Evacuate or Shelter-in-place? The Role of Corporate Memory and Political Environment in Hospital-evacuation Decision Making

2015 ◽  
Vol 30 (3) ◽  
pp. 233-238 ◽  
Author(s):  
Karen A. Ricci ◽  
Anne R. Griffin ◽  
Kevin C. Heslin ◽  
Derrick Kranke ◽  
Aram Dobalian
Keyword(s):  
Decision Making ◽  
New York ◽  
Medical Center ◽  
Lessons Learned ◽  
Influential Factor ◽  
Political Environment ◽  
Superstorm Sandy ◽  
Hurricane Irene ◽  
Corporate Memory

AbstractProblemHospital-evacuation decisions are rarely straightforward in protracted advance-warning events. Previous work provides little insight into the decision-making process around evacuation. This study was conducted to identify factors that most heavily influenced the decisions to evacuate the US Department of Veterans Affairs (VA) New York Harbor Healthcare System’s (NYHHS; New York USA) Manhattan Campus before Hurricane Irene in 2011 and before Superstorm Sandy in 2012.MethodsSemi-structured interviews with 11 senior leaders were conducted on the processes and factors that influenced the evacuation decisions prior to each event.ResultsThe most influential factor in the decision to evacuate the Manhattan Campus before Hurricane Irene was New York City’s (NYC’s) hospital-evacuation mandate. As a federal facility, the Manhattan VA medical center (VAMC) was exempt from the city’s order, but decision makers felt compelled to comply. In the case of Superstorm Sandy, corporate memory of a similar 1992 storm that crippled the Manhattan facility drove the decision to evacuate before the storm hit.ConclusionsResults suggest that hospital-evacuation decisions are confounded by political considerations and are influenced by past disaster experience. Greater shared situational awareness among at-risk hospitals, along with a more coordinated approach to evacuation decision making, could reduce pressure on hospitals to make these high-stakes decisions. Systematic mechanisms for collecting, documenting, and sharing lessons learned from past disasters are sorely needed at the institutional, local, and national levels.RicciKA, GriffinAR, HeslinKC, KrankeD, DobalianA. Evacuate or shelter-in-place? The role of corporate memory and political environment in hospital-evacuation decision making. Prehosp Disaster Med2015;30(3):1-6

scholarly journals The COVID Army: Experiences from the Deployment of Non-Hospitalist Physician Volunteers during the 2020 COVID Pandemic

2021 ◽  
pp. 1-15
Author(s):  
Kevin Hauck ◽  
Katherine Hochman ◽  
Mark Pochapin ◽  
Sondra Zabar ◽  
Jeffrey A Wilhite ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Medical Center ◽  
The United States ◽  
Lessons Learned ◽  
Front Line ◽  
Clinical Leadership ◽  
Team Members ◽  
Medical Centers ◽  
Hospitalist Physician

Abstract Objective New York City was the epicenter of the outbreak of the 2020 COVID-19 pandemic in the United States. As a large, quaternary care medical center, NYU Langone Medical Center was one of many New York medical centers that experienced an unprecedented influx of patients during this time. Clinical leadership effectively identified, oriented, and rapidly deployed a “COVID Army”, consisting of non-hospitalist physicians, to meet the needs of this patient influx. We share feedback from our providers on our processes and offer specific recommendations for systems experiencing a similar influx in the current and future pandemics. Methods In order to assess the experiences and perceived readiness of these physicians (n=183), we distributed a 32-item survey between March and June of 2020. Thematic analyses and response rates were examined in order to develop results. Results Responses highlighted varying experiences and attitudes of our front-line physicians during an emerging pandemic. Thematic analyses revealed a series of lessons learned, including the need to: (1) provide orientations, (2) clarify roles/ workflow, (3) balance team workload, (4) keep teams updated on evolving policies, (5) make team members feel valued, and (6) ensure they have necessary tools available. Conclusions Lessons from our deployment and assessment are scalable at other institutions.

