HISTORY HAS PROVIEDED whole civilizations with few truly defining moments. Some of these are technology-related and might include December 17, 1903, when Orville and Wilbur Wright first flew their airplane from the beach at Kitty Hawk; or July 20, 1969, when Neil Armstrong first set foot on the moon. Other events are economic in nature, such as the stock market crash in 1929 that led to the Great Depression in the United States and severely affected Europe as it tried to recover from World War I. However, most notable as defining moments are those events initiating worldwide conflict, including the attack by Japanese forces on Pearl Harbor, Hawaii on December 7, 1941, an event that completed the circle to make World War II a global conflict.
In that vein, the words "nine-eleven" will forever be etched in the consciousness of the United States and much of the world. The numbers are stark: 4 aircraft, 19 hijackers, 3 buildings, 3,214 persons dead or missing, and 8,800 persons injured.
In the days, weeks, and months immediately following the September 11 attacks, a number of unexpected jolts, much like earthquake aftershocks, hit healthcare organizations across the nation. Some of the unanticipated aftereffects include the following:
* A health system CEO anticipates that insurance premiums overall will continue to climb given a combination of payouts associated with the 9/11 attacks and the slump in the stock market, which has seriously eroded the portfolio values of insurance companies.
* An executive of a large integrated delivery network notes that many staff are members of Army and Air Force reserve units. As a result of the ramp-up of military operations post-September ii, a hospital's staffing level can be significantly affected, particularly when the reserve members are physicians who have to leave at a moment's notice.
* The same executive has noticed the effects on hospital construction as new and improved security measures are put into place, including limiting the number of building entrances and implementing lockdown procedures.
No doubt, hospitals and healthcare providers will be central to the survival of a community immediately after a devastating manmade, or natural, disaster. The question is, how should healthcare organizations prepare for these types of calamitous events?
In this issue of Frontiers, we are privileged to have two uniquely qualified individuals write from different yet connected perspectives. In "9/11: A Healthcare Provider's Response," David J. Campbell, FACHE, president and CEO of St. Vincent Catholic Medical Centers (SVCMC) in New York, writes about the experience he and his staff encountered as the closest Level i trauma center to the site of the World Trade Center. …