Regional Disaster Response Coordination to Support Health Outcomes Surge Management: Workshop in Brief (2015) / Chapter Skim
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Regional Disaster Response Coordination to Support Health Outcomes: Surge Management - Workshop in Brief
Regional Disaster Response Coordination to Support Health Outcomes: Surge Management - Workshop in Brief
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The first workshop, held in Irvine, California, explored issues of community planning and engagement.1 The forum convened a second regional workshop in Minneapolis, bringing together key stakeholders to examine how information and incident management can augment response efforts in a complex, regional emergency.2 The third and final workshop in this series, which this document summarizes, was held in New Orleans and considered how community engagement and information sharing can impact issues of surge management across the public health and health care spectrum.3 Workshop chair Craig Vanderwagen, former Assistant Secretary for Preparedness and Response (ASPR) , asked, for example, "How can assets across a region be better managed?
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Ward mentioned federal bills authorizing funding for grant programs that support trauma system planning, regionalization of emergency care, trauma care centers, and trauma service availability, but funding has not yet been appropriated, and some will need to be reauthorized before the programs can begin.4 Effective regional health care systems could assist in a stronger response to infectious diseases like Ebola and other public health emergencies. In the cases of geographically remote regions, where the nearest specialty care center may be 500 miles away, a participant noted the importance of forming multistate consortiums to collaborate on assessing needs and priorities for evacuation with such distance in mind.
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Because of this, the state did not have the awareness of the information and transports that were seen at the regional level, which led to a disconnect and gaps in situational awareness. She said now CMOC's Web Emergency Operations Center (EOC)
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Public Health Surge Capacity and Community Resilience The discussion on public health surge capacity and community resilience also built off an earlier series meeting -- on community engagement -- as much of the conversation included how to build sustainable and inclusive health coalitions that can allow for greater resources, communication, and surge capacity when needed. Many of the suggestions by participants and discussion leaders Umair Shah, director of Harris County, Texas Public Health and Environmental Services, and Andrew Stevermer, regional emergency coordinator for ASPR, focused on longterm goals of making communities more resilient by addressing social determinants of health.5 If public health can address those determinants such as housing, transportation, education, access to health care and nutrition, and others prior to a disaster, then communities could become more resilient in disasters and there will be less of a clinical surge burden on regional hospitals.
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Monique Davis, health educator and risk communicator for the Hudson Regional Health Commission, described three approaches for increasing surge capacity through public health: the activation of medical needs shelters, mobilization of alternative care sites and extended treatment areas, and development of regional public health emergency preparedness workplans prior to disaster. She stressed that the goal of these approaches is to decompress emergency departments and health care facility bed surges throughout the region by having a place for those not in critical condition to receive treatment.
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As a few participants noted, having NGOs integrated into the state and local emergency response plan as an identified resource can alleviate some of the confusion when a crisis does occur. Ron Perry, emergency manager for Jefferson Parish, Louisiana, stated that when he and his staff review the parish's All-Hazard Plan, they include Red Cross, United Way, and other local NGOs into their planning process as part of the staff.
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Challenges • NGOs are uncertain where they fit within the response system and where their best entry points should be • Sustaining NGO commitment between disasters Opportunities • Identify the "it" message, meaning the message that will catch the attention and solicit buy-in of potential NGO partners; communicating a reason that has strong meaning to an NGO can better leverage NGO engagement • Scale up engagement around the "it" by conducting exercises - Include businesses in planning for emergency operations centers and points of dispensing • Resource typing Potential Partnerships • Local: corporations and faith-based, cultural, and service organizations • State: voluntary organizations active in disasters • National: federal level, national service organizations Case Study: Louisiana Department of Health and Hospitals Prats discussed lessons in coordination and surge management learned from Hurricane Katrina in 2005, and progress made since that time. She said the storm brought attention to gaps in evacuation procedures (after the storm)
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These are both great examples of using community assets and resources to reduce the clinical surge burden on hospitals. In response to a question about creating sustainable and resilient health systems, Prats, Upton, and Davis all highlighted the continually decreasing Hospital Preparedness Program (HPP)
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Dyjack Robert Wood Johnson Foundation, Department of Homeland Security, Federal Emergency Management National Association of County and Princeton, NJ City Health Officials, Washington, DC Agency; Department of Homeland Security, Office of Health Affairs; Lewis J Radonovich Department of Transportation, National Highway Traffic Safety Bruce Evans Department of Veterans Affairs, National Association of Emergency Washington, DC Administration; Department of Veterans Affairs; Emergency Nurses Medical Technicians, Upper Pine River Association; Food and Drug Administration; Infectious Diseases Fire Protection District, Bayfield, CO Stephen C
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