The Disaster-Preparedness Gap

Five Days at Memorial

This thread follows the gap between written emergency plans and the resources, coordination, and all-hazards thinking needed to carry them out.

increasing

Bearing strength in each event

decreasing

Planning for the Wrong Emergency

Planning for the Wrong Emergency Terrorism Takes Priority Federal preparedness funding after September 11 encouraged detailed planning for bioterrorism. Memorial’s bioterrorism scenario was far longer than its hurricane plan. The Missing Scenario Plans addressed individual hazards but did not combine flooding, power loss, communications failure, and evacuation. The hospital had paperwork for emergencies without a workable plan for the emergency that arrived.

The Hurricane Pam Exercise The Hurricane Pam Exercise from "Five Days at Memorial". The Hurricane Pam Exercise A Catastrophe Modeled The exercise considered a major hurricane and thousands of hospital patients who might need help.

The Hurricane Pam Exercise from "Five Days at Memorial". The Hurricane Pam Exercise A Catastrophe Modeled The exercise considered a major hurricane and thousands of hospital patients who might need help.

The Hurricane Pam Exercise A Catastrophe Modeled The exercise considered a major hurricane and thousands of hospital patients who might need help. Participants raised questions about which patients should be extracted and how limited resources would be used. Warnings Without Execution The scenario anticipated many features of Katrina, yet plans for buses, staff, and hospital evacuation remained incomplete. The exercise showed that imagining a disaster did not itself create the capacity to respond.

Known Equipment Risks Known Equipment Risks from "Five Days at Memorial". Known Equipment Risks Flood-Exposed Systems Officials had asked hospitals whether generators and electrical gear could withstand deep flooding.

Known Equipment Risks from "Five Days at Memorial". Known Equipment Risks Flood-Exposed Systems Officials had asked hospitals whether generators and electrical gear could withstand deep flooding.

Known Equipment Risks Flood-Exposed Systems Officials had asked hospitals whether generators and electrical gear could withstand deep flooding. Memorial knew that important components remained near or below ground level. Costs Deferred The hospital’s improvements competed with other capital needs. The decision not to elevate or protect vulnerable equipment became consequential when water reached the basement.

A Fragmented Response A Fragmented Response from "Five Days at Memorial". A Fragmented Response No Single Coordinator Hospitals, companies, and public agencies maintained different lists and communicated through unreliable channels.

A Fragmented Response from "Five Days at Memorial". A Fragmented Response No Single Coordinator Hospitals, companies, and public agencies maintained different lists and communicated through unreliable channels.

A Fragmented Response No Single Coordinator Hospitals, companies, and public agencies maintained different lists and communicated through unreliable channels. Memorial was described variously as a high, low, or first priority for evacuation. Responsibility Circulates Organizations pointed toward one another for resources and decisions. The resulting confusion left patients waiting while everyone searched for a clear authority.

Lessons Revisited Lessons Revisited from "Five Days at Memorial". Lessons Revisited A New Hospital at Risk During Hurricane Sandy, hospitals in New York again faced flooding and backup-power threats.

Lessons Revisited from "Five Days at Memorial". Lessons Revisited A New Hospital at Risk During Hurricane Sandy, hospitals in New York again faced flooding and backup-power threats.

Lessons Revisited A New Hospital at Risk During Hurricane Sandy, hospitals in New York again faced flooding and backup-power threats. Staff confronted questions that had echoes of Memorial’s experience. Improvement and Repetition Some systems had become more organized, but emergency plans still lacked realistic backup-to-backup provisions. Katrina’s lessons were influential without being fully absorbed.

2001–2005

August 23–24, 2005

Before August 29, 2005

August 30–September 1, 2005

2012, during Hurricane Sandy