KIDNEY FUNCTION IN YOUNG INFANTS

PEDIATRICS ◽  
1950 ◽  
Vol 5 (2) ◽  
pp. 171-179
Author(s):  
HENRY L. BARNETT
Keyword(s):  
New York ◽  
Kidney Function ◽  
Public Health Service ◽  
Medical Center ◽  
Heart Association ◽  
Primary Role ◽  
Young Infants ◽  
New York Heart Association ◽  
Clinical Problems

IT IS with gratitude that I accept this second E. Mead Johnson Award, being fully aware of the honor it brings to all of us who have shared in the work. The progress of the work has been stimulated by the encouragement and guidance given previously by Dr. Alexis F. Hartmann in St. Louis and, more recently, by Dr. Samuel Z. Levine in New York. I also wish to thank the doctors, nurses, technicians, secretaries and laboratory helpers who have actively participated and especially Miss Helen McNamara who makes the editorial "we" a reality. The nature of our studies required substantial financial support and we wish to express appreciation to the U. S. Public Health Service and the New York Heart Association for supplementing the excellent facilities for research at the New York Hospital-Cornell Medical Center. It is the purpose of this paper to consider the development and present status of our knowledge of kidney function in young infants and to indicate some of its application to clinical problems. This knowledge is understandably incomplete because it is only during the last 10 years that the precise technics of kidney physiologists have been applied to the study of kidney function in young infants. The primary role of the kidneys in regulating the composition and volume of body fluids had been established earlier by an important series of observations, utilizing the technics of water and electrolyte balances. In many of these earlier observations there were already indications of an underdeveloped kidney function in young infants.

Conclusion

2020 ◽  
pp. 293-296
Author(s):  
Yuri G. Raydugin
Keyword(s):  
Decision Making ◽  
Monte Carlo ◽  
Lessons Learned ◽  
The Political ◽  
Risk Quantification ◽  
System Dynamics Modelling ◽  
Project Failures ◽  
Dynamics Modelling ◽  
High Level

This chapter provides a high-level overview of concepts, models, and results discussed in this book. It is accentuated that risk quantification used in decision-making can be tagged as ‘political mathematics’. The political aspects are defined by various realizations of bias from strategic misrepresentation to the Hiding Hand principle. It is pointed out that the mathematical aspects may succumb to the similar realizations of bias as political ones. Recommendations to balance the political and mathematical aspects are proposed. A role of the non-linear Monte Carlo N-SCRA methodology supported by the project system dynamics modelling is established as a role of the Revealing Hand. It should provide ammunition for decision-making before the project approval, not after in a form of lessons learned as the Hiding Hand does. This is a way to decline the invitation to attend a ‘banquette of consequences’ referring to project failures as ‘unpleasant unsurprises’.

Part I United States, 2 The Liquidation of Lehman Brothers Inc, the New York Brokerage of the Lehman Global Enterprise

2017 ◽  
Author(s):  
Caputo Kenneth J ◽  
Giddens James W ◽  
Kiplok Christopher K
Keyword(s):  
New York ◽  
Lessons Learned ◽  
Legal Issues ◽  
Regulatory Regime ◽  
Financial Instruments ◽  
Financial Products ◽  
Lehman Brothers ◽  
Foreign Affiliates ◽  
The Impact

This chapter explores the statutory and regulatory regime in place in 2008 that governed the operation and liquidation of Lehman Brothers Inc. (LBI) and highlights key legal issues in the liquidation. Section I provides an overview of the Securities Investor Protection Act (SIPA) statute. Section II describes LBI, its role as the broker-dealer in the global Lehman enterprise, and the story of its collapse in September 2008. Section III highlights some hallmarks of the LBI liquidation, including the emergency sale to Barclays, account transfers, the transfer of all of LBI’s subsidiaries on the eve of LBI’s filing, the atomization of foreign affiliates with different regulatory regimes, and the role of LBI as a counterparty in the financial products market, which led to a substantial general estate. Section IV addresses the impact of the broker-dealer liquidation under SIPA on the treatment of complex financial instruments. Section V reflects on lessons learned.

