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Facilitating Hospital Emergency Preparedness: Introduction of a Model Memorandum of Understanding

Published online by Cambridge University Press:  08 April 2013

James G. Hodge Jr ,
Evan D. Anderson ,
Thomas D. Kirsch  and
Gabor D. Kelen
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Abstract

Effective emergency response among hospitals and other health care providers stems from multiple factors depending on the nature of the emergency. While local emergencies can test hospital acute care facilities, prolonged national emergencies, such as the 2009 H1N1 outbreak, raise significant challenges. These events involve sustained surges of patients over longer periods and spanning entire regions. They require significant and sustained coordination of personnel, services, and supplies among hospitals and other providers to ensure adequate patient care across regions. Some hospitals, however, may lack structural principles to help coordinate care and guide critical allocation decisions. This article discusses a model Memorandum of Understanding (MOU) that sets forth essential principles on how to allocate scarce resources among providers across regions. The model seeks to align regional hospitals through advance agreements on procedures of mutual aid that reflect modern principles of emergency preparedness and changing legal norms in declared emergencies.

(Disaster Med Public Health Preparedness. 2011;5:54-61)

Keywords

hospital planningcommunity health planningdisaster responsedisaster planningresource allocationpublic health preparednessliability, legalcosts and cost analysiseconomics, hospitaldelivery of health careNational Incident Management Systemlaw and medicinejurisprudencehospitalsemergencieshealth personnelpublic health
Type
Special Focus
Information
Disaster Medicine and Public Health Preparedness , Volume 5 , Issue 1 , March 2011 , pp. 54 - 61
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2011

