Workshop committee chair Michael Anderson noted that we are past the starting line and have made progress in many areas related to children’s needs, but still need to get to a better state. The participation of national leaders and subject-matter experts was a key strength of this Institute of Medicine workshop, as was the broad array of topics discussed relevant to taking better care of children faced with disaster, he continued. Despite the diversity of experts in the room, Anderson again reiterated that there is still the need to bring others to the table and broaden the group of stakeholders that engages in these conversations at the national and local levels (e.g., more involvement from the child care and education fields, private practitioners). Many nontraditional partners familiar with children could bring a wealth of knowledge to the public health and health care professionals to augment planning and response, but they are often not engaged, or do not realize they could be a resource.
Many of the barriers to progress that were discussed are financial as well as a lack of centralization and coordination for information and resources. As noted by many participants, there is usually no payment or reimbursement for preparedness activities. Administrators and child services providers are increasingly asked to do more with less, and although they acknowledge the importance of emergency planning, there are many competing priorities. How do advocates for children make and keep disaster preparedness for children and families a priority? The concept of multifaceted efforts (i.e., designing things to meet daily operational needs that can also meet the needs of patients during disasters) was discussed as one opportunity for progress in preparedness in the face of financial constraints. Also mentioned was balancing the
wealth of resources, tools, and best practices happening at the grassroots level with the lack of coordination and centralization for these issues. Moving forward, children and family issues in preparedness could use a centralized home that practitioners and caregivers across the country can access to augment their planning.
Revisiting remarks from Irwin Redlener’s keynote speech, Anderson pointed out that the challenge now is figuring out how to move from lessons learned to actions taken, actually implementing the many best practices shared by speakers. In the same vein, testing the many plans and annexes that have been developed is an important second step in making sure that they are sufficient and robust enough to perform as expected. Various speakers highlighted the need for a national exercise focused on pediatrics and surge capacity. Upperman presented promising ideas to improve competency in pediatrics and using games and drills at the hospital level to familiarize providers, but taking this to a higher level and coordinating drills across regions or across the country could be very beneficial to identifying remaining gaps in plans and seeing where strengths are.
Finally, Anderson pointed out that although the summary of the workshop will help disseminate information about the many tools, websites, and resources discussed by the participants, there remains a need for a “clearing house” for sharing information and best practices. With the continued interest and engagement of invested federal agencies mentioned throughout the summary, as well as the reauthorization of the Pandemic and All-Hazards Preparedness Act of 2013, the conditions are favorable to make strong impacts in these areas of children and families in disaster preparedness, response, and recovery.