Decision Support to Masters, Mates on Watch, and Pilots: The Piloting Expert System

1990 ◽  
Vol 43 (03) ◽  
pp. 364-384 ◽  
Author(s):  
Martha Grabowski
Keyword(s):  
Decision Making ◽  
New York ◽  
Decision Support ◽  
Expert System ◽  
Decision Aid ◽  
Decision Aids ◽  
Gulf Of Alaska ◽  
Lessons Learned ◽  
Simple Task ◽  
Cognitive Decision

Piloting large vessels in increasingly congested waterways is no simple task. As in many ‘decision-making under uncertainty’ scenarios, masters, mates and pilots engaged in piloting are inundated with much information and required to make crucial decisions in real time. Piloting is also an inherently judgmental activity. Pilots and ships' captains invariably develop heuristics for transiting particular waterways. As vessels become larger, cargoes more hazardous, and the waterways more congested, decision aid technology is being considered to improve piloting decision-making. This paper describes one approach to providing improved on-board decision support to masters, mates on watch, and pilots navigating in restricted waters. We discuss (1) the use of cognitive decision aids in piloting, (2) the design of such a decision aid developed for New York harbour, (3) simulator experiments evaluating the expert system, and (4) plans to apply the approach and ‘lessons learned’ to the development of an expert system for tankers transiting the Gulf of Alaska.

The Role of Forensic Organizational Ergonomics

2011 ◽  
Vol 19 (1) ◽  
pp. 29-32 ◽  
Author(s):  
Joseph Cohen
Keyword(s):  
Decision Making ◽  
Human Performance ◽  
Medical Center ◽  
Chlorine Gas

This article introduces forensic organizational ergonomics through the presentation of a case study of worker injury. It describes how a consultant expert in organizational ergonomics revealed systematic failures of management and design within an organization that ultimately exposed employees, contractors, visitors, and patients of a medical center to harmful chlorine gas. The case study demonstrates how forensic organizational ergonomics can bring meaning to and understanding of the role of human performance in modern complex technologies to those charged with decision making in litigation.

Missing the Point: The Role of the Right Hemisphere in the Processing of Complex Linguistic Materials11This chapter reports research conducted over the past several years at the Aphasia Research Center, Department of Neurology, Boston University School of Medicine, and the Boston Veterans Administration Medical Center. The research was supported by the National Institute of Neurological Diseases, Communication Disorders, and Stroke (NS 11408), the Veterans Administration, and Harvard Project Zero. Earlier versions of this chapter were presented at the International Neuropsychology Symposium, Dubrovnik, Yugoslavia, June 1979; the Academy of Aphasia, San Diego, October 1979; and the Conference on Cognitive Processes and the Right Hemisphere, New York University, October 1980. In addition, much of the research reported here was described in more preliminary form in Wapner, Hamby, and Gardner, “The Role of the Right Hemisphere in the Processing of Complex Linguistic Materials,” Brain and Language, 1981, 14,15–33. We thank the editor of that journal, Prof. Harry Whitaker, and Academic Press for permission to adapt portions of that article.

1983 ◽  
pp. 169-191 ◽  
Author(s):  
HOWARD GARDNER ◽  
HIRAM H. BROWNELL ◽  
WENDY WAPNER ◽  
DIANE MICHELOW
Keyword(s):  
New York ◽  
Right Hemisphere ◽  
Medical Center ◽  
Neurological Diseases ◽  
Veterans Administration ◽  
Academic Press ◽  
Boston University ◽  
School Of Medicine ◽  
The Right

Health in Action: Evaluation of a Participatory Grant-Making Project in East Harlem

2019 ◽  
Vol 21 (6) ◽  
pp. 910-917
Author(s):  
Christina I. Nieves ◽  
Judy Chan ◽  
Rachel Dannefer ◽  
Cinthia De La Rosa ◽  
Carmen Diaz-Malvido ◽  
...  
Keyword(s):  
Decision Making ◽  
New York ◽  
Health Department ◽  
Local Health Department ◽  
Local Health ◽  
Community Needs ◽  
East Harlem ◽  
Department Of Health ◽  
Decision Making Processes

Decision-making processes that include resident input have been shown to be effective in addressing community needs. However, few examples discuss the role of a local health department in leading a participatory decision-making process. In 2016, the New York City Department of Health and Mental Hygiene implemented a participatory grant-making process to allocate grant funds to community organizations in East Harlem. Findings from the evaluation suggest that a participatory grant-making process can be an effective way to include community member as decision makers. It can also build capacity among organizations and foster meaningful community engagement with a local health department.

Sign in / Sign up

Export Citation Format

Share Document