Sandra Shields

Publications (3)1.53 Total impact

• Source

  Available from: Stephanie L Taylor

  Article: Prioritizing "psychological" consequences for disaster preparedness and response: a framework for addressing the emotional, behavioral, and cognitive effects of patient surge in large-scale disasters.

  Lisa S Meredith, David P Eisenman, Terri Tanielian, Stephanie L Taylor, Ricardo Basurto-Davila, James Zazzali, Dickson Diamond, Barbara Cienfuegos, Sandra Shields
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  ABSTRACT: While information for the medical aspects of disaster surge is increasingly available, there is little guidance for health care facilities on how to manage the psychological aspects of large-scale disasters that might involve a surge of psychological casualties. In addition, no models are available to guide the development of training curricula to address these needs. This article describes 2 conceptual frameworks to guide hospitals and clinics in managing such consequences. One framework was developed to understand the antecedents of psychological effects or "psychological triggers" (restricted movement, limited resources, limited information, trauma exposure, and perceived personal or family risk) that cause the emotional, behavioral, and cognitive reactions following large-scale disasters. Another framework, adapted from the Donabedian quality of care model, was developed to guide appropriate disaster response by health care facilities in addressing the consequences of reactions to psychological triggers. This framework specifies structural components (internal organizational structure and chain of command, resources and infrastructure, and knowledge and skills) that should be in place before an event to minimize consequences. The framework also specifies process components (coordination with external organizations, risk assessment and monitoring, psychological support, and communication and information sharing) to support evidence-informed interventions.
  Disaster Medicine and Public Health Preparedness 03/2011; 5(1):73-80. · 1.53 Impact Factor
• Source

  Available from: nachc.com

  Article: Psychological effects of patient surge in large-scale emergencies: a quality improvement tool for hospital and clinic capacity planning and response.

  Lisa S Meredith, James L Zazzali, Sandra Shields, David P Eisenman, Halla Alsabagh
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  ABSTRACT: Although information is available to guide hospitals and clinics on the medical aspects of disaster surge, there is little guidance on how to manage the expected surge of persons needing psychological assessment and response after a catastrophic event. This neglected area of disaster medicine is addressed by presenting a novel and practical quality improvement tool for hospitals and clinics to use in planning for and responding to the psychological consequences of catastrophic events that create a surge of psychological casualties presenting for health care. Industrial quality improvement processes, already widely adopted in the healthcare sector, translate well when applied to disaster medicine and public health preparedness. This paper describes the development of the tool, presents data on facility preparedness from 31 hospitals and clinics in Los Angeles County, and discusses how the tool can be used as a benchmark for targeting improvement. The tool can serve to increase facility awareness of which components of disaster preparedness and response must be addressed through hospitals' and clinics' existing quality improvement programs. It also can provide information for periodic assessment and evaluation of progress over time.
  Prehospital and disaster medicine: the official journal of the National Association of EMS Physicians and the World Association for Emergency and Disaster Medicine in association with the Acute Care Foundation 25(2):107-14.
• Article: Pediatric disaster preparedness in the medical setting: integrating mental health.

  Jeffrey I Gold, Zorash Montano, Sandra Shields, Nicole E Mahrer, Viktoria Vibhakar, Tanya Ybarra, Nancy Yee, Jeffrey Upperman, Nancy Blake, Kathleen Stevenson, Alan L Nager
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  ABSTRACT: The increasing prevalence of disasters worldwide highlights the need for established and universal disaster preparedness plans. The devastating events of September 11 and Hurricane Katrina have spurred the development of some disaster response systems. These systems, however, are predominantly focused on medical needs and largely overlook mental health considerations. Negative outcomes of disasters include physical damage as well as psychological harm. Mental health needs should be considered throughout the entire disaster response process, especially when caring for children, adolescents, and their families. To provide an overview and recommendations for the integration of mental health considerations into pediatric disaster preparedness and response in the medical setting. Recommendations were developed by a panel of disaster preparedness and mental health experts during the Childrens Hospital Los Angeles Pediatric Disaster Resource and Training Center: Workshop on Family Reunification in Los Angeles, California, March 31-April 1, 2008. Experts discussed the inclusion of mental health-specific considerations and services at all stages of disaster preparedness and response. Recommendations involve the integration of mental health into triage and tracking, the adoption of a child ambassador model, environment, and developmentally appropriate interventions, education, communication, death notification, and family reunification. The inclusion of mental health concerns into pediatric disaster preparedness may help prevent further and unnecessary psychological harm to children and adolescent survivors following a disaster.
  American journal of disaster medicine 4(3):137-46.