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Question: Analyse the Case Study provided - Evacuate or Stay? Northshore LIJ and Hurricane Sandy and write a report using the attached Writing a case study response as a guide. Answer: Introduction Emergency situations can be at the operation theatre or a patient admitted with medical case that needs to be treated urgently. Whereas, there are other emergencies also that arise due to natural calamity. Natural calamities like severe storms, hurricanes often devastate places that lay on their path. Hence, an important question looms over the hospital Authorities whether to evacuate or to stay. Staying is not always the best option while evacuating needs a whole lot of cooperation and coordination of the hospital staffs, nurses and the doctors. If the evacuation procedure is not done correctly, then it can jeopardize several valuable lives, which includes not only the patients but also the hospital staff, nurses and the doctors. The case study is based on emergency responses arising due to natural calamity like hurricane and how the hospital authority must tackle the emergency situation. The problems that arise due to natural calamities include relocation of the patients, the huge burden of relocation the patients rely on the hospital authorities and the proper coordination and cooperation of the hospital staffs, nurses and the doctors. Hence, another problem is that if the hospital staffs, nurses and the doctors do not coordinate and cooperate properly then it might lead to escalation of health issues and even the valuable lives of the patients can be at jeopardy. Description Low lying areas or the coastal areas are the major vulnerable regions that get affected badly due to natural calamities or hazards like hurricanes. Along with such vulnerabilities, the presence of hospitals and health care centers in such areas even worsens the situation. Several issues like the patient safety, timely relocation of all the patients and even minimizing assets loses are the major issues which make the hospital authorities to contemplate. similarly, same kind of issue arose on August 2011, hurricane named Irene wreak havoc on the East coast of New York City. Forecaster even predicted the path of the hurricane Irene, and accordingly the New York city Authorities evacuated the low lying areas and the coastal communities. North shore long Island Jewish Hospitals (North shore LIJ) had 15 hospitals in the long island and According to the predictions of the forecasters the hospitals were located in the low lying areas and thus were at risk of flooding and severe storm. Likewi se, the North Shore LIJ hospital authorities on 24th august 2011 relocated all the 947 patients to other hospitals further inland. However, the hurricane Irene lost its strength and the greater New York was left unscathed. It is needless to say, the relocation of the 947 patients was an unnecessary step (1). Although there were no negative consequences, the experience gained from the exercise made the north Shore LIJ vice president of the protective services and the chief operating officer to take in to account the pros and the cons of relocation of patients during such extreme weather events. After around 14 months, an almost same event occurred, the North Shore LIJ was again under the radar of another hurricane named Sandy. The hurricane Sandy already devastated a big portion of the Caribbean islands, thus risk looms over the North Shore LIJ, whether the hospital Authority should evacuate the hospital or stay. Discussion Issues and its implication on different stakeholders Previously, the hurricane Irene did not affect and wreaked any damage to the hospital because Irene lost its strength, but before the hurricane Irene lost its strength, the hospital authorities made an important decision of relocating all the 947 patients from the hospital to further inland. Hence, the hospital authorities contemplating that the decision of relocating the patient was not right (1). The main issue that now looms over the North Shore LIJ is the another incidence hurricane named Sandy which can wreak havoc upon the coastal areas of New York City. The prime stake holders according to the present situation are the North Shore LIJ hospital, the patients, the hospital staffs and the doctors, James Romagnoli (vice president of protective services), Mark Solazzo (Chief operating officer) (1). Thus, the major question that is looming over both James Romagnoli and Mark Solazzo is should they relocate the patients again considering the hurricane Sandy or should they stay back. The major implications on the different stakeholder can be assessed as follows: The patients- leaving the patients in to the hands of the devastating Hurricane Sandy can be fatal, whereas the shifting the patients far into the inner parts of the city will be uncomfortable for the majority of the patients (2). The North Shore LIJ hospital- relocating the patients is a costly affair, the hospital authorities have done it before, but doing the same again can put a strain on to finances of the hospital. James Romagnoli Mark Solazzo- the vice president of protective services and the chief operating officer respectively are the have got the experiences of relocating the patients previously. Thus the responsibility of patients safety and the procedures to be followed are on both these officials. Whatever decision they will take will directly affect the patients and the hospital staffs and doctors. The hospital staffs and the doctors- relocating 947 patients from one location to another is a cumbersome job. It needs good coordination of the staff, nurses and the doctors. Hence, it will test their abilities again (2). Issues and linkage with academic researches The first major issue is relocation of the patients- the relocation of the patients to a different hospital due to an emergency of natural calamity is a laborious and cumbersome job both affecting the patients mental and physical state. A hospital has several kinds of patients ranging from disabled to patients receiving the intensive care. Even to turn the bed or using a toilet makes relocation task a very delicate and complex issue. Shifting a disabled patient requires manually to handle the patient and shifting the patient to a wheelchair while a bedridden patient can be