Response Of The Department Of Health And Human Services To The Nation S Emergency Care Crisis

Response of the Department of Health and Human Services to the nation's emergency care crisis: hearing before the Committee on Oversight and Government Reform, House of Representatives, One Hundred Tenth Congress, first session, June 22, 2007.

Response of the Department of Health and Human Services to the nation's emergency care crisis : hearing before the Committee on Oversight and Government Reform, House of Representatives, One Hundred Tenth Congress, first session, June 22, 2007.

The influenza pandemic caused by the 2009 H1N1 virus underscores the immediate and critical need to prepare for a public health emergency in which thousands, tens of thousands, or even hundreds of thousands of people suddenly seek and require medical care in communities across the United States. Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations draws from a broad spectrum of expertise-including state and local public health, emergency medicine and response, primary care, nursing, palliative care, ethics, the law, behavioral health, and risk communication-to offer guidance toward establishing standards of care that should apply to disaster situations, both naturally occurring and man-made, under conditions in which resources are scarce. This book explores two case studies that illustrate the application of the guidance and principles laid out in the report. One scenario focuses on a gradual-onset pandemic flu. The other scenario focuses on an earthquake and the particular issues that would arise during a no-notice event. Outlining current concepts and offering guidance, this book will prove an asset to state and local public health officials, health care facilities, and professionals in the development of systematic and comprehensive policies and protocols for standards of care in disasters when resources are scarce. In addition, the extensive operations section of the book provides guidance to clinicians, health care institutions, and state and local public health officials for how crisis standards of care should be implemented in a disaster situation.

Disasters and public health emergencies can stress health care systems to the breaking point and disrupt delivery of vital medical services. During such crises, hospitals and long-term care facilities may be without power; trained staff, ambulances, medical supplies and beds could be in short supply; and alternate care facilities may need to be used. Planning for these situations is necessary to provide the best possible health care during a crisis and, if needed, equitably allocate scarce resources. Crisis Standards of Care: A Toolkit for Indicators and Triggers examines indicators and triggers that guide the implementation of crisis standards of care and provides a discussion toolkit to help stakeholders establish indicators and triggers for their own communities. Together, indicators and triggers help guide operational decision making about providing care during public health and medical emergencies and disasters. Indicators and triggers represent the information and actions taken at specific thresholds that guide incident recognition, response, and recovery. This report discusses indicators and triggers for both a slow onset scenario, such as pandemic influenza, and a no-notice scenario, such as an earthquake. Crisis Standards of Care features discussion toolkits customized to help various stakeholders develop indicators and triggers for their own organizations, agencies, and jurisdictions. The toolkit contains scenarios, key questions, and examples of indicators, triggers, and tactics to help promote discussion. In addition to common elements designed to facilitate integrated planning, the toolkit contains chapters specifically customized for emergency management, public health, emergency medical services, hospital and acute care, and out-of-hospital care.

Today our emergency care system faces an epidemic of crowded emergency departments, patients boarding in hallways waiting to be admitted, and daily ambulance diversions. Hospital-Based Emergency Care addresses the difficulty of balancing the roles of hospital-based emergency and trauma care, not simply urgent and lifesaving care, but also safety net care for uninsured patients, public health surveillance, disaster preparation, and adjunct care in the face of increasing patient volume and limited resources. This new book considers the multiple aspects to the emergency care system in the United States by exploring its strengths, limitations, and future challenges. The wide range of issues covered includes: • The role and impact of the emergency department within the larger hospital and health care system. • Patient flow and information technology. • Workforce issues across multiple disciplines. • Patient safety and the quality and efficiency of emergency care services. • Basic, clinical, and health services research relevant to emergency care. • Special challenges of emergency care in rural settings. Hospital-Based Emergency Care is one of three books in the Future of Emergency Care series. This book will be of particular interest to emergency care providers, professional organizations, and policy makers looking to address the deficiencies in emergency care systems.

“What a wonderful resource!"--Doody's Medical Reviews “The 4th Edition is unique in recognizing the rapid changes in both the causes of crises and the latest attempts to provide timely multidisciplinary approaches to the practice of this growing specialty...Evident throughout this edition is the call to identify crisis leadership among the increasingly talented base of nurses who have responsibility to move the profession to recognize and accept that they can be advocates for better planning, coordination, education and training.” - Frederick M. Burkle, Jr., MD, MPH, DTM, PhD(Hon.), FAAP, FACEP Senior Fellow & Scientist, Harvard Humanitarian Initiative, Harvard University & T.C. Chan School of Public Health From the Foreword “This impressive edition builds upon the solid foundation of the first three award-winning editions with an expanded focus on climate change related disasters, globalization and its implications for emerging and re-emerging infectious diseases, the accommodation of high-risk, high-vulnerability populations, and the potential for disaster arising from a world witnessing increasing community violence and civil unrest.” -Patricia M. Davidson, PhD, MED, RN, FAAN Professor & Dean, Johns Hopkins School of Nursing From the Foreword “The contributing authors read like a “Who’s Who” of disaster leaders. They lend their special expertise and insights, which are supported and elucidated by cogent learning strategies in the use of case studies, student questions, and packed content in all areas of disaster participation, preparedness, policies, and research. For over 16 years [this book] has been the hallmark text in its field and this edition proves to be the best ever.” -Loretta C. Ford, RN, PNP, EdD Dean Emeritus, University of Rochester School of Nursing Founder of the National Nurse Practitioner Program Member, National Women’s Hall of Fame Featuring the most current, valid, and reliable evidence-based content available, this three-time AJN winner once again presents an unparalleled resource for disaster and emergency preparedness. Disasters lay heavy burdens upon healthcare systems that stretch all levels of society. While natural and man-made disasters are not new, the global nature, rate, type, and totality of their impact has only increased. The fourth edition of this foundational text uniquely addresses the rapid changes in these crises and analyzes the latest attempts to provide timely, multidisciplinary healthcare. Nurses consistently comprise seventy or more percent of responders to local, national, regional, and global crises, and represent a potentially untapped resource to achieve surge capacity goals and optimize population health outcomes. Considering recent world events and increasing geopolitical tensions, Disaster Nursing and Emergency Preparedness, Fourth Edition now features expanded content on the ubiquitous threat of terrorism, potential detonation of thermonuclear weapons, emerging and reemerging infectious diseases, and increasing frequency and intensity of natural disasters from climate change. This text promotes competency-based expert nursing care during disasters and positive health outcomes for small and large populations consistent with the Federal Disaster Response Framework. Whenever possible, content is mapped to published core competencies for preparing health professions’ students for response to terrorism, disaster events, and public health emergencies. The fourth edition retains the clearly organized format in each chapter that includes an overview, learning objectives, a summary, and case study with reflective questions. New to the Fourth Edition: Addresses the most recent landmark agreements Sendai Framework for Disaster Risk Reduction 2015–2030, the United Nations’ Sustainable Development Goals, and the Paris Climate Agreement Covers public health emergencies involving community violence and civil unrest Expands coverage of planning for and accommodating high-risk, high-vulnerability populations Aligns with the U.S. National Health Security Strategy and the National Planning Frameworks Provides focused content on medical countermeasures Includes an improved instructor package with guide, PowerPoint slides, and case studies with questions for reflection in every chapter