Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-10T06:26:08.652Z Has data issue: false hasContentIssue false
  • English
  • Français

Emergency Preparedness Law and Willingness to Respond in the EMS Workforce

Published online by Cambridge University Press:  21 July 2014

Lainie Rutkow ,
Jon S. Vernick ,
Carol B. Thompson ,
Ronald G. Pirrallo  and
Daniel J. Barnett
Lainie Rutkow*
Affiliation:
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland USA
Jon S. Vernick
Affiliation:
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland USA
Carol B. Thompson
Affiliation:
Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland USA
Ronald G. Pirrallo
Affiliation:
Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin USA Milwaukee County Emergency Medical Services, Milwaukee, Wisconsin USA National Registry of EMTs Longitudinal Emergency Medical Technician Attributes & Demographics Study (LEADS) Committee Chairman, Columbus, Ohio USA
Daniel J. Barnett
Affiliation:
Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland USA
*
Correspondence: Lainie Rutkow, JD, PhD, MPH Johns Hopkins Bloomberg School of Public Health 624 N. Broadway, Room 513 Baltimore, MD 21205 USA E-mail hrutkow@jhsph.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

For effective responses to emergencies, individuals must have the ability to respond and also be willing to participate in the response. A growing body of research points to gaps in response willingness among several occupational cohorts with response duties, including the Emergency Medical Services (EMS) workforce. Willingness to respond is particularly important during an influenza or other pandemic, due to increased demands on EMS workers and the potential for workforces to be depleted if responders contract influenza or stay home to care for sick dependents. State emergency preparedness laws are one possible avenue to improve willingness to respond.

Hypothesis

Presence of certain state-level emergency preparedness laws (ie, ability to declare a public health emergency; requirement to create a public health emergency plan; priority access to health resources for responders) is associated with willingness to respond among EMS workers.

Methods

Four hundred twenty-one EMS workers from the National Registry of Emergency Medical Technicians’ (NREMT's) mid-year Longitudinal EMT Attributes and Demographics Study (LEADS) were studied. The survey, which included questions about willingness to respond during an influenza pandemic, was fielded from May through June 2009. Survey data were merged with data about the presence or absence of the three emergency preparedness laws of interest in each of the 50 US states. Unadjusted logistic regression analyses were performed with the presence/absence of each law and were adjusted for respondents’ demographic/locale characteristics.

Results

Compared to EMS workers in states that did not allow the government to declare a public health emergency, those in states that permitted such declarations were more likely to report that they were willing to respond during an influenza pandemic. In adjusted and unadjusted analyses, this difference was not statistically significant. Similar results were found for the other state-level emergency preparedness laws of interest.

Conclusion

While state-level emergency preparedness laws are not associated with willingness to respond, recent research suggests that inconsistencies between the perceived and objective legal environments for EMS workers could be an alternative explanation for this study's findings. Educational efforts within the EMS workforce and more prominent state-level implementation of emergency preparedness laws should be considered as a means to raise awareness of these laws. These types of actions are important steps toward determining whether state-level emergency preparedness laws have the potential to promote response willingness among EMS workers.

RutkowL , VernickJS , ThompsonCB , PirralloRG , BarnettDJ . Emergency Preparedness Law and Willingness to Respond in the EMS Workforce. Prehosp Disaster Med. 2014;29(4):1-6.

Keywords

disaster planninghealth policylegislationjurisprudencerescue workwillingness to respond
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 29 , Issue 4 , August 2014 , pp. 358 - 363
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

