Preserving lifesavers in the wake of a natural disaster

When Hurricane Sandy hit New York City in 2012 and four flooded hospitals had to be evacuated, their patients, doctors, and services were left in chaos and upheaval for months. People who had no idea where to go for treatment wandered the city. Physicians set up at makeshift offices had trouble accessing medical records. Prescriptions went unfilled.

Johns Hopkins University researchers will help lead a National Science Foundation-funded effort to prevent these sorts of critical community services from falling apart in the wake of natural disasters.

Johns Hopkins and the University of Maryland will split a three-year, $2.5 million grant, working to build a model that exposes a community's vulnerabilities during a hurricane or an earthquake and suggests ways to strengthen a region's complex, intertwined network of services.

The goal is to map the myriad ways in which critical systems, like a community's health care system, depend on services like water, electricity, gas, roads, and, of course, the soundness of many individual buildings. In an emergency, these services also require constant communication with everyone from doctors, nurses, and technicians to administrators, facilities managers, and janitors to emergency responders, policymakers, and suppliers of drugs, equipment, and even food.

"How do all of these pieces connect and how does one piece affect the resilience of the entire health care system?" said Judy Mitrani-Reiser, a civil engineer who is leading the Johns Hopkins team. "We are trying to connect the vulnerabilities of the physical components to community outcomes through disruptions in services."

Others at Johns Hopkins working on the project include computer scientist Matt Green, health policy expert Helaine Rutkow, Dr. Tom Kirsch, who directs the university's Center for Refugee and Disaster Response, and Jonathan Links, director of the university's Center for Public Health Preparedness.

"The project is unique in that it will incorporate public policy, organizational policy, emergent organizational behaviors, and risk communication considerations into a broader quantitative assessment of disaster resilience under multiple hazard types," said Elise Miller-Hooks, who will lead the University of Maryland's team.

The nine researchers will first try to map all of the moving parts within a health care system.

Next, they will build a dynamic computer model of a complex regional healthcare system. The model will be used to assess and study the disaster's impact on various parts of the system over time.

The final step will be creating a model to replicate what might happen to a real health care system in a natural disaster. The model will be based on stakeholders in New York, Maryland, and Oregon.

"We're going to give decision-makers the tools to make better decisions," Mitrani-Reiser said. "We want people to use the model to visualize the impact to the entire system through the course of an event."

The grant also includes an educational component that the lead investigators, both women, will use to encourage young women to think about careers in engineering. The researchers will work with local Girl Scouts on an emergency response patch and girls at area high school students will have a chance to intern in the participating labs.