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Assessing Hospital Disaster Readiness Over Time at the US Department of Veterans Affairs

Published online by Cambridge University Press:  14 December 2016

Claudia Der-Martirosian*
Affiliation:
Veterans Emergency Management Evaluation Center, US Department of Veterans Affairs, North Hills, CaliforniaUSA
Tiffany A. Radcliff
Affiliation:
Veterans Emergency Management Evaluation Center, US Department of Veterans Affairs, North Hills, CaliforniaUSA Department of Health Policy & Management, School of Public Health, Texas A&M University, College Station, TexasUSA
Alicia R. Gable
Affiliation:
Veterans Emergency Management Evaluation Center, US Department of Veterans Affairs, North Hills, CaliforniaUSA
Deborah Riopelle
Affiliation:
VA Health Services Research and Development Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, North Hills, CaliforniaUSA
Farhad A. Hagigi
Affiliation:
Veterans Emergency Management Evaluation Center, US Department of Veterans Affairs, North Hills, CaliforniaUSA Department of Family Medicine, School of Medicine, University of California-Los Angeles, Los Angeles, CaliforniaUSA Anderson School of Management, University of California-Los Angeles, Los Angeles, CaliforniaUSA
Pete Brewster
Affiliation:
Department of Veterans Affairs, Veterans Health Administration, Office of Emergency Management, Martinsburg, West VirginiaUSA
Aram Dobalian
Affiliation:
Veterans Emergency Management Evaluation Center, US Department of Veterans Affairs, North Hills, CaliforniaUSA Department of Health Policy and Management, Fielding School of Public Health, University of California-Los Angeles, Los Angeles, CaliforniaUSA School of Nursing, University of California-Los Angeles, Los Angeles, CaliforniaUSA
*
Correspondence: Claudia Der-Martirosian, PhD 16111 Plummer St. MS-152 North Hills, California 91343 USA E-mail: Claudia.Der-Martirosian@va.gov

Abstract

Introduction

There have been numerous initiatives by government and private organizations to help hospitals become better prepared for major disasters and public health emergencies. This study reports on efforts by the US Department of Veterans Affairs (VA), Veterans Health Administration, Office of Emergency Management’s (OEM) Comprehensive Emergency Management Program (CEMP) to assess the readiness of VA Medical Centers (VAMCs) across the nation.

Hypothesis/Problem

This study conducts descriptive analyses of preparedness assessments of VAMCs and examines change in hospital readiness over time.

Methods

To assess change, quantitative analyses of data from two phases of preparedness assessments (Phase I: 2008-2010; Phase II: 2011-2013) at 137 VAMCs were conducted using 61 unique capabilities assessed during the two phases. The initial five-point Likert-like scale used to rate each capability was collapsed into a dichotomous variable: “not-developed=0” versus “developed=1.” To describe changes in preparedness over time, four new categories were created from the Phase I and Phase II dichotomous variables: (1) rated developed in both phases; (2) rated not-developed in Phase I but rated developed in Phase II; (3) rated not-developed in both phases; and (4) rated developed in Phase I but rated not- developed in Phase II.

Results

From a total of 61 unique emergency preparedness capabilities, 33 items achieved the desired outcome – they were rated either “developed in both phases” or “became developed” in Phase II for at least 80% of VAMCs. For 14 items, 70%-80% of VAMCs achieved the desired outcome. The remaining 14 items were identified as “low-performing” capabilities, defined as less than 70% of VAMCs achieved the desired outcome.

Conclusion:

Measuring emergency management capabilities is a necessary first step to improving those capabilities. Furthermore, assessing hospital readiness over time and creating robust hospital readiness assessment tools can help hospitals make informed decisions regarding allocation of resources to ensure patient safety, provide timely access to high-quality patient care, and identify best practices in emergency management during and after disasters. Moreover, with some minor modifications, this comprehensive, all-hazards-based, hospital preparedness assessment tool could be adapted for use beyond the VA.

Der-MartirosianC, RadcliffTA, GableAR, RiopelleD, HagigiFA, BrewsterP, DobalianA. Assessing Hospital Disaster Readiness Over Time at the US Department of Veterans Affairs. Prehsop Disaster Med. 2017;32(1):46–57.