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. McCabe, OL, Barnett, DJ, Taylor, HG, et al. Ready, willing, and able: a framework for improving the public health emergency preparedness system. Disaster Med Public Health Prep. 2010;4(2):161-168.Google Scholar
2. Errett, NA, Barnett, DJ, Thompson, CB, et al. Assessment of medical reserve corps volunteers’ emergency response willingness using a threat- and efficacy-based model. Biosecur Bioterror. 2013;11(1):29-40.Google Scholar
3. Balicer, RD, Catlett, CL, Barnett, DJ, et al. Characterizing hospital workers’ willingness to respond to a radiological event. PLoS One. 2011;6(10):e25327.Google Scholar
4. Masterson, L, Steffen, C, Brin, M, et al. Willingness to respond of emergency department personnel and their predicted participation in mass casualty terrorist events. J Emerg Med. 2009;36(1):43-49.Google Scholar
5. Barnett, DJ, Thompson, CB, Errett, NA, et al. Determinants of emergency response willingness in the local public health workforce by jurisdictional and scenario patterns: a cross-sectional survey. BMC Public Health. 2012;12:164.Google Scholar
6. Chaffee, M. Willingness of health care personnel to work in a disaster: an integrative review of the literature. Disaster Med Public Health Prep. 2009;3(1):42-56.CrossRefGoogle Scholar
7. Dimaggio, C, Markenson, D, T Loo, G, et al. The willingness of U.S. Emergency Medical Technicians to respond to terrorist incidents. Biosecur Bioterror. 2005;3(4):331-337.CrossRefGoogle ScholarPubMed
8. Barnett, DJ, Levine, R, Thompson, CB, et al. Gauging U.S. Emergency Medical Services workers’ willingness to respond to pandemic influenza using a threat- and efficacy-based assessment framework. PLoS One. 2010;5(3):e9856.Google Scholar
9. Devnani, M. Factors associated with the willingness of health care personnel to work during an influenza public health emergency: an integrative review. Prehosp Disaster Med. 2012;27(6):551-566.CrossRefGoogle ScholarPubMed
10. Barnett, DJ, Balicer, RD, Thompson, CB, et al. Assessment of local public health workers’ willingness to respond to pandemic influenza through application of the extended parallel process model. PLoS One. 2009;4(7):e6365.CrossRefGoogle ScholarPubMed
11. Basta, NE, Edwards, SE, Schulte, J. Assessing public health department employees’ willingness to report to work during an influenza pandemic. J Public Health Manag Pract. 2009;15(5):375-383.Google Scholar
12. Balicer, RD, Barnett, DJ, Thompson, CB, et al. Characterizing hospital workers’ willingness to report to duty in an influenza pandemic through threat- and efficacy-based assessment. BMC Public Health. 2010;10:436.Google Scholar
13. Stergachis, A, Garberson, L, Lien, O, et al. Health care workers’ ability and willingness to report to work during public health emergencies. Disaster Med Public Health Prep. 2011;5(4):300-308.Google Scholar
14. Watt, K, Tippett, VC, Raven, SG, et al. Attitudes to living and working in pandemic conditions among emergency prehospital medical care personnel. Prehosp Disaster Med. 2010;25(1):13-19.Google Scholar
15. Catlett, CL, Jenkins, JL, Millin, MG. Role of emergency medical services in disaster response: resource document for the National Association of EMS Physicians position statement. Prehosp Emerg Care. 2011;15(3):420-425.Google Scholar
16. Garrett, AL, Park, YS, Redlener, I. Mitigating absenteeism in hospital workers during a pandemic. Disaster Med Public Health Prep. 2009;3(Suppl 2):S141-S147.CrossRefGoogle ScholarPubMed
17. Rutkow, L, Vernick, JS, Gakh, M, et al. The public health workforce and willingness to respond to emergencies: a 50-state analysis of potentially influential laws. J Law Med Ethics. 2014;42(1):64-71.CrossRefGoogle ScholarPubMed
18. Wagenaar, AC, Burris, S, eds. Public Health Law Research: Theory and Methods. San Francisco, California USA: Jossey-Bass; 2013.Google Scholar
19. Disaster Declarations by State/Tribal Government. Federal Emergency Management Agency website. http://www.fema.gov/disasters/grid/state-tribal-government. Accessed January 12, 2014.Google Scholar
20. ZIP Code Tabulation Areas. US Census Bureau website. http://www.census.gov/geo/reference/zctas.html. Accessed January 12, 2014.Google Scholar
21. American FactFinder. US Census Bureau website. http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml. Accessed January 12, 2014.Google Scholar
22. American FactFinder American Community Survey. US Census Bureau website. http://factfinder2.census.gov/faces/nav/jsf/pages/wc_acs.xhtml. Accessed January 12, 2014.Google Scholar
23. European Commission. Humanitarian aid and civil protection: vademecum – civil protection. European Commission website. http://ec.europa.eu/echo/civil_protection/civil/vademecum/index.html. Accessed May 1, 2014.Google Scholar
24. The Model State Emergency Health Powers Act. Centers for Law and the Public's Health website. http://www.publichealthlaw.net/MSEHPA/MSEHPA.pdf. Accessed January 12, 2014.Google Scholar
25. National Center for Immunzation Respiratory Diseases, Centers for Disease Control and Prevention. Use of influenza A (H1N1) 2009 monovalent vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009. MMWR Recomm Rep. 2009;58(RR-10):1-8.Google Scholar
26. Jacobson, PD, Wasserman, J, Botoseneanu, A, et al. The role of law in public health preparedness: opportunities and challenges. J Health Polit Policy Law. 2012;37(2):297-328.Google Scholar
27. Brown, WE, Dickison, PD, Misselbeck, WJ, et al. Longitudinal Emergency Medical Technician Attribute and Demographic Study (LEADS): an interim report. Prehosp Emerg Care. 2002;6(4):433-439.Google Scholar