RAPID: Organizational Decision-making and Restoration of Rural Healthcare Infrastructure and Access in Texas Smokehouse Creek Fire

Wildfires are extremely destructive to critical infrastructure sectors, especially in rural communities. Among them, healthcare and public health systems are frequently disrupted or destroyed. Yet, little is known about the decision-making processes that lead to prioritization of resources and efforts as community transitions from response to recovery.

This Rapid Response Research (RAPID) project supports research on theoretical and practical implications of organizational behavior and decision-making processes to restore healthcare access in the wake of wildfire disasters. A key focus is on examining differences between work as planned (stipulated in emergency management plans, incident action plans, recovery plans, etc.) and the work as done (implementation of these plans) as well as their effect on vulnerable populations (e.g., persons with physical and mental health vulnerabilities) within vulnerable communities (e.g., rural, low capacity).

Using the recent Texas Smokehouse Creek Fire as a case study, this project explores an emerging theme of research on how decisions are made and implemented with respect to prioritizing the restoration of healthcare access as incident operations transition from response to recovery. In February 2024, nearly 1.25 M acres of the rural Texas panhandle was consumed by fire in less than two weeks.

It significantly disrupted healthcare operations, access, and services in affected communities. To better understand the phenomenon, the research team collects highly ephemeral data including participant observations in planning meetings and briefings within the Emergency Operation Centers, emergency management offices, local and regional health departments, hospitals, nursing homes, and other health care facilities as well as in-person semi-structured interviews with officials across public health, emergency management and relevant public safety leaders in the communities directly impacted by the fire.

They are supplemented with secondary data including incident action plans, demobilization plans, operational briefings, recovery plans, and communications with the public and media immediately preceding, during, and after the fire. Deidentified data are shared and published via NHERI DesignSafe for research community use. Through analysis of the interviews, observations, and plans and other documents, the team develops transferable knowledge critical to informing planning and decision-making for restoration of essential health services, particularly for vulnerable communities affected by wildfires and other disasters.

This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.