Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-23T13:38:33.092Z Has data issue: false hasContentIssue false

Assessing Levels of Hospital Emergency Preparedness

Published online by Cambridge University Press:  28 June 2012

Bruria Adini
Affiliation:
Emergency and Disaster Management Division, Ministry of Health, Israel Faculty of Health Sciences, Ben GurionUniversity of the Negev, Beer-Sheva, Israel
Avishay Goldberg
Affiliation:
Faculty of Health Sciences, Ben GurionUniversity of the Negev, Beer-Sheva, Israel
Danny Laor
Affiliation:
Emergency and Disaster Management Division, Ministry of Health, Israel
Robert Cohen
Affiliation:
Center for Medical Education, Hebrew University, Jerusalem, Israel
Roni Zadok
Affiliation:
Emergency and Disaster Management Division, Ministry of Health, Israel
Yaron Bar-Dayan*
Affiliation:
Faculty of Health Sciences, Ben GurionUniversity of the Negev, Beer-Sheva, Israel Israeli Defense Force Home Front Command, Israel
*
Col. Dr. Y. Bar-Dayan, MD, MHA, Chief Medical Officer, Israeli Defense Force Home Front Command, 16 Dolev St., Neve Savion, Or-Yehuda, ISRAEL E-mail: bardayan@netvision.net.il

Abstract

Introduction:

Emergency preparedness can be defined by the preparedness pyramid, which identifies planning, infrastructure, knowledge and capabilities, and training as the major components of maintaining a high level of preparedness.The aim of this article is to review the characteristics of contingency plans for mass-casualty incidents (MCIs) and models for assessing the emergency preparedness of hospitals.

Characteristics of Contingency Plans:

Emergency preparedness should focus on community preparedness, a personnel augmentation plan, and communications and public policies for funding the emergency preparedness. The capability to cope with a MCI serves as a basis for preparedness for non-conventional events. Coping with chemical casualties necessitates decontamination of casualties, treating victims with acute stress reactions, expanding surge capacities of hospitals, and integrating knowledge through drills. Risk communication also is important.

Assessment of Emergency Preparedness:

An annual assessment of the emergency plan is required in order to assure emergency preparedness. Preparedness assessments should include: (1) elements of disaster planning; (2) emergency coordination; (3) communication; (4) training; (5) expansion of hospital surge capacity; (6) personnel; (7) availability of equipment; (8) stockpiles of medical supplies; and (9) expansion of laboratory capacities. The assessment program must be based on valid criteria that are measurable, reliable, and enable conclusions to be drawn. There are several assessment tools that can be used, including surveys, parameters, capabilities evaluation, and self-assessment tools.

Summary:

Healthcare systems are required to prepare an effective response model to cope with MCIs. Planning should be envisioned as a process rather than a production of a tangible product. Assuring emergency preparedness requires a structured methodology that will enable an objective assessment of the level of readiness.

