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Public Health Preparedness

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Hospitals could be better linked with other community response teams to manage public health emergencies

Recent natural disasters and terrorist attacks have underscored the need for hospitals to integrate their activities with other community response teams. Many hospitals report substantial integration in community preparedness planning and familiarity with local emergency response plans. Nevertheless, a new study, supported in part by the Agency for Healthcare Research and Quality (HS13728), found that relationships between hospitals, public health departments, and other critical first responders are not adequately robust. Investigators analyzed questionnaire responses from 575 hospital representatives involved in emergency management at 1,750 U.S. hospitals in 2004. The questionnaire asked about community linkages related to training and drills, equipment, surveillance, laboratory testing, surge capacity (ability to handle a large, sudden surge in patients), incident management, and communication.

Most hospitals (88 percent) engaged in community-wide drills and exercises, and most (82 percent) conducted a collaborative threat and vulnerability analysis with community responders. Yet only 57 percent of hospital representatives reported that their community plans addressed their hospital's need for additional supplies and equipment for disaster response. Community plans addressed decontamination capacity needs for 73 percent of hospitals and the need to expand hospital capacity to isolate people or support ventilator-dependent patients for only half of hospitals. Finally, community plans addressed mechanisms for tracking patient location and managing a large volume of calls for nearly half of hospitals.

Few hospitals reported a direct link to the Health Alert Network (54 percent) and around-the-clock access to a live voice from a public health department (40 percent). Most community plans had identified community-based alternative care sites to help with hospital overflow. Performance on many of 17 community planning elements was better in large and urban hospitals, and was associated with a high number of perceived hazards, previous national security event preparation, and experience in actual disaster response.

See "Integrating hospitals into community emergency preparedness planning," by Barbara I. Braun, Ph.D., Nicole V. Wineman, M.A., M.P.H., M.B.A., Nicole L. Finn, M.A., and others, in the June 6, 2006, Annals of Internal Medicine 144, pp. 799-811.

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