Hospital Employee Willingness to Work during Earthquakes Versus Pandemics

Abstract

Background

Research indicates that licensed health care workers are less willing to work during a pandemic and that the willingness of nonlicensed staff to work has had limited assessment.

Objective

We sought to assess and compare the willingness to work in all hospital workers during pandemics and earthquakes.

Methods

An online survey was distributed to Missouri hospital employees. Participants were presented with 2 disaster scenarios (pandemic influenza and earthquake); willingness, ability, and barriers to work were measured. T tests compared willingness to work during a pandemic vs. an earthquake. Multivariate linear regression analyses were conducted to describe factors associated with a higher willingness to work.

Results

One thousand eight hundred twenty-two employees participated (15% response rate). More willingness to work was reported for an earthquake than a pandemic (93.3% vs. 84.8%; t = 17.1; p < 0.001). Significantly fewer respondents reported the ability to work during a pandemic (83.5%; t = 17.1; p < 0.001) or an earthquake (89.8%; t = 13.3; p < 0.001) compared to their willingness to work. From multivariate linear regression, factors associated with pandemic willingness to work were as follows: 1) no children ≤3 years of age; 2) older children; 3) working full-time; 4) less concern for family; 5) less fear of job loss; and 6) vaccine availability. Earthquake willingness factors included: 1) not having children with special needs and 2) not working a different role.

Conclusion

Improving care for dependent family members, worker protection, cross training, and job importance education may increase willingness to work during disasters.

Introduction

The willingness of hospital staff to report to work during disasters is paramount given that staff in all areas are necessary to maintain hospital functioning. Previous researchers have shown that factors affecting staff willingness to work during disasters are multidimensional, complex, and vary across occupations 1, 2, 3. In particular, previous studies have identified the following factors as having an impact on workers' ability and willingness to work during disasters: type of disaster, with workers being less willing to work during a biological or radiological event; occupation; perceived importance of job role during disaster response; concern for family; and perceived confidence that the employing hospital will provide worker protection during an event 1, 2, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13.

Some researchers, including Qureshi et al. and Garrett et al., have assessed willingness to work among health care personnel employed in urban-based hospitals, but no study has evaluated a broader sample of hospital workers spanning multiple hospital sizes and types 2, 5. In addition, most previous research has either focused on those directly involved in patient care services or looked at ancillary staff as a group—rather than the full spectrum of ancillary staff whose absence during a disaster would significantly hamper the overall functioning of the hospital. Understanding where the largest potential absentee gaps exist within staff areas allows for more focused disaster planning and education to those areas. With this information, disaster planners may develop a greater understanding of who will actually show up for work—this in turn will allow for improved distribution of these limited staff throughout the hospital. For instance, it may be determined that staff should not work in their usual capacity but rather in staffing decontamination teams or transporting patients. The purposes of this study are as follows: 1) assess willingness (desiring to work) of hospital staff to report to work during a natural disaster (earthquake) compared to a biological event (pandemic influenza), and 2) identify factors associated with lower willingness and ability (i.e., able to get to and function at work) to work in both scenarios.