The 14 th World Conference on Earthquake Engineering October 12-17, 2008, Beijing, China SEISMIC RESILIENCE OF HEALTH CARE FACILITIES G.P. Cimellaro 1 Cristina Fumo 2 A. Reinhorn 3 and M. Bruneau 3 1 Postdoctoral Research Associate, Department of Civil, Structural & Environmental Engineering - University at Buffalo- (SUNY), Buffalo, NY 14260 - USA Email: cimellaro@gmail.com 2 Ph.D. Candidate, Department of Civil Engineering, University of Udine. Via delle Scienze, 208 33100 – Udine – Italy 3 Professor, Department of Civil, Structural & Environmental Engineering - University at Buffalo- (SUNY), Buffalo, NY 14260 - USA ABSTRACT : Resilience is defined as the ability of engineering and socio-economic systems to rebound after severe disturbances, or disasters, such as earthquakes. This paper presents a comprehensive conceptual framework to quantify resilience including both technical and organizational aspects. An organizational model (metamodel) describing the response of the hospital emergency department has been implemented. The metamodel is able to estimate the hospital capacity and its dynamic response in real time and incorporate the influence of the facility’s damage in structural and non-structural systems on the organizational ones. The waiting time, a measure of efficiency and capability to respond, it is used to evaluate seismic resilience of health care facilities. Its behavior is described using a double exponential function and its parameters are calibrated based on simulated data. The metamodel has been designated to cover a large range of hospital configurations and takes into account hospital resources, in terms of staff and infrastructures, operational efficiency and possible existence of an emergency plan, maximum capacity and behavior both in pre-saturated and saturated conditions. KEYWORDS: Damage state, functionality, hospital, metamodel, organization, resilience. 1. INTRODUCTION Health care facilities have been recognized as strategic buildings in hazardous events and play a key role in the disaster response and recovery; however no attempt was made so far to practically relate the structural and organizational damage on the performance of hospitals. There is an extensive literature on the definition of the main parameters of seismic resilience (see Bruneau et al., 2003; Bruneau and Reinhorn, 2007; Cimellaro et al., 2008) for health care systems and on the definition of the general framework, however there is no information regarding the modeling and the measure of the organizational aspects of resilience. Indeed, an organizational resilience model is needed, to be able to determine the response of the community to hazardous events, and evaluate the real loss in terms of healthy population and quality of care provided. In this paper an organizational metamodel describing the response of the hospital’s emergency department (ED) has been implemented. The model intends to offer a first approach to the problem and a more comprehensive evaluation of the multidimensional aspects of resilience. The metamodel is able to estimate the hospital capacity and incorporate the influence of the facility damage in structural and non-structural components on the organizational ones. 2. ORGANIZATIONAL RESILIENCE The main purpose of this research is to relate the technical and organizational aspects of health care facilities, to obtain a measure of organizational resilience that has not been attempted so far. The goal is to relate the measure of resilience to the quality of care (QC) provided and the eventual loss of healthy population, caused by