Applying the Haddon Matrix to Decision Engineering for Hospital Disaster Preparedness

The Haddon matrix is a systematic analytic tool for identifying relevant, modifiable factors contributing to injury and illness throughout a disaster's life cycle.  Developed in 1969 by Dr. William Haddon, Jr. of the U.S. National Highway Safety Bureau, the matrix was initially applied toward automotive traffic-related death and injury. In the years since, the Haddon matrix has been used to identify root causes and interventions for a variety of hazards, including driver’s fatigue, safety belts and airbags, youth injuries, death investigations, and construction injuries.

More recently, this model has begun to be applied toward disaster management considerations.  Barnett and colleagues, for example, have described how this matrix could be used to systematically enhance preparedness and response to a broad range of public health threats, including pandemic influenza.

In this presentation, we will describe a novel application of the Haddon matrix as a decision engineering tool for healthcare administrators and related leadership stakeholders to use in optimizing disaster preparedness efforts.  Specifically, we will highlight how this matrix addresses and integrates disaster planning considerations in the following highly relevant domains: human infrastructure, physical infrastructure, and relevant laws and policies in disasters.  We will illustrate this application through Haddon matrix-informed retrospective analyses of a variety of recent disasters, including Hurricane Sandy, Hurricane Katrina, and the 2009 H1N1 influenza pandemic.  Each of these events underscored the need for more systematic and nuanced administrative approaches to adressing the critical interfaces between healthcare workers and the physical and legal/policy environments that affect their functioning in disaster contexts.  We will describe in detail how the Haddon matrix offers a user-friendly tool to address this timely administrative need.