Integrating Hospitals into Community Emergency.
The contemporary terrorist attacks and natural disasters necessitate the complete scheme for response measures to be carefully examined. The hospitals and their integration to the whole response process are considered the weakest link. Therefore a special attention has to be paid to this particular section of the planning of the response process.
In the article Integrating Hospitals into Community Emergency the authors evaluate the role of the hospital personnel in the counteractions to disasters and the way the hospitals have to react according to the disaster’s type and location. The mechanism of an effective response of the hospital staff is bound up with the preparedness of the community to respond and the pre event integration of the hospitals in the response process. For a better understanding the level to which the hospitals are included in the community response planning and to assess if they are the weakest link in that planning the authors implement a study carried out through the whole country. Figure 1 of the article illustrates the link between the hospital personnel and the rest stakeholders in the emergency process.
The methods used by the study comprised the convoking a technical group of experts who made up and spread nationwide a questionnaire to evaluate the character and existence of hospital – community services relations that made easier the answer to the local emergencies, promoted a hospital model strategy, administered the survey instrument and analyzed the collected data.
The rate of response of hospitals to the questionnaire was very low, and the answers were not verified. Table 1 from the article contains the Topics to which the questionnaire is addressed.
Hospital and community planning
Community-wide training and drills
Community plans for additional supplies and equipment
Systems for public health reporting and laboratory capacity
Community surge capacity plans relating to staffing, transportation, and
Sharing information about available resources
Communication mechanisms and protocols
(Table 1, Integrating Hospitals into Community Emergencies, Web)
With duly advices from the expert panel the questionnaire was mailed to 1750 U. S. medical – surgical hospitals but only 678 agreed to join the initiative, and 575 of them completed the questionnaire. We obtain the picture about the proportion between the two targeted groups of hospitals the urban and the rural from Table 2 presented in the commented article.
The analysis of the result of this study show that the urban and large hospitals perform in a better way these seventeen basic elements, included in the research, and the fact was connected to the high number of hazards in the urban areas, and the experience these hospitals had responding these hazards, and the last but not less significant – participation and preparation in previous events of national security.
The study showed that the major part of the hospitals integrated in the response process but many questions remained opened such as:
What happens with the population of the rural areas where the hospitals do not integrate enough to satisfy the requirements for such process?
What has to be done to improve the integration between the hospitals and public health departments?
How the general response strategy has to be applied in order to enhance its efficiency?
How the population to be better informed about the possible hazards and to be acquainted with the general strategy for response?
How to perform efficient training to all participants in the response process?
Together with many other questions the abovementioned ones are discussed in details and wait for their solution.
Braun, Barbara PhD, Wineman, Nicole V. MA, Finn, Nicole L. MA, Barbera, Joseph A. MD, Smaltz, Stephan P. PhD, Loeb, Jerad M. PhD, Integrating Hospitals into Community Emergency,
Annals of Internal Medicine, Web www.annals.org 2006