Lessons learnt from the 2021 Pacific Northwest heat dome: a qualitative study of western Washington’s healthcare community response

Objective The 2021 Pacific Northwest heat dome was Washington state’s deadliest recorded weather event and presented unprecedented response challenges to the state’s health sector. Understanding the impacts of this extreme heat event (EHE) on the sector as well as the barriers to and facilitators of...

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Main Authors: Nathaniel Matthews-Trigg, Jeremy Hess, Amruta Nori-Sarma, Kelly Hill, Matias Korfmacher, Cat Hartwell, Gregory Wellenius, Nicole Errett
Format: Article
Language:English
Published: BMJ Publishing Group 2025-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/4/e089093.full
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author Nathaniel Matthews-Trigg
Jeremy Hess
Amruta Nori-Sarma
Kelly Hill
Matias Korfmacher
Cat Hartwell
Gregory Wellenius
Nicole Errett
author_facet Nathaniel Matthews-Trigg
Jeremy Hess
Amruta Nori-Sarma
Kelly Hill
Matias Korfmacher
Cat Hartwell
Gregory Wellenius
Nicole Errett
author_sort Nathaniel Matthews-Trigg
collection DOAJ
description Objective The 2021 Pacific Northwest heat dome was Washington state’s deadliest recorded weather event and presented unprecedented response challenges to the state’s health sector. Understanding the impacts of this extreme heat event (EHE) on the sector as well as the barriers to and facilitators of implementing effective heat response is critical to preparing for future events, which are happening more frequently in the region due to climate change.Design Guided by an implementation science framework, we convened listening sessions and focus groups of the health sector in western Washington to reflect on regional response efforts.Setting Health sector organisations in 15 counties in western Washington State, USA: Clallam, Grays Harbor, Island, Jefferson, King, Kitsap, Lewis, Mason, Pacific, Pierce, San Juan, Skagit, Snohomish, Thurston and Whatcom.Participants A convenience sample of 109 listening group participants was recruited through the professional networks of the Northwest Healthcare Response Network, a regional healthcare coalition. 27 of the health sector professionals were recruited using purposive sampling to participate in seven focus groups organised by organisation type.Results The co-presence of the COVID-19 pandemic, limited staff capacity, resource acquisition challenges and inadequate regional collaboration emerged as key barriers, while advanced planning, indoor cooling capabilities, adapting strategies to local needs, robust internal relationships and strong external partnerships were reported to facilitate effective response. Establishing centralised coordination ahead of heat events, making improvements to the cooling capabilities of the built environment, developing plans and policies for EHEs that have co-benefits for other events, adopting evidence-informed response strategies, institutionalising the knowledge and relationships developed through prior events and improving evaluative processes (such as developing real-time monitoring capacity) will enable more effective response to future EHEs.Conclusions Western Washington’s health sector implemented EHE response activities that enabled essential service continuity, despite limited resources, unfamiliarity with EHEs and other systemic challenges. The recency of the heat dome presents an opportunity to incorporate lessons learnt into practice, policies, plans and built environment; these are necessary improvements ahead of future large-scale events the region may experience in the coming decades.
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spelling doaj-art-72be5805032e4e73b3744f1dc82058832025-08-20T02:10:44ZengBMJ Publishing GroupBMJ Open2044-60552025-04-0115410.1136/bmjopen-2024-089093Lessons learnt from the 2021 Pacific Northwest heat dome: a qualitative study of western Washington’s healthcare community responseNathaniel Matthews-Trigg0Jeremy Hess1Amruta Nori-Sarma2Kelly Hill3Matias Korfmacher4Cat Hartwell5Gregory Wellenius6Nicole Errett7Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USADepartment of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USACenter for Climate and Health, Boston University, Boston, Massachusetts, USANorthwest Healthcare Response Network, Tukwila, Washington, USADepartment of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USADepartment of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USACenter for Climate and Health, Boston University, Boston, Massachusetts, USADepartment of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USAObjective The 2021 Pacific Northwest heat dome was Washington state’s deadliest recorded weather event and presented unprecedented response challenges to the state’s health sector. Understanding the impacts of this extreme heat event (EHE) on the sector as well as the barriers to and facilitators of implementing effective heat response is critical to preparing for future events, which are happening more frequently in the region due to climate change.Design Guided by an implementation science framework, we convened listening sessions and focus groups of the health sector in western Washington to reflect on regional response efforts.Setting Health sector organisations in 15 counties in western Washington State, USA: Clallam, Grays Harbor, Island, Jefferson, King, Kitsap, Lewis, Mason, Pacific, Pierce, San Juan, Skagit, Snohomish, Thurston and Whatcom.Participants A convenience sample of 109 listening group participants was recruited through the professional networks of the Northwest Healthcare Response Network, a regional healthcare coalition. 27 of the health sector professionals were recruited using purposive sampling to participate in seven focus groups organised by organisation type.Results The co-presence of the COVID-19 pandemic, limited staff capacity, resource acquisition challenges and inadequate regional collaboration emerged as key barriers, while advanced planning, indoor cooling capabilities, adapting strategies to local needs, robust internal relationships and strong external partnerships were reported to facilitate effective response. Establishing centralised coordination ahead of heat events, making improvements to the cooling capabilities of the built environment, developing plans and policies for EHEs that have co-benefits for other events, adopting evidence-informed response strategies, institutionalising the knowledge and relationships developed through prior events and improving evaluative processes (such as developing real-time monitoring capacity) will enable more effective response to future EHEs.Conclusions Western Washington’s health sector implemented EHE response activities that enabled essential service continuity, despite limited resources, unfamiliarity with EHEs and other systemic challenges. The recency of the heat dome presents an opportunity to incorporate lessons learnt into practice, policies, plans and built environment; these are necessary improvements ahead of future large-scale events the region may experience in the coming decades.https://bmjopen.bmj.com/content/15/4/e089093.full
spellingShingle Nathaniel Matthews-Trigg
Jeremy Hess
Amruta Nori-Sarma
Kelly Hill
Matias Korfmacher
Cat Hartwell
Gregory Wellenius
Nicole Errett
Lessons learnt from the 2021 Pacific Northwest heat dome: a qualitative study of western Washington’s healthcare community response
BMJ Open
title Lessons learnt from the 2021 Pacific Northwest heat dome: a qualitative study of western Washington’s healthcare community response
title_full Lessons learnt from the 2021 Pacific Northwest heat dome: a qualitative study of western Washington’s healthcare community response
title_fullStr Lessons learnt from the 2021 Pacific Northwest heat dome: a qualitative study of western Washington’s healthcare community response
title_full_unstemmed Lessons learnt from the 2021 Pacific Northwest heat dome: a qualitative study of western Washington’s healthcare community response
title_short Lessons learnt from the 2021 Pacific Northwest heat dome: a qualitative study of western Washington’s healthcare community response
title_sort lessons learnt from the 2021 pacific northwest heat dome a qualitative study of western washington s healthcare community response
url https://bmjopen.bmj.com/content/15/4/e089093.full
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