Seismic resilience of a hospital system

In this paper we examine the reconstitution of the Emergency Operations Centre (EOC) after its destruction in the World Trade Center attack, using that event to highlight several features of resilience. The paper summarises basic EOC functions, and then presents conceptions of resilience as understood from several disciplinary perspectives, noting that work in these fields has sought to understand how a natural or social system that experiences disturbance sustains its functional processes. We observe that, although the physical EOC facility was destroyed, the organisation that had been established to manage crises in New York City continued, enabling a response that drew on the resources of New York City and neighbouring communities, states and the federal government. Availability of resources--which substituted for redundancy of personnel, equipment and space--pre-existing relationships that eased communication challenges as the emergency developed and the continuation of organisational patterns of response integration and role assignments were among the factors that contributed to resilience following the attack.