastname: Dobalian
mesh_terms: D055867:Cyclonic Storms; D004189:Disaster Planning; D004190:Disasters; D006787:Hospitals, Veterans / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D009518:New York; D010564:Personnel, Hospital; D036301:Qualitative Research; D014186:Transportation; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration*
keywords: Disaster response; Hospital; Professional duty; Recovery; US Department of Veterans Affairs; Veterans