Facilitating Hospital Emergency Preparedness: Introduction of a Model Memorandum of Understanding
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.
- SourceAvailable from: Dan Hanfling[Show abstract] [Hide abstract]
ABSTRACT: The hallmark of a successful response to a nuclear detonation will be the resilience of the community, region, and nation. An incident of this magnitude will rapidly become a national incident; however, the initial critical steps to reduce lives lost, save the lives that can be saved with the resources available, and understand and apply resources available to a complex and dynamic situation will be the responsibility of the local and regional responders and planners. Expectations of the public health and health care systems will be met to the extent possible by coordination, cooperation, and an effort to produce as consistent a response as possible for the victims. Responders will face extraordinarily stressful situations, and their own physical and psychological health is of great importance to optimizing the response. This article illustrates through vignettes and supporting text how the incident may unfold for the various components of the health and medical systems and provides additional context for the discipline-related actions outlined in the state and local planners' playbook.Disaster Medicine and Public Health Preparedness 03/2011; 5 Suppl 1(S1):S73-88. DOI:10.1001/dmp.2011.28 · 0.70 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Aim. This article is a report of a study carried out to investigate the procedures that are likely to induce pain and anxiety in children in a Mexican emergency department. Background. In emergency rooms, children often experience unpredictable diagnostic and therapeutic procedural-related pain that can be associated with considerable anxiety. Design. A prospective, descriptive and cross sectional study was conducted to investigate the prevalence of procedures or situations that probably induced anxiety and/or pain in children in an emergency room. Methods. Procedural pain and anxiety were evaluated in children and adolescents (8–16 years) who were admitted to the emergency department of a paediatric hospital between February–September 2010. Children rated their pain and anxiety using a 100-mm visual analogue scale. Results. A total of 252 children with a mean age of 10·1 years were evaluated. Four-hundred fifty-nine procedures were completed, with an average of 1·82 events/child. Of these procedures, 369 (80·4%) were rated painful and 357 (77·8%) were rated stressful. The most frequently reported procedural pain or stressful episodes were peripheral catheterization, clinical examination and vascular puncture. Overall, 32·5% of the painful events were rated severe, 32·0% were rated moderate and 35·5% were rated slight. However, 30% of the stressful events were rated severe, 38·9% were rated moderate and 31·1% were rated slight. Peripheral catheterization was rated severe in 58 children (33·9%), moderate in 55 children (32·2%) and slight in 58 (33·9%) children. Conclusion. This study provides data on common emergency department procedures that cause pain and anxiety in children and young adolescents. Healthcare providers must consider the best psychological and pharmacological interventions to reduce procedural anxiety and pain.Journal of Advanced Nursing 03/2012; 68(12). DOI:10.1111/j.1365-2648.2012.05969.x · 1.74 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: The objective of this review is to stimulate the reader's considerations for developing community disaster mitigation. Disaster mitigation begins long before impact and is defined as the actions taken by a community to eliminate or minimize the impact of a disaster. The assessment of vulnerabilities, the development of infrastructure, memoranda of understanding, and planning for a sustainable response and recovery are parts of the process. Empowering leadership and citizens with knowledge of available resources through the planning and development of a disaster response can strengthen a community's resilience, which can only add to the viability and quality of life enjoyed by the entire community.Southern medical journal 01/2013; 106(1):13-6. DOI:10.1097/SMJ.0b013e31827cb037 · 0.93 Impact Factor