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Open-File Report O-18-03, Oregon coastal hospitals preparing for Cascadia
by Yumei Wang; 97 p. report.

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Executive Summary:

Hospital facilities in western Oregon are not expected to perform well after a Cascadia subduction zone earthquake and tsunami. Due to their close proximity to the Cascadia fault, the 11 hospitals along the coast will likely incur the most serious damage and may take over 3 years to fully recover to an operational state (OSSPAC, 2013; Wang, 2014, 2017). The Oregon Health Authority (OHA) partnered with the Oregon Department of Geology and Minerals Industries (DOGAMI) to provide technical assistance and to determine what is needed for coastal hospitals to provide healthcare services immediately after a Cascadia earthquake. DOGAMI worked with OHA Healthcare Preparedness Program (HPP) regional liaisons and met with representatives from the coastal hospitals to learn about the expected post-earthquake performance.

Although all coastal hospitals have emergency plans and capabilities, DOGAMI findings verify that no hospital facilities are likely to be functional due to the expected severity of a magnitude 9 Cascadia earthquake and tsunami damage. Seismic vulnerabilities include building structures; non-structural components that are part of the building as well as equipment; and the limitations of on-site utilities such as power and water. Four of the eleven hospitals are located in the tsunami evacuation zone and face difficulties with tsunami planning.

To improve hospitals’ state of readiness for future Cascadia earthquakes, DOGAMI’s Recommendation 1 improves seismic requirements, Recommendations 2 and 3 focus on technical support and accelerating seismic preparedness activities for the eleven coastal hospitals, and Recommendation 4 provides earthquake planning information to hospitals across the state.

DOGAMI proposes that the recommended tasks be conducted in a three-year work plan. For Recommendation 1, DOGAMI proposes that OHA determine its own timeline. Recommendation 2 can be completed in the first year. Recommendations 3 and 4 can be accomplished in the second and third years. Toward the end of the third year of sustained efforts, OHA and its coastal healthcare system partners can reevaluate the need for any future efforts.

OHA evaluate, clarify, and improve existing requirements on hospitals and healthcare systems regarding seismic preparedness. This would affect all of the hospitals and healthcare systems in the state and would improve the state’s level of resilience. A few specific areas to be addressed involve: Oregon Revised Statute 455.400; performance level objectives and plan review of new hospitals via the Oregon Structural Specialty Code; and seismic preparedness standards for water districts that serve hospitals.

DOGAMI, with the help of HPP region 1, 2, and 3 liaisons, conduct on-site consultative visits to each coastal hospital to provide technical assistance. This would allow coastal hospitals to focus and make progress on key aspects of disaster preparedness.

OHA establish a coastal hospital resilience network with specific focus on preparing for Cascadia earthquakes. This would involve developing and sharing best practice guidance and other preparedness information among hospitals and healthcare systems. Periodic training sessions, co-organized by HPP region liaisons, DOGAMI, and hospitals, would allow for networking and acceleration of preparedness activities. Although this network is designed to improve the resilience of coastal hospitals, certain aspects of the network would also benefit noncoastal hospitals and improve the state’s resilience.

DOGAMI and the Oregon Department of Energy (ODOE), in coordination with HPP regional liaisons, provide Cascadia earthquake and emergency fuel planning information to all hospitals across the state. This would provide critical information to help improve statewide preparedness.