Healthcare workers’ ability and willingness to report to duty during catastrophic disasters

With the occurrence of a catastrophic disaster, it can be immensely difficult for healthcare systems to manage an acute and large influx of patients. During these acutely stressful periods, specialized efforts are required to keep up with the demand of space, resources, and healthcare professionals that can tend to the patients. In urban settings with high population densities, it is imperative to analyze how healthcare workers can respond to catastrophic events when there are discrepancies in staff availability.

This study aims to observe both willingness and ability of healthcare workers to report to work during various scenarios of chemical, biological, radiological, and explosion events in the New York City Metropolitan area. This study sought the approval of The Columbia University Institutional Review Board to distribute anonymous surveys to a convenience sample of over 6,000 healthcare workers from 47 different facilities that were willing to participate in the study. The facilities surveyed included 31 hospitals, 11 long-term care facilities, and 5 community health centers.

Out of the participants that responded to the survey, many reported issues with an ability to work during an event such as personal obligations or availability to take on additional shifts or work in other facilities; 53% reported that they had childcare responsibilities and 27.1% reported eldercare obligations. Different responses were collected from the respondents depending on the type of hazard; 80.6% reported ability to report during an environmental disaster and 71% for a chemical incident, whereas 68.6% indicated the ability to report during smallpox, 63.5% for COVID-19, 48.9% for a snowstorm, and  20% of respondents were unsure.

The reasons for not being able to report include childcare, transportation problems, personal health concerns, and eldercare responsibilities. The authors explored the willingness of staff to report to work by assessing their concerns and fears of safety for themselves and their families, and by a stratifying willingness by event type. 

After conducting a multivariate analysis, the conclusions revealed that ability and willingness to report to the facility varied by event type; the ability and willingness were lowest for events where employees perceived risk to be very high to themselves or their families. The significance of this study is that many reasons that prevent willingness to report can be addressed, such as childcare and transportation issues. This planning can be used to enhance the ability and willingness for healthcare workers to respond during catastrophic events. 

Read the abstract and download the journal article here