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References

REFERENCES

1.Institute of Medicine. Guidance for Establishing Standards of Care for Use in Disaster Situations: A Letter Report. Washington, DC: National Academies of Science; 2010.Google Scholar
2.Hick, JL, Barbera, JA, Kelen, GD.Refining surge capacity: conventional, contingency, and crisis capacity. Disaster Med Public Health Prep. 2009;3 2(Suppl)S59–S67.Google Scholar
3.Devereaux, AV, Dichter, JR, Christian, MDTask Force for Mass Critical Care. Definitive care for the critically ill during a disaster: a framework for allocation of scarce resources in mass critical care from a Task Force for Mass Critical Care summit meeting, January 26-27, 2007, Chicago, IL. Chest. 2008;133 5(Suppl)51S–66S.CrossRefGoogle ScholarPubMed
4.Centers for Law and the Public's Health: A Collaborative at Johns Hopkins and Georgetown Universities. 2009 H1N1 (Swine Flu) Legal Preparedness and Response. http://www.publichealthlaw.net/Projects/swinefluphl.php. Accessed March 25, 2010.Google Scholar
5.Barnett, DJ, Taylor, HA, Hodge, JG Jr, Links, JM.Resource allocation on the frontlines of public health preparedness and response: report of a summit on legal and ethical issues. Public Health Rep. 2009;124 (2):295–303.Google Scholar
6.Preparedness and Catastrophic Event Response (PACER) consortium. Model Memorandum of Understanding Between Hospitals During Declared Emergencies. http://www.pacercenter.org/pacer/pdf/PACER_Model_MOU.pdf. Published June 2009. Accessed March 25, 2010.Google Scholar
7.Hick, JL, Chipman, J, Loppnow, G.Hospital response to a major freeway bridge collapse. Disaster Med Public Health Prep. 2008;2(Suppl 1)S11–S16.CrossRefGoogle Scholar
8.Hogan, DE, Waeckerle, JF, Dire, DJ, Lillibridge, SR.Emergency department impact of the Oklahoma City terrorist bombing. Ann Emerg Med. 1999;34 (2):160–167.CrossRefGoogle ScholarPubMed
9.Gutierrez De Ceballos, JP, Turégano Fuentes, F, Perez Diaz, D, Sanz Sanchez, M, Martin Llorente, C, Guerro Sanz, JE.Casualties treated at the closest hospital in the Madrid, March 11, terrorist bombings. Crit Care Med. 2005;33 1(Suppl)S107–S112.Google Scholar
10.Cairns, BA, Stiffler, A, Price, F, Peck, MD, Meyer, AA.Managing a combined burn trauma disaster in the post-9/11 world: lessons learned from the 2003 West Pharmaceutical plant explosion. J Burn Care Rehabil. 2005;26:114–150.Google Scholar
11.Kirschenbaum, L, Keene, A, O’Neill, P, Westfal, R, Astiz, ME.The experience at St. Vincent's Hospital, Manhattan, on September 11, 2001: preparedness, response and lessons learned. Crit Care Med. 2005;33 1(Suppl)S48–S52.Google Scholar
12.Schultz, CH, Koenig, KL, Lewis, RJ.Implications of hospital evacuation after the Northridge, California, earthquake. N Engl J Med. 2003;348 (14):1349–1355.Google Scholar
13.US House of Representatives. Report 109-377: A Failure of Initiative—Final Report of the Select Bipartisan Committee to Investigate the Preparation for and Response to Hurricane Katrina. http://www.gpoaccess.gov/serialset/creports/katrinasupp.html. Published March 2006. Accessed March 25, 2010.Google Scholar
14.Hodge, JG, Anderson, ED.Principles and practice of legal triage during public health emergencies. NYU Ann Surv Am L. 2008;64:249–291.Google Scholar
15.Hoffman, S, Goodman, RA, Stier, DD.Law, liability, and public health emergencies. Disaster Med Public Health Prep. 2009;3 (2):117–125.CrossRefGoogle ScholarPubMed
16.Rosenbaum, S, Harty, MB, Sheer, J.State laws extending comprehensive legal liability protections for professional health-care volunteers during public health emergencies. Public Health Rep. 2008;123 (2):238–241.Google Scholar
17.Agency for Healthcare Research and Quality. Altered Standards of Care in Mass Casualty Events: Bioterrorism and Other Public Health Emergencies. Publ No. 05-0043. Rockville, MD; 2005.Google Scholar
18.Hodge, JG Jr, Garcia, A, Anderson, ED, Kaufman, T.Emergency legal preparedness for hospitals and health care personnel. Disaster Med Public Health Prep. 2009;3 2(Suppl)S37–S44.CrossRefGoogle ScholarPubMed
19.Campbell, VA, Gilyard, JA, Sinclair, L, Sternberg, T, Kailes, JI.Preparing for and responding to pandemic influenza: implications for people with disabilities. Am J Public Health. 2009;99(Suppl 2)S294–S300.Google Scholar
20.Federal Emergency Management Agency Reference Guide. Section VII, Non-Discrimination Principles of the Law. http://www.fema.gov/oer/reference/principles.shtm. Published June 4, 2009. Accessed March 25, 2010.Google Scholar
21.Coleman, CH, Reis, A.Potential penalties for health care professionals who refuse to work during a pandemic. JAMA. 2008;299 (12):1471–1473.Google Scholar
22.US Constitution. amend. XIII.Google Scholar
23.US Constitution. amend. V and XIV.Google Scholar
24.Quigley, WP.Thirteen ways of looking at Katrina: human and civil rights left behind again. Tulane Law Rev. 2007;81:1009–1010.Google Scholar
25.Kass, NE, Otto, J, O’Brien, D, Minson, M.Ethics and severe pandemic influenza: maintaining essential functions through a fair and considered response. Biosecur Bioterror. 2008;6 (3):227–236.Google Scholar
26.Preparedness and Catastrophic Event Response (PACER) consortium. Domain B2: Assessment and Recommendation for Standardization of Memoranda of Understanding (MOUs) for Enhanced Health System Integration. Briefing Book Re: MOUs in Emergency Settings (on file with the author), October 9, 2007.Google Scholar
27.NIMS Integration Center, Federal Emergency Management Agency. NIMS Alert: NIMS implementation activities for hospitals and healthcare systems. http://www.fema.gov/pdf/emergency/nims/imp_act_hos_hlth.pdf. Published September 2006. Accessed March 25, 2010.Google Scholar
28.International Emergency Management Group. International Emergency Management Assistance Memorandum of Understanding. http://www2a.cdc.gov/PHLP/docs/IEMAC.pdf. Published July 2000. Accessed March 25, 2010.Google Scholar
29.Stier, DD, Goodman, RA.Mutual aid agreements: essential legal tools for public health preparedness and response. Am J Public Health. 2007;97(Suppl 1)S62–S68.Google Scholar
30.US Constitution. art. I, sec. 10, cl. 3.Google Scholar
31.Franklin, MA, Rabin, RL.Tort Law and Alternatives. New York: Foundation Press; 2001.Google Scholar
32.Valhal Corporation v Sullivan Associates, Inc, 44 F3d 195, 202 (3d Cir. 1995).Google Scholar
33. 42 USC § 1395dd (2003).Google Scholar
34. PACER Model MOU § 1.8.Google Scholar
35. PACER Model MOU § 2.9(a).Google Scholar
36. PACER Model MOU § 2.9(b).Google Scholar
37. PACER Model MOU § 2.5.Google Scholar
38. PACER Model MOU § 2.6.Google Scholar
39. PACER Model MOU § 2.4.Google Scholar
40. PACER Model MOU § 3.1.Google Scholar
41. PACER Model MOU § 3.1(f).Google Scholar
42. PACER Model MOU § 3.2.Google Scholar