Evacuate or Stay? North Shore LIJ and Hurricane Sandy


This case examines the pros and cons of evacuating medical facilities in the face of a looming natural disaster. In October 2012, the North Shore-Long Island Jewish Hospitals (North Shore-LIJ) network braced—together with rest of the East coast—for the advent of Hurricane Sandy. Weather forecasters painted a grim picture, and North Shore-LIJ had three hospitals in low-lying areas. Vice President of Protective ServicesJames Romagnoli and COO Mark Solazzo had seen this scenario only a year earlier, when in August 2011 they evacuated hospitals in advance of Hurricane Irene. But Irene had, at the last moment, spared New York City. With that unnecessary evacuation fresh in their minds, the two officials had to decide what to do as Sandy approached.

Students will learn about incidents of hospital evacuations over the years leading up to Hurricane Sandy. The case looks at a variety of disasters from earthquakes to fire to floods. It examines the costs and benefits of evacuation, and clarifies the burdens placed not only on patients but on other area hospitals when one evacuates. Students are given an insider’s look at the realities of emergency management in the healthcare system.

This case provides a basis for classroom discussion of emergency management best practices, the relationship between good planning and events on the ground, and whether training can ever be sufficient for an unpredictable reality, How well does an Incident Command System work? What kind of decisionmaking structure functions best in a crisis? How should one best deploy staff and other resources? What are the legal and ethical trade-offs between evacuating patients and sheltering in place?

Use this case in a class/course on disaster preparedness, crisis management or health care system logistics.


This case was written by Eric Smalley for the Case Consortium @ Columbia and the Mailman School of Public Health. The faculty sponsor was Assistant Professor David Abramson of Mailman. (0513)

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