Regional Disaster Response Coordination to Support Health Outcomes Summary of a Workshop Series (2015) / Chapter Skim
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1 Introduction
1 Introduction
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The purpose of each regional workshop was to discuss potential mechanisms to strengthen coordination among multiple jurisdictions in various regions to ensure fair and equitable treatment of communities from all impacted areas. Each of the three workshops covered different topics that may strengthen regional disaster response.
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The third and final workshop in this series was held in New Orleans and considered how the first two topics of community engagement and information sharing could impact issues of surge management across the public health and health care spectrum. This includes patient tracking and evacuation, reducing the surge burden on clinical health care facilities, and improving services available within public health and community programs.
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, American Red Cross, and American Public Health Association. The workshop series planning committee chose to focus each of the regional workshops on one of three domains of the NHSPI that were ranked in 2013 as warranting greater attention: community planning and engagement; information sharing and incident management; and surge management.
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MEETING OBJECTIVES On March 26, July 24, and November 15, 2014, the IOM's Forum on Medical and Public Health Preparedness to Catastrophic Events organized a series of 1-day workshops at locations around the country to gather input from varied participants about the opportunities to strengthen regional coordination to ensure effective medical and public health response to a large-scale, multi-jurisdictional disaster. Represented sectors included state and local public health, emergency management, emergency medical services, hospital preparedness planners, academic
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The specific meeting objectives for each workshop in the series are listed in Box 1-1.4 BOX 1-1 Community Planning and Engagement: March 26, 2014 – Irvine, CA Meeting Objectives • Examine how Community Planning and Engagement strength en regional preparedness initiatives. • Discuss community collaboration with schools, businesses, and community organizations across regions.
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• Consider how improved information sharing and data collec tion capabilities can support decision making of policy makers. Surge Management: November 15, 2014 – New Orleans, LA Meeting Objectives • Define and discuss the challenges of evacuation and rapidly surging health systems across a region.
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As many speakers pointed out in the workshop on community engagement, these health care coalitions typically include the obvious partners, such as the Red Cross, Salvation Army, and local health care providers, but also non-traditional partners, such as schools, community organizations, special needs organizations, and large employers. Coalitions are not only crucial during the planning and engagement period prior to disasters, but also during a disaster and the recovery process.
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Keeping Partners Engaged Erosion of collaborations and sustained partnerships have been occurring due to loss of key staff, and failure to maintain the regional communication and trainings that have been built in the past decade, asserted Rosanne Prats, executive director of emergency preparedness at the Louisiana Department of Health and Hospitals. This decrease in funding and overall support from the national level makes it difficult to persuade hospital administrators that regional preparedness is a valuable effort to their institutions.
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Incorporating the Medical Community into Intelligence Centers Although some of the discussions about inclusion during the meeting series revolved around NGOs and private-sector partners, several participants also highlighted the challenges of bringing health expertise into law enforcement and public safety intelligence centers. Serino described the operations of the Medical Intelligence Center in Boston and how the partnership with the Boston Regional Intelligence Center allows synergy of health-related information exchange.
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This is becoming increasingly common both during a disaster and in everyday routine care, thanks to recent regulations and incentives through the Health Information Technology for Economic and Clinical Health Act (within the American Recovery and Reinvestment Act) 8 in 2009 and the Patient Protection and Affordable Care Act (ACA)
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, run through HHS may also be collecting similar information, but there was a lack of clarity about how all of these systems could most efficiently and effectively interact. Understandable challenges lie in the difficulty in sharing proprietary information among competing hospitals, accountability of completing information correctly, as well as rules under the Health Insurance Portability and Accountability Act.10 But continuing emphasis in this area, seeing where the gaps lie within large-scale events such as Hurricanes Katrina and Gustav, and achieving standards and interoperability among systems in this area, can assist in ensuring successful outcomes and greater transparency for a regional disaster.
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A few participants also noted that broadening coalitions to include the private sector, including information technology, can help to disseminate important public messages quickly in a health emergency, and they can increase capabilities for systems monitoring during an ongoing response. In addition, recognizing children, especially unaccompanied, as an at-risk population and broadening coordination efforts with local and state human service agencies to address their needs could improve a comprehensive response.
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