This paper illustrates a study conducted into the managerial practices implemented to mitigate the consequences of a major fire emergency and to promptly restore normal business operations at a large pediatric hospital. Stemming from prior research on crisis response and recovery in critical infrastructures, this investigation demonstrates that factors such as the complexity of the underlying stakeholder networks, the vulnerability of the involved actors, and several temporal and spatial constraints, all contribute in hampering the intervention of crisis managers. In these situations, relying on consolidated best practices may enable more rapid response and more adequate recovery.This study adopts a qualitative approach to build a retrospective case study that highlights the crucial issues that healthcare crisis managers are requested to face when exposed to thorny work conditions: presence of numerous actors from the public and the private sector, involvement of organizations with contrasting interests, need for a balance among public health, cost containment and legitimacy, etc. The findings of the present investigation expand the theoretical knowledge on the dynamics that characterize crises occurring at critical infrastructures and provide practical recommendations for healthcare emergency managers to improve their response to, and recovery from, major fire emergencies.

Robotic surgery is a good clinical alternative to laparoscopic and open surgery (for many pediatric operations). However, the costs of robotic procedures are higher than the equivalent laparoscopic and open surgical interventions. Therefore, in the short run, these findings do not seem to support the decision to introduce a robotic system in our hospital.

A399Such hybrid studies generally involve integration of datasets from multiple electronic sources such as electronic data capture (EDC) systems for clinical trials and observational studies, claims databases held by public and private payers, and myriad others. When conceptualizing a hybrid analytic approach, researchers should give thought to the use and potential repurposing of existing data sources, the structure of "new" data sources (e.g., EDC) and planning analyses for individual, partially merged, and fully merged datasets. This presentation will explore design and operational considerations for hybrid retrospective-prospective studies, including merging databases of different sizes and formats and analyzing data from individual and pooled datasets with a focus on which data can and should be captured, such as efficacy/effectiveness outcomes, healthcare resource utilization (HRU), and costs/ claims. Based in the design and conduct of actual studies, the presentation will conceptualize a hybrid study design and targeted data management and analysis approach. Building on this example, the presentation will enumerate important data elements and design considerations for study start-up and ongoing management and analysis of singular studies that utilize one retrospective dataset (e.g., electronic health records (EHR)) and one prospective dataset (e.g., EDC) as well as multi-year, multi-dataset drug and disease registries that utilize large amounts of both prospective and retrospective data.