Public Health Emergencies: Is Health Care Ready to Respond?

The United States experiences hundreds of disasters each year exacting a tremendous toll on health and property.

The Federal Emergency Management Agency (FEMA) reports that between January 2016 and July 2017 there were more than 60 major disaster declarations in the United States. ^a  Thousands of people are injured or killed each year as a result of natural or man-made calamities, and the economic toll can be staggering.

While populations on coastal areas continue to grow, so do the health and economic risks posed by natural disasters like ­­hurricanes, floods, and earthquakes. But communities across the United States can feel the impact of catastrophic events. Tornadoes, wildfires, drought, wide-scale flooding, disease epidemics, industrial or environmental accidents, and violent acts such as mass shootings all pose a litany of health response challenges for healthcare providers and community, state, and federal authorities. On a smaller scale, this kind of planning and response plays out every day in many hospital emergency departments.

It also begs the question: Is your hospital or health system adequately prepared to handle a disaster? Is there true collaboration among the various healthcare institutions and other emergency responders in your area? Is there a formal contingency plan if your hospital was overwhelmed with demand following a natural or man-made disaster?

A report titled “2017-2022 Health Care Preparedness and Response Capabilities” by the U.S. Department of Health and Human Services’ (HHS’) Office of the Assistant Secretary for Preparedness and Response outlines four core capabilities for healthcare institutions. ^b

Lay the groundwork. Build a foundation for healthcare and medical readiness by developing relationships with institutions, services and other providers (healthcare coalition), identifying hazards and risks, and prioritizing and addressing gaps through planning, training, exercising, and managing resources.

Create a response plan. Work with other healthcare organizations and the lead agency within a jurisdiction to share and analyze information, manage resources, and coordinate strategies to deliver medical care during emergencies.

Establish continuity of healthcare delivery. Collaborate with healthcare delivery organizations to provide medical care to populations in the face of damaged or disabled healthcare infrastructure. “Healthcare workers are well trained, well educated, and well equipped to care for patients during emergencies. Simultaneous response and recovery operations result in a return to normal or, ideally, improved operations,” the report states.

Manage the surge. Deliver timely and efficient care to patients even when the demand for healthcare services exceeds available supply. Work in collaboration with various entities inside and outside of the healthcare coalition to manage resources and maintain a conventional surge response. The goal is to create a plan for a “timely return to conventional standards of care as soon as possible,” the report says.

Collaboration is key to success, according to the report. Coalitions should actively work on crafting a strategic plan, operational plan and response, structure and plan for information sharing, and resource coordination and management.

Other benefits of undertaking such an effort, according to the report, include the following:

• Meeting regulatory and accreditation requirements
• Enhancing purchasing power (e.g., bulk purchasing agreements)
• Accessing clinical and non-clinical expertise
• Networking among peers
• Sharing leading practices
• Developing interdependent relationships
• Reducing risk
• Addressing community needs, including meeting requirements for tax exemption through community benefit

The risks associated with natural or man-made disasters or public health emergencies are evident, but having thoughtful and strategic partnerships to respond can save lives. If, as the old saying goes, an ounce of prevention is worth a pound of cure, perhaps an ounce of preparedness is worth a pound of an emergency response. 

Footnotes

a. “Disasters: Total Number of Declared Disasters by State/Tribal Government by Year,” 2016-2017. FEMA.

b. 2017-2022 Health Care Preparedness and Response Capabilities, Health and Human Services, Assistant Secretary for Preparedness and Response, Nov. 2016.