Type
Original Research
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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References

1. Sauer, LM, McCarthy, ML, Knebel, A, Brewster, P. Major influences on hospital emergency management and disaster preparedness. Disaster Med Public Health Prep. 2009;3(1Suppl):S68-S73.Google Scholar
2. Buyman, A, Dubruiel, N, Torghele, K, Alperin, M, Miner, KR. Can summits lead to curricula change? An evaluation of emergency preparedness summits of schools of nursing in Georgia. J Contin Educ Nurs. 2009;40(5):210-215.Google Scholar
3. Ferrer, RR, Ramirez, M, Sauser, K, Iverson, E, Upperman, JS. Emergency drills and exercises in health care organizations: assessment of pediatric population involvement using after-action reports. Am J Disaster Med. 2009;4(1):23-32.Google Scholar
4. Levy, LA, Rokusk, CF, Bragg, SM, Howell, JT. Interdisciplinary approach to all-hazards preparedness: are you ready? How do we know? J Public Health Manag Pract. 2009;15(2Suppl):S8-S12.Google Scholar
5. Wang, C, Wei, S, Xiang, H, et al. Development and evaluation of a leadership training program for public health emergency response: results from a Chinese study. BMC Public Health. 2008;8:377.Google Scholar
6. Barbera, JA, Yeatts, DJ, Macintyre, AG. Challenge of hospital emergency preparedness: analysis and recommendations. Disaster Med Public Health Prep. 2009;3(2Suppl):S74-S82.Google Scholar
7. Adini, B, Laor, D, Cohen, R, Zadok, R, Bar-Dayan, Y. Assessing levels of hospital emergency preparedness. Prehosp Disaster Med. 2006;21(6):451-457.Google Scholar
8. Adini, B, Godlberg, A, Cohen, D, Bar-Dayan, Y. Evidence-based support for the all-hazards approach to emergency preparedness. Isr J Health Policy Res. 2012;1(1):40.Google Scholar
9. Adini, B, Laor, D, Hornik-Lurie, T, Schwartz, D, Aharonson-Daniel, L. Improving hospital mass casualty preparedness through ongoing readiness evaluation. Am J of Med Quality. 2012;27(5):426-433.Google Scholar
10. Kaji, A, Langford, V, Lewis, RJ. Assessing hospital disaster preparedness: a comparison of an on-site survey, directly observed drill performance, and video analysis of teamwork. Ann Emerg Med. 2008;52(3):195-201.Google Scholar
11. Jenkins, JL, Kelen, GD, Sauer, LM, Fredericksen, KA, McCarthy, ML. Review of hospital preparedness instruments for National Incident Management System compliance. Disaster Med Public Health Prep. 2009;3(1Suppl):S83-S89.Google Scholar
12. McCarthy, ML, Brewster, P, Hsu, EB, Macintyre, AG, Kelen, G. Consensus and tools needed to measure health. Disaster Med Public Health Prep. 2009;3(1Suppl):S45-S51.Google Scholar
13. Adini, B, Goldberg, A, Cohen, R, Bar-Dayan, Y. Relationship between standards of procedures for pandemic flu and level of hospital performance in simulated drills. Ann Emerg Med. 2008;52(3):222-229.Google Scholar
14. Kaji, AH, Lewis, RJ. Hospital disaster preparedness in Los Angeles County. Academic Emerg Med. 2006;13(11):1198-1203.CrossRefGoogle ScholarPubMed
15. Macintyre, AG, Barbera, JA, Brewster, P. Health care emergency management: establishing the science of managing mass casualty and mass effect incidents. Disaster Med Public Health Prep. 2009;3(1Suppl):S52-S58.Google Scholar
16. Higgins, W, Wainright, C, Lu, N, Carrico, R. Assessing hospital preparedness using an instrument based on the mass casualty disaster plan checklist: results of a statewide survey. Am J of Infection Control. 2004;32(6):327-332.CrossRefGoogle ScholarPubMed
17. Hick, J, Koenig, K, Barbisch, D, Bey, T. Surge capacity concepts for health care facilities: the CO-S-TR model for initial incident assessment. Disaster Med Public Health Prep. 2008;2(1Suppl):S51-S57.Google Scholar