shifted only by shifting the patient to a stretcher (3). While shifting a patient who is receiving intensive care needs to be done with outmost caution and care, while several complications include changing site of the vascular catheters, sedation management, carefully scheduling the procedures (4). The 3-5% of patients are the high risk patients and the rising risk patient includes 20-30% while the majority are th e low risk patients which include a whopping 70%. Hence, to deal with the care of the high risk patients, each of these patient must have one assigned doctor to monitor the patient continuously or can be monitored remotely through artificial intelligence, hence moving such patient requires the most attention (5). Secondly, the rising risk patients do not need to be assessed by individual doctors but care must be taken so that such rising risk patient do not escalate to high risk. Rising to high risk can again spell problems for both the patient and the doctors that increase the complexity of the case (6). Lastly, the low risk patient forms the majority of the patients, thus managing these patients requires planning and proper cooperation and execution of the same between the staffs and the nurses (7). Suggestions Regarding the issue of evacuation or stay. It can be suggested that evacuation can be done on a priority basis. Strong hurricanes can disrupt the power supply, hampering the patients that are under the intensive care. Hence, such patients must be relocated first and the patients that can be categorized as low risk patients (7), such patients can be kept in the hospital to minimize the complications. Because a large number of patients fall under this low risk category and relocating such patients both includes huge finances and larger staff cooperation. The location of hospitals is vital for both the communities that are getting benefitted, however hospitals should not be built near the coastal areas that are prone to strong hurricanes (8). Such step will minimize asset loses that arise due to devastating storms and hurricanes. The hospitals staffs, doctors and the nurses must be trained to deal with emergencies arising due to storms and hurricanes. Storm and hurricanes arrive before several days. Hence the hospital staffs can stay prepared to handle such situations. Hospitals within the vicinity of storms and hurricanes can set up mock drills that can help the staffs to prepare for the emergencies (9). Also workshops and seminars can be organized that will emphasize on the emergency preparedness and adaptability of the hospital staffs with regard to emergencies. Providing effective training to the staffs is not enough unless the same is given to the patients as well. Research shows that relocating patients affect them mentally, hence, mentally preparing the patients by training them to understand that the relocation is for their own benefit can yield fruitful results (10). Evaluation of the suggestion based upon the selected case According to this case, all the solutions suggested above is applicable. The previous attempt of relocating patient went well with negative outcomes and even the hurricane Irene lost its strength. Hence, the attempt although successful, was needless and unnecessary. Whereas, this argument is only put forward after the storm got weakened, but before the storm was predicted by the National Weather Services, the outcome was uncertain. Likewise, the present question is whether to evacuate or stay because of another hurricane named Sandy. The patients health condition is one of the major concerns of any hospital. Whether it is high risk patient or a low risk patient, the safety concerns remains the prime motive of every hospital. Hence, relocating patient based on the priority of health condition can help a lot to reduce confusion and complexity (11). Training the patients and making them mentally prepared before relocation is helpful to reduce escalations of health risks. Management of t he staffs, nurses, doctors and providing them with the necessary training will help a great deal in increasing cooperation during the patient relocations (12). Conclusions Therefore, from the above disclosure, it can be concluded that during crisis situations like the severe storms and hurricanes. It is often necessary to relocate patients to a safer location, to minimize the escalations of health conditions. Often the hospital authorities stay in dilemma whether to evacuate or stay during a storm and hurricane warning. Evacuations as a whole mean to relocate the patients which include both the high risk and low risk patients. Relocating patients is a logistical and labor intensive job which needs proper coordination and continuous monitoring of high risk patients and cooperation between the hospital staffs, nurses and the doctors. The main reason due to which the hospital authorities often perform the relocation task is because, for them the health conditions of the patients is the major concern. The health conditions of the high risk patients like the patients that are under the intensive care require uninterrupted power supply to continue the proper functioning of the life supporting services. Such patients require to be relocated to safety on priority basis. While the low risk patients can be relocated later depending upon the urgency and need to minimize the chances of health condition escalation. According to several researches, it is found that 70% of the patients fall into the category of low risk patients which often do not require active monitoring and doctor watch. Hence, such low risk patients can be relocated depending on the degree of health condition (13). The hospitals no doubt are the important for every community, but their location near the coastal areas often make them vulnerable to storms and hurricanes. Such hospitals need to constructed after assessing their geographical positon and such hospitals must have the emergency power supply to support the electrical equipment needed to drive the life supporting devices and equipment (14). During an emergency situation arising due to natural calamity, the hospital staffs and the nurses are first to respond to such situations. Hence, the hospital staffs and the nurses need to be properly trained to deal with emergency situations (15). 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