Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-09T09:48:27.007Z Has data issue: false hasContentIssue false
  • English
  • Français

Vulnerable Populations in Hospital and Health Care Emergency Preparedness Planning: A Comprehensive Framework for Inclusion

Published online by Cambridge University Press:  22 February 2016

Debra Kreisberg ,
Deborah S.K. Thomas ,
Morgan Valley ,
Shannon Newell ,
Enessa Janes  and
Charles Little
Debra Kreisberg*
Affiliation:
Department of Environmental and Occupational Health, Colorado School of Public Health; University of Colorado Anschutz Medical Campus, Aurora, Colorado USA Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado USA
Deborah S.K. Thomas
Affiliation:
Department of Geography and Environmental Sciences, University of Colorado Denver, Denver, Colorado USA
Morgan Valley
Affiliation:
Department of Psychology, Colorado State University, Fort Collins, Colorado USA
Shannon Newell
Affiliation:
Department of Surgery, VA Eastern Colorado Health Care System, Denver, Colorado USA
Enessa Janes
Affiliation:
Michael Baker International, Lakewood, Colorado USA
Charles Little
Affiliation:
Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado USA
*
Correspondence: Debra Kreisberg, PhD Department of Environmental and Occupational Health Colorado School of Public Health Mail Stop B119 13001 East 17th Place Aurora, Colorado 80045 USA E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

As attention to emergency preparedness becomes a critical element of health care facility operations planning, efforts to recognize and integrate the needs of vulnerable populations in a comprehensive manner have lagged. This not only results in decreased levels of equitable service, but also affects the functioning of the health care system in disasters. While this report emphasizes the United States context, the concepts and approaches apply beyond this setting.

Objective

This report: (1) describes a conceptual framework that provides a model for the inclusion of vulnerable populations into integrated health care and public health preparedness; and (2) applies this model to a pilot study.

Methods

The framework is derived from literature, hospital regulatory policy, and health care standards, laying out the communication and relational interfaces that must occur at the systems, organizational, and community levels for a successful multi-level health care systems response that is inclusive of diverse populations explicitly. The pilot study illustrates the application of key elements of the framework, using a four-pronged approach that incorporates both quantitative and qualitative methods for deriving information that can inform hospital and health facility preparedness planning.

Conclusions

The conceptual framework and model, applied to a pilot project, guide expanded work that ultimately can result in methodologically robust approaches to comprehensively incorporating vulnerable populations into the fabric of hospital disaster preparedness at levels from local to national, thus supporting best practices for a community resilience approach to disaster preparedness.

KreisbergD , ThomasDSK , ValleyM , NewellS , JanesE , LittleC . Vulnerable Populations in Hospital and Health Care Emergency Preparedness Planning: A Comprehensive Framework for Inclusion. Prehosp Disaster Med. 2016;31(2):211–219.

