Modelling the impact of extreme weather events on healthcare infrastructure using rich picture diagrams

Healthcare infrastructure for a community comprises not only its hospital but also many other related facilities such as primary care clinics, community health centres, rural nursing posts, aged care centres, etc. These facilities form a complex set of relationships which need to work collectively for an effective response to climatechange related extreme weather events such as floods and storms. The aim of this research is to develop a conceptual understanding of the dynamic relationships of hospital facilities before, during and after an extreme weather event. This is an essential step in framing a systems model that will assist facility managers to maintain critical healthcare infrastructure during an emergency. Rich Picture Diagrams (RPDs) were used to map relationships between critical healthcare infrastructure components such as the base hospital; access roads; aged care facilities and remotely located supplies. The rich information on the inter-organisational, system and governance complexities associated with responding to extreme weather events was obtained from three hospital case studies (two in Australia and one in New Zealand). The main finding of this research is that RPDs have considerable potential in the development of soft systems models which will assist decision takers involved in the design and management of healthcare infrastructure particularly in the context of extreme weather events. The soft systems methodology which underpins this research challenges the conventional view of what constitutes a ‘facility’ and consequently has important implications for those constructing and managing facilities.