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Being prepared for a natural disaster, infectious disease outbreak or other emergency where many injured or ill people need medical care while maintaining ongoing operations is a significant challenge for local health systems. Health care providers’ focus on emergency-preparedness activities waxes and wanes, reflecting the many pressures and competing demands they face.
Using the lens of the 2009 H1N1 influenza pandemic, this study examined the activities of emergency-preparedness coalitions in 10 U.S.
While hospitals and public health departments participated in all emergency-preparedness coalitions in the communities studied, involvement of nonhospital providers and other stakeholders varied significantly across the communities (see Table 1). When working with nontraditional partners, community coalitions reported difficulty in aligning goals and securing buy in from those who view emergency management as outside their scope of responsibility.
Both hospital and community practice respondents acknowledged a sense of alienation from each other, noting that the smaller the practice, the more difficult it is to participate and have a voice in community collaborations. Most primary care respondents agreed that physicians are focused mainly on their patients’ day-to-day needs and do not see preparedness as part of their mission.
A few respondents reported that competition did affect preparedness collaborations, particularly when hospital leaders are guarded about sharing capabilities and needs with peers at other institutions. During the H1N1 pandemic, for example, some coalitions developed plans to distribute supplies in advance. Ultimately, nearly all respondents agreed that successful coalitions require ongoing attention to relationships.
Nearly all hospitals working with both hospital-employed physicians and independent community-based physicians reported that hospital-employed physicians are easier to engage, suggesting that markets with larger physician groups and more hospital employment of physicians would be better positioned to build integrated surge-capacity plans. Because of the generally collegial approach to preparedness activities, respondents reported that tighter hospital affiliations in consolidated markets had little impact. While all providers felt the strain of competing demands in allocating resources for emergency preparedness, rural providers were particularly strapped.
Respondents did report that local partnerships and emergency response in small towns were more cohesive because of strong day-to-day relationships among health care providers, first-hand knowledge of the population they serve and a strong community feel. Across sites, respondents consistently reported that hospitals and hospital-owned physician practices typically are much more involved in emergency-preparedness coalitions than other stakeholders, reflecting both the federal financial support hospitals receive for preparedness activities and their size, structure and resources.
There are two general approaches policy makers could consider to broaden participation in emergency-preparedness coalitions: providing incentives for more stakeholders to join existing preparedness coalitions or building preparedness into activities providers already are pursuing. This study examined the activities of community-based emergency-preparedness coalitions in 10 communities. Emergency preparedness requires coordination of diverse entities at the local, regional and national levels. There are two general approaches policy makers could consider to broaden participation in emergency-preparedness coalitions: providing incentives for more stakeholders to join existing coalitions or building preparedness into activities providers already are pursuing.


11, 2001, terrorist attacks, many health care providers have adopted emergency-preparedness plans, including participation in such activities as community-wide drills and tabletop exercises, to strengthen their ability to respond to a disaster. By April 26, the government determined that H1N1 represented a national public health emergency and began releasing stores of personal-protective equipment and antiviral medications to states from the strategic national stockpile.
First, preparedness activities, such as planning, training and participating in drills, do not generate revenue for health care providers but have costs in staff time and materials.
Few communities involve independent practitioners other than maintaining a list of those willing to volunteer in the event of a disaster, for which no special training or expertise in disaster response is required.
Nonmedical stakeholders, such as police, fire, coroners, school systems and employers, have varying degrees of involvement in medical emergency planning collaboration. According to respondents, state and local medical societies generally have not played an important role to date in helping small practices to collaborate with each other or other stakeholders.
In practice, sharing happened less formally; for example, a single institution would make a request through the coalition and another coalition member would respond. In some hospital systems, the system’s preparedness plan directly encompassed physician practices owned by the hospital system. Rural respondents reported depending on buy in from a smaller pool of institutional leaders, and these leaders did not always perceive value in allocating limited funding and staff time for emergency management and participation in coalitions. For example, outside Seattle, three small rural hospitals pooled funds to hire a shared emergency manager across the facilities. As one rural South Carolina respondent noted, a small town in which people know and look after their neighbors can help responders identify and protect more vulnerable community members in an emergency situation. However, most attention has focused on population-level management of obesity or chronic illness rather than disaster preparedness and response. Policy makers could encourage groups whose participation is currently limited in most communities, such as independent physician practices, to join traditional preparedness coalitions that meet regularly to develop joint plans or coordinate responses.
For example, programs that offer extra payment to primary care practices to coordinate care of patients with specific chronic conditions might also encourage and reward coordination related to emergency preparedness or the creation of business continuity plans.
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Given the diversity of stakeholders, fragmentation of local health care systems and limited resources, developing and sustaining broad community coalitions focused on emergency preparedness is difficult.
Maintaining preparedness is a daunting task, given that emergencies can spring up at a national, regional or local level and take forms as varied as a global pandemic, a regional hurricane or a local outbreak of food-borne illness. The H1N1 influenza pandemic was the most recent national event that required large-scale preparedness and response. Respondents reported that CDC guidance was generally well received, and nearly all respondents turned to the CDC on a regular basis during the H1N1 pandemic for information and guidance. Given the low probability of certain events, stockpiling supplies and committing staff to emergency preparedness often are not high institutional priorities.4 In addition, community coalitions require competitors to work collaboratively. Regional or specialty-based medical societies may maintain similar lists and can provide basic training in disaster planning through continuing medical education. A hospital respondent in another community coalition cited reluctance to work with nursing homes because of the perception that they are primarily looking for a place to offload patients in an emergency. However, respondents across all sites generally agreed that providers put normal competitive dynamics aside for preparedness efforts and meet and share information on capacity and supply chains when needed.
Many respondents noted issues with securing adequate amounts of personal-protective equipment.


As one respondent said, “Rural hospitals are facing huge budgetary issues right now.
Each of these factors may affect how planning responsibilities, staff and information are most efficiently shared in preparation for and during a disaster. No-one can ascertain this emergency probabilities in the tragedy with no an unexpected emergency Reply Strategy. Defensive activities for life security certainly are a essential section of Emergency Response Plan. And, unlike other events that health care organizations must prepare for, such as Joint Commission inspections, there are no predictable, short-term consequences for failing to engage in collaborative, community-level disaster planning. The focus on hospitals reflects their historic importance in providing staff, space for planning and response, and treatment of emergency victims, including such specialized services as decontamination or burn care. Some health systems did expect employed physicians in community practices to work collaboratively in disaster planning.
Emergencies can sometimes include normal dilemmas such as storm epidemics, terrorist invasion, virtually any ferocious road car accident, a number of compound leak with virtually any compound vegetable for example.
Acceptable arranged programs must be ready to apply to offer this unexpected emergency circumstances running a business and also organization things. No rural respondents described working with their state office of rural health on emergency preparedness. Lack of time, training and sometimes simply awareness that they have a role in disaster response also are important factors.
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Sixty-seven telephone interviews were conducted between June 2011 and May 2012 with representatives of state and local emergency management agencies and health departments, emergency-preparedness coalitions, hospital emergency preparedness coordinators, primary care practices and other organizations working on emergency preparedness and response. This plan of action ought to contain a collaborative strategy which usually helps this group do the job. Business plans are well written and well structured documents that give you assurance of achievement of your business goals within defined time period while […]Business Plan Template for NGOs NGOs are non-profitable organizations that are getting very popular day by day. Other respondents reported frequent communication among competing hospitals on shared pandemic plans and hospital policies for emergencies. If there is no risk […]Project Plan Template Time is always very important for project planning to ensure timely completion and submission of projects.
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