Keywords

delivery of health caredisastershealth facility planningpublic healthvulnerable populations
Type
Special Reports
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 2 , April 2016 , pp. 211 - 219
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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. Cutter, SL, Boruff, BJ, Shirley, WL. Social vulnerability to environmental hazards. So Sci Q. 2003;84(2):242-261.CrossRefGoogle Scholar
2. Diamond, LC, Wilson-Stronks, A, Jacobs, EA. Do hospitals measure up to the national culturally and linguistically appropriate services standards? Med Care. 2010;48(12):1080-1087.Google Scholar
3. Brooks, N, Adger, N, Kelly, P. The determinants of vulnerability and adaptive capacity at the national level and the implications for adaptation. Glob Environ Change. 2004;15(2):151-163.Google Scholar
4. Adler, N, Boyce, T, Chesney, A, Cohen, S. Socio-economic status and health: the challenge of the gradient. Am Psychol. 1994;49(1):15-24.CrossRefGoogle Scholar
5. Flaskerud, JH, Winslow, BJ. Conceptualizing vulnerable population’s health-related research. Nurs Res. 1998;47(2):69-78.Google Scholar
6. Centers for Disease Control and Prevention. Public Health Preparedness Capabilities: National Standards for State and Local Planning. CDC Web site. http://www.cdc.gov/phpr/capabilities/DSLR_capabilities_July.pdf. Published 2011. Accessed December 8, 2014.Google Scholar
7. Morrow, BM. Identifying and mapping community vulnerability. Disasters. 1999;23:1-18.Google Scholar
8. Chandra, A, Acosta, J, Meredith, L, et al. Understanding Community Resilience in the Context of National Health Security. Santa Monica, California USA: RAND Corporation; 2010.Google Scholar
9. Barbisch, DF, Koenig, KL. Understanding surge capacity: essential elements. Acad Emerg Med. 2006;13(11):1098-1102.Google Scholar
10. Runkle, JD, Brock-Martin, A, Karmaus, W, Svendsen, ER. Secondary surge capacity: a framework for understanding long-term access to primary care for medically vulnerable populations in disaster recovery. Am J Public Health. 2012;102(12):e24-e32.CrossRefGoogle ScholarPubMed
11. Agency for Healthcare Research and Quality, prepared by Health Research Systems Inc. Altered Standards of Care in Mass Casualty Events. http://archive.ahrq.gov/research/altstand/altstand.pdf. Published 2005. Accessed April 28, 2015.Google Scholar
12. U.S Department of Health Services and Human Services, OPHS, Office of Minority Health. National Standards for Culturally and Linguistically Appropriate Services in Health Care: Final Report. http://minorityhealth.hhs.gov/assets/pdf/checked/finalreport.pdf. Published 2001. Accessed December 8, 2014.Google Scholar
13. The Joint Commission. Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for Hospitals. http://www.jointcommission.org/assets/1/6/ARoadmapforHospitalsfinalversion727.pdf. Published 2010. Accessed April 28, 2015.Google Scholar
14. Gröne, O, Garcia-Barbero, M. Trends in Integrated Care: Reflections on Conceptual Issues. Copenhagen, Denmark: World Health Organization; 2002. www.researchgate.net/publication/237739454_Trends_in_Integrated_Care_-_Reflections_on_Conceptual_Issues. Published 2002. Accessed September 18, 2015.Google Scholar
15. Crupi, RS, Asnis, DS, Lee, CC, Santucci, T, Marino, MJ, Flanz, BJ. Meeting the challenge of bioterrorism: lessons learned from West Nile virus and anthrax. Am J Emerg Med. 2003;21(1):77-79.Google Scholar
16. Fauci, AS. Ebola—underscoring the global disparities in health care resources. N Engl J Med. 2014;371(12):1084-1086.Google Scholar
17. Gostin, LO, Hodge, JG, Burris, S. Is the United States prepared for Ebola? JAMA. 2014;312(23):2497-2498.Google Scholar
18. Messias, DKH, Lacy, EC. Katrina-related health concerns of Latino survivors and evacuees. J Health Care Poor Underserved. 2007;18(2):443-464.Google Scholar
19. Ghosh, AK, Ghosh, KK. Translating evidence-based information into effective risk communications: current challenges and opportunities. J Lab Clin Med. 2005;145(4):171-180.Google Scholar
20. Solet, DJ, Norvell, JM, Rutan, GH, Frankel, RM. Lost in translation: challenges and opportunities in physician to physician communication during patient hand-offs. Acad Med. 2005;80(12):1094-1099.Google Scholar
21. The Joint Commission. Standing Together: An Emergency Planning Guide for America's Communities. TJC Web site. www.jointcommission.org/standing_together__an_emergency_planning_guide_for_americas_communities/. Published 2006. Accessed September 17, 2015.Google Scholar
22. Federal Emergency Management Agency. Emergency Support Function #8 – Public Health and Medical Services Annex. FEMA Web site. www.fema.gov/pdf/emergency/nrf/nrf-esf-08.pdf. Published 2008. Accessed April 28, 2015.Google Scholar
23. Department of Health and Human Services. National Health Security Strategy of the United States of America. http://www.phe.gov/preparedness/planning/authority/nhss/strategy/documents/nhss-final.pdf. Published 2009. Accessed April 28, 2015.Google Scholar
24. Office of the Assistant Secretary for Preparedness and Response. Healthcare Preparedness Capabilities: National Guidance for Healthcare System Preparedness. http://www.phe.gov/Preparedness/planning/hpp/reports/Documents/capabilities.pdf. Published 2012. Accessed December 6, 2014.Google Scholar
25. Lurie, N, Jung, M, Lavisso-Mourey, R. Disparities and quality improvement: federal policy levers. Health Aff. 2005;24(2):354-364.Google Scholar
26. Beaton, R, Bridges, E, Salazar, MK, et al. Ecological model of disaster management. AAOHN J. 2008;56(11):471-478.Google Scholar
27. Federal Emergency Management Agency. National Incident Management System. FEMA Web site. www.fema.gov/national-incident-management-system. Accessed September 17, 2015.Google Scholar
28. Murphy, BL. Locating social capital in resilient community-level emergency management. Nat Hazards. 2007;41:297-315.CrossRefGoogle Scholar
29. Jacobs, CG, Graves, DL, Kenyon, J, Pacheco, G. Advancing culturally and linguistically appropriate services at all phases of a disaster. Wash & Lee J Civil Rts & Soc Just. 2012;19(1):3.Google Scholar
30. Eisenman, DP, Glik, D, Gonzalez, L, et al. Improving Latino disaster preparedness using social networks. Am J Prev Med. 2009;37(6):512-517.Google Scholar
31. Eisenman, DP, Glik, D, Maranon, R, Gonzales, L, Asch, SM. Developing a disaster preparedness campaign targeting low-income Latino immigrants: focus group results for project PREP. J Health Care Poor Underserved. 2009;20(2):330-345.Google Scholar
32. Paton, D, Johnston, D. Disasters and communities: vulnerability, resilience, and preparedness. Disaster Prevention and Management: An International Journal. 2001;10(4):270-277.Google Scholar
33. Allen, H, Katz, R. Demography and public health emergency preparedness: making the connection. Popul Res Policy Rev. 2010;29(4):527-539.Google Scholar
34. Thomas, D, Stephens, P, Goldsmith, J. “Measuring and conveying social vulnerability.” In: Thomas DS, Fothergill A, Blinn-Pike L, (eds). Social Vulnerability to Disasters. Boca Raton, Florida USA: CRC Press; 2010: 323-344.Google Scholar
35. Albanese, J, Birnbaum, M, Cannon, C, et al. Fostering disaster resilient communities across the globe through the incorporation of safe and resilient hospitals for community-integrated disaster responses. Prehosp Disaster Med. 2008;23(05):385-390.Google Scholar
36. The United States Census Bureau. TIGER/Line Shapefiles. www.census.gov/geo/maps-data/data/tiger-line.html. Accessed April 30, 2014.Google Scholar
37. Andrulis, D, Delbanco, T, Avakian, L, Shaw-Taylor, Y. Conducting a Cultural Competence Self-assessment. New York, New York USA: State University of New York. www.rmhpcommunity.org/sites/default/files/resource/Cultural%20Competence%20Self-Assessment.pdf. Published 1999. Accessed September 17, 2015.Google Scholar