title: Rising to the Challenge: The Response to Hurricane Sandy in a Psychiatric Emergency Room.
abstract: In October 2012, Hurricane Sandy ravaged the East coast claiming 159 lives and destroying an estimated $65 billion in property. Overnight, hospitals still in operation, such as Maimonides Medical Center, were faced with seemingly insurmountable challenges in providing adequate health care services.
  
  
  
  This study had 3 goals: (1) to assess the impact of Hurricane Sandy on the number and pattern of visits to the psychiatric emergency room (PER) at Maimonides Medical Center; (2) to analyze the procedures implemented in addressing increased demands; and (3) to identify any shortcomings in our response and explore how it can be altered to face future challenges.
  
  
  
  We reviewed systems data for the 12 months before and after Hurricane Sandy, including total number of visits to the PER, length of stay in the PER, and percentage of admissions and discharges from the PER. We also reviewed the interventions implemented by the designated response unit, the Command Center, and interviewed senior leadership involved in the process.
  
  
  
  The total number of visits increased dramatically, with the highest increase recorded in the first month after Hurricane Sandy. There were 3554 visits in the 12 months before the hurricane compared with 4674 in the 12 months after the storm (P<0.001). In addition, there were 273 visits to the PER in November 2011 compared with 408 in November 2012, which was the month after the hurricane (P<0.001). The average length of stay increased and the percentage of admissions decreased significantly (P<0.001). There were no increased staff assignments, but significant resources were provided by the Command Center.
  
  
  
  The results of this study highlight the fact that hospitals can never be over-prepared for disasters. By being adaptive and creative, the PER was able to serve a greater number of patients, which is critical in the current health care environment.
authors.affiliation: Department of Psychiatry, Maimonides Medical Center, Brooklyn, NY.
authors.forename: Kandace
authors.initials: K
authors.lastname: Licciardi
authors.forename: Maria
authors.initials: M
authors.lastname: Bodic
authors.forename: Abraham
authors.initials: A
authors.lastname: Taub
authors.forename: Peter
authors.initials: P
authors.lastname: Homel
authors.forename: Theresa
authors.initials: T
authors.lastname: Jacob
mesh_terms: D055867:Cyclonic Storms; D004189:Disaster Planning; D004636:Emergency Service, Hospital; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D009519:New York City; D012189:Retrospective Studies