Type
Comprehensive Review
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Simon, R, Teperman, S: The World Trade Center attack: Lessons for disaster management. Crit Care 2001;5(6):318320.Google Scholar
2.Ryan, J, Montgomery, MB: The London attacks-preparedness: Terrorism and the medical response. N Engl J Med 2005;353(6):543545.CrossRefGoogle ScholarPubMed
3.Quarentelli, EL: Research Based Criteria for Evaluating Disaster Planning and Managing. International Seminar on Chernobyl and Beyond: Humanitarian Assistance to Victims of Technological Disasters. Moscow, Russia: Department of Humanitarian Affairs of the United Nations, 1997.Google Scholar
4.Quarentelli, EL: Organizational Behavior in Disasters and Implications for Disaster Planning. Newark, DE: Disaster Research Center, University of Delaware, 1985.Google Scholar
5.Health Systems Research Inc.: Altered Standards of Care in Mass Casualty Events. AHRQ Publication No. 05–0043. Rockville, MD: Agency for Healthcare Research and Quality; 2005.Google Scholar
6.Healthcare Association of Hawaii: Hospital Capability Assessment for Readiness. Version 1.10. Honolulu; Healthcare Association of Hawaii, 2001.Google Scholar
7.American Hospital Association: Disaster readiness, 2005. Available at http://www.hospitalconnect.com/aha/key_issues/disaster_readiness/readiness. Accessed 15 October 2005.Google Scholar
8.American Hospital Association: Hospital Preparedness for Mass Casualties, Final Report, Summary of an Invitational Forum convened March 8–9 2000. American Hospital Association; Chicago, August 2000.Google Scholar
9.Halpern, P, Tsai, MC, Arnold, JL et al: Mass-casualty, terrorist bombings: Implications for emergency department and hospital emergency response (Part II). Prehosp Disast Med 2003;18(3):235241.Google Scholar
10.Einav, S, Feigenberg, Z, Weissman, C et al: Evacuation priorities in mass casualty terror-related events—implications for contingency planning. Ann Surg 2004;239(3):304310.Google Scholar
11.Agency for Healthcare Research and Quality: Disaster Planning Drills and Readiness Assessment. Bioterrorism and Health System Preparedness. Issue Brief No. 2. Rockville, MD: Agency for Healthcare Research and Quality, 2003.Google Scholar
12.Keim, ME, Pesik, N, Twum-Danso, NAY: Lack of hospital preparedness for chemical terrorism in a major US city: 1996–2000. Prehosp Disast Med 2003;18(3):193199.Google Scholar
13.National Academy of Sciences: Making the Nation Safer: The Role of Science and Technology in Countering Terrorism. Washington: The National Academics Press, 2002.Google Scholar
14.Okumura, T, Ninomiya, N, Ohta, M: The chemical disaster response system in Japan. Prehosp Disast Med 2003;18(3):189192.Google Scholar
15.Becker, SM: Emergency communication and information issues in terrorist events involving radioactive materials. Biosecur Bioterror 2004;2(3):195207.Google Scholar
16.Hirano, D, Christensen, B: Communications and Media Relations. In: Public Health Administration. Novick, LF (ed). Gaithersburg, MD: Aspen Publishers; 2001. pp 457473.Google Scholar
17.Chess, C, Salomone, KL, Sandman, P: Risk communication activities of state health agencies. Am J Public Health 1991;81(4):489491.Google Scholar
18.Centers for Disease Control and Prevention: Crisis and Emergency Risk Communication. Atlanta: Center for Disease Control; 2002.Google Scholar
19.Joint Commission for the Accreditation of Healthcare Organization: Joint Commission Perspectives. Special Issue, 2001;21(12).Google Scholar
20.Clark County Multi-Jurisdictional: Mass Casualty Plan. 2005. Available at http://www.accessclarkcounty.com/Administrative_services/OEM/MCI_P LAN.pdf. Accessed 24 October 2005.Google Scholar
21.Mass-casualty incident Job Action Sheet Packets for the Emergency Department—2004. Available at http://www.downstate.edu/emergency_medicine/default.html. Accessed 24 October 2005.Google Scholar
22.Rotz, LD, Koo, D, O'Carroll, PW et al: Bioterrorism preparedness: Planning for the future. J Public Health Manag Pract 2000;6(4):4549.Google Scholar
23.Hogan, DE, Waeckerie, JF, Dire, DJ, Lillibridge, SR: Emergency department impact of the Oklahoma City terrorist bombing. Ann Emerg Med 1999;34:160167.CrossRefGoogle ScholarPubMed
24.Klein, RN, Brandenburg, DC, Atas, JG, Maher, A: The use of trained observers as an evaluation tool for a multi-hospital bioterrorism exercise. Prehosp Disast Med 2005;20(3):159161.Google Scholar
25.ERI international Inc.: Capabilities Assessment for Readiness, (Capabilities Assessment for Readiness 2000), by 2000. Available at http://www.rothstein.com/drjbooks/drj545a.htm. Accessed 15 October 05.Google Scholar
26.Government Accountability Office: DHS Efforts to Enhance First Responders: All-Hazards Capabilities Continue to Evolve, July 2005. Available at http://www.gao.gov/new.items/d05652.pdf. Accessed 24 October 05.Google Scholar
27.Agency for Healthcare Research and Quality. Emergency Planning and Preparedness: Text Version of a Slide Presentation at a Web-assisted Audioconference. Rockville, MD; Agency for Healthcare Research and Quality, 2003. Available at http://www/ahrq.gov/news/ulp/disastertele/skid- mortxt/htm. Accessed 21 October 05.Google Scholar
28.Health Resources and Services Administration: A 2002 National Assessment of State Trauma System Development, Emergency Medical Services Resources, and Disaster Readiness for Mass Casualty Events. Rockville, Maryland: Health Resources and Services Administration, 2003.Google Scholar
29.Raisbeck, G: How the choice of measures of effectiveness constrains operational analysis. Interfaces 1979;9(4):8593.Google Scholar
30.Burkle, FM Jr. : Measures of effectiveness in largescale bioterrorism events. Prehosp Disast Med 2003;18(3):258262.CrossRefGoogle ScholarPubMed
31.Federal Emergency Management Agency: National Emergency Management Baseline Capability Assurance Program. Washington, DC: Federal Emergency Management Agency, 2005. Available at http://www.fema.gov/preparedness/tcars.shtm. Accessed 24 October 05.Google Scholar
32.Griffith, JR, Knutzen, SR, Alexander, JA: Structural versus outcomes measures in hospitals: A comparison of Joint Commission and Medicare outcomes scores in hospitals. Qual Manag Health Care 2002;10(2):2938.CrossRefGoogle ScholarPubMed
33.Manning, FJ, Goldfrank, L (ed): Tools for Evaluating the Metropolitan Medical Response System Program: Phase I Report. Washington, DC: National Academy Press, 2001.Google Scholar
34. Emergency Readiness Assurance Plans. Available at http://www.ssa.doe.gov/Sp40/directives/g1511-1v5-3.pdf. Accessed 16 October 05.Google Scholar
35.Uden-Holman, T, Walkner, L, Huse, D et al: Matching documented training needs with practical capacity: Lessons learned from project public health ready. J Public Health Manag Pract 2005;11(6):s106–s112.Google Scholar