Regional Disaster Response Coordination to Support Health Outcomes Summary of a Workshop Series (2015) / Chapter Skim
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3 Public Health Surge Capacity and Community Resilience
3 Public Health Surge Capacity and Community Resilience
Pages 23-40
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From page 23... ...
• To reduce the clinical surge burden on hospitals, communities can provide alternative care and medical needs shelters, as well as in crease training and use of community paramedicine, and incorporate better coordination and integration of Emergency Support Function (ESF) -6 and ESF-8, prior to and during a disaster.
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From page 24... ...
"Surge capacity" can involve area hospitals, as well as alternative care sites and other medically capable shelters specially set up during a disaster to divert people away from overcrowded emergency departments. This chapter examines the opportunities for public health services and other community services to coordinate across a region and keep hospitals and health centers from overcrowding, as well as ideas for better planning across sectors related to vulnerable populations.
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From page 25... ...
In additioon, access to H1N1 antiviral a treattment becamee increasinglly problemattic. Thereffore, MDH leeaders created d partnershipps with existing nurse triaage telepho one lines opeerating in thee state to creeate a coordinnated statewiide nurse triage line thhat could targ get high-risk groups acrosss counties annd recommend care an nd treatment where w necessaary.
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From page 26... ...
DeVries stated that more than 27,000 individuals from 86 counties called the Minnesota Flu Line during the epidemic, with the highest call volumes from rural, northern Minnesota counties. MDH officials estimated that approximately 11,000 in-person health care encounters may have been pre
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From page 27... ...
Medical Needs Shelters, Alternative Care Sites, and Extended Treatment Areas Monique Davis of the Hudson County, New Jersey, Regional Health Commission presented their experiences in integrating public health and human services to increase surge capacity. The integration represented the linkage of Emergency Support Function (ESF)
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From page 28... ...
Alternative Care Sites and Extended Treatment Areas Another common approach to decompress emergency departments is by standing up alternative care sites and extended treatment areas. In New Jersey, planning for these sites began 2 years before Superstorm Sandy, Davis noted.
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From page 29... ...
Additionally, ensuring the staff members recruited to work these alternative care sites are trained appropriately has also proven challenging. During Superstorm Sandy, many nurses in the MRC turned out to be school-based nurses who needed training to take care of a common patient presentation, such as a diabetic patient who needed wound care.
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From page 30... ...
improve community resilience through cross-sector collaboration; (2) maximize public health and health care system response capabilities; (3)
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From page 31... ...
Froom the exxercises the state s learned a lot about equipping alll shelters wiith sufficiient battery power p to meeet the needss of people w with functionnal needs. Shelters hav ve a durable medical m equippment cache th that allows peeople witth basic mediical needs to stay in generaal populationn shelters, keeeps familiees/caregivers together, and d reduces the need for meddical surge.
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From page 32... ...
In addition to receiving care in their home, he noted the benefits to the community by keeping patients out of the emergency department -- on a routine basis but also during an emergency: The Mobile Integrated Health Care program has helped the community by increasing the capacity of the hospital and the health care system, returning thousands of emer gency department and inpatient bed hours, in other words, freeing up beds and staff time that were previous ly used because all 911 calls resulted in transports to the hospital. It has improved collaboration across the health care continuum, and providers in the program work very closely with primary care and emergency department physicians.
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From page 33... ...
BUILDING COMMUNITY RESILIENCE The discussions on public health surge capacity and community resilience built off of multiple meetings on both surge management and community engagement. Much of the conversation included how to build sustainable and inclusive health coalitions that can allow for greater resources, communication, and surge capacity when needed.
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From page 34... ...
. In recent years, some states and local jurisdictions have also been developing Children's Emergency Task Forces to respond to children's needs in disasters.4 These are models of community collaboration that include ESF-6 and ESF-8 partners, including pediatricians, 211 call centers, behavioral health, child care providers, schools, public health, VOAD, and local social services.
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From page 35... ...
Previous experiences have shown that communities that have high levels of social connectedness (often referred to as social capital or social cohesion) display resilience that serves them well in postdisaster recovery (Aldrich and Sawada, 2015)
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From page 36... ...
social capital (linkaages across different d sociaal networks tthrough instittutions, schools, and sports clubs, among otherr venues) ; andd linking social capitall (connectionns between ciitizens and goovernment annd elected offficials who w hold posiitions of autho ority and powwer)
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From page 37... ...
There is nno way of guuaranteeing anny bridgee or any levy will w hold, butt social cohession, in contraast from expeerience and a data, is what w drives resilience. Prom moting sociall cohesion, saaid Aldricch, should be part of the jo ob descriptionn of city officcials and emeergency managers.
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From page 38... ...
HIGHLIGHTED OPPORTUNITIES FOR OPERATIONAL CHANGES During various discussions on these issues throughout the meetings, individual participants voiced suggestions for potential changes ranging from the local level up to the national level, in order to better accommodate some of the needs highlighted: • Ken Schor, director of the National Center for Disaster Medicine and Public Health, remarked on the need to create an evidence base about social cohesion's effects to mitigate disasters and build resilience. He said community members need to have ac cess to the evidence to inform academia, policy makers, and community organizers and gain their support for the methods.
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From page 39... ...
Shah suggested possibly tying ASPR and CDC funding incentives to regional and cross-sector en gagement in the agreements to better integrate various sectors at the local level.
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