18. Hick, J, Barbera, J, Kelen, G. Refining surge capacity: conventional, contingency, and crisis capacity. Disaster Med Public Health Prep. 2009;3(1Suppl):S59-S67.Google Scholar
19. Hick, J, Christian, M, Sprung, C. Surge capacity and infrastructure. Intensive Care Med. 2010;36(1Suppl):S11-S20.Google Scholar
20. Hick, J, Hanfling, D, Cantrill, S. Allocating scarce resources in disasters: emergency department principles. Ann Emerg Med. 2012;59(3):177-187.Google Scholar
21. Kaji, A, Koenig, K, Bey, T. Surge capacity for health care systems: a conceptual framework. Ann Emerg Med. 2006;13(11):1157-1159.Google Scholar
22. Legemaate, GAG, Burkle, FM Jr., Bierens, JJLM. The evaluation of research methods during disaster exercises: applicability for improving disaster health management. Prehosp Disaster Med. 2012;26(6):1-9.Google Scholar
23. Ingrassia, P, Prato, F, Geddo, A, et al. Evaluation of medical management during a mass casualty incident exercise: an objective assessment tool to enhance direct observation. J Emerg Med. 2010;39(5):629-636.Google Scholar
24. Kaji, A, Lewis, R. Assessment of the reliability of the Johns Hopkins/Agency for Healthcare Research and Quality Hospital Disaster Drill Evaluation Tool. Ann Emerg Med. 2008;52(3):204-210.Google Scholar
25. Association of State and Territorial Health Officials. The National Health Security Preparedness Index: a new way to measure and advance our nation’s preparedness. http://www.nhspi.org/. Accessed July 16, 2014.Google Scholar
26. Barbisch, D, Koenig, K. Understanding surge capacity: essential elements. Academic Emerg Med. 2006;13(11):1098-1102.Google Scholar
27. Webster, PJ, Holland, GJ, Curry, JA, Chang, HR. Changes in tropical cyclone number, duration, and intensity in a warming environment. Science. 2005;309(5742):1844-1846.Google Scholar
28. Hay, J, Mimura, N. The changing nature of extreme weather and climate events: risks to sustainable development. Geomatics, Natural Hazards and Risk. 2010;1(1):3-18.Google Scholar
29. United States Agency for International Development (USAID). http://www.usaid.gov/what-we-do/global-health/pandemic-influenza-and-other-emerging-threats. Accessed July 16, 2014.Google Scholar
30. Dobalian, A, Callis, R, Davey, VJ. Evolution of the Veterans Health Administration’s role in emergency management since September 11, 2001. Disaster Med Public Health Prep. 2011;5(Suppl2):S182-S184.Google Scholar
31. Manning, F, Goldfrank, L. (eds). Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program. Washington, DC USA: National Academy of Sciences; 2002.Google Scholar
32. Dobalian, A, Stein, JA, Radcliff, TA, et al. Developing valid measures of emergency management capabilities within US Department of Veterans Affairs Hospitals. Prehosp Disaster Med. 2016;31(5):475-484.Google Scholar
33. Jacobs, R, Mannion, R, Davies, HTO, Harrison, S, Konteh, F, Walshe, K. The relationship between organizational culture and performance in acute hospitals. Social Science Med. 2013;(76):115-125.Google Scholar
34. United States Department of Veterans Affairs, Veterans Health Administration (VHA). Blueprint of Excellence. VHA 9/21/2014. http://www.va.gov/ HEALTH/docs/VHA_Blueprint_for_Excellence.pdf. Accessed July 16, 2015.Google Scholar
35. Emergency Preparedness Standards for Medicare and Medicaid Participating Providers and Suppliers: A Rule by CMS on 9/16/2016. https://www.federalregister.gov/documents/2016/09/16/2016-21404/medicare-and-medicaid-programs-emergency-preparedness-requirements-for-medicare-and-medicaid. Accessed September 30, 2016.Google Scholar