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All Disasters Begin Locally!

ASSESSMENT OF PUBLIC HEALTH AND HEALTHCARE PREPAREDNESS CAPABILITIES : ANALYZING CORRECTIVE ACTIONS TO IDENTIFY PRIORITIES. Lisa McCormick, DrPH ; Jonathan Wilson, RN, MSN, CHEP; Elena Linn, MPH; W. Terry McLeod, RN, BSN, CHEP; Jim Craig, BS, CPM. All Disasters Begin Locally!.

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All Disasters Begin Locally!

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  1. ASSESSMENT OF PUBLIC HEALTH AND HEALTHCARE PREPAREDNESS CAPABILITIES: ANALYZING CORRECTIVE ACTIONS TO IDENTIFY PRIORITIES Lisa McCormick, DrPH; Jonathan Wilson, RN, MSN, CHEP; Elena Linn, MPH; W. Terry McLeod, RN, BSN, CHEP; Jim Craig, BS, CPM

  2. All Disasters Begin Locally! • Initial Detection • Initial Response • Initial Recovery Local Preparedness Is Essential

  3. Linking Response Systems First Responders Fire/EMS Medical & Mental Health Services Law Enforcement Public Health Emergency Management

  4. Capability Overlap Healthcare Emergency Management Public Health National Preparedness and Core Capabilities 10 Essential Services of Public Health PHP and HCP Capabilities

  5. Capabilities Overview

  6. National Preparedness Core Capabilities

  7. Exercises and Real-life events • Capabilities are tested via exercises and real-life events • Information and data collected in AARs/IPS are used to identify: • strengths • areas for improvement • capability performance • corrective actions

  8. Current Need • Need exists for a systematic, rigorous process for examining AARs and IPs • Method to examine trends and patterns within areas of improvement across capabilities in order to ensure: • Lesson learned are not ignored • Lessons learned are incorporated into future planning • Mistakes are not repeated

  9. Introduction to the CAP (corrective action prioritization) process • Purpose: creation of a tool that captures themes within corrective actions overtime • Depicts trends in areas of improvement • Allows for comparisons (event vs. exercises, exercise type vs. exercise type, year to year) • Identifies systemic problem areas that occur over time • Goal: enhance preparedness and response by prioritizing resources & strengthening capabilities Note: This analysis does NOT look at strengths resulting from exercises/events. It is a way to look at reoccurring themes in areas for improvements.

  10. Data • Data was collected from 12 MSDH after-action reports (AARs) from 2010 to 2013 • 3 Events (note: two events flood/tornado 2011 combined into one AAR) • 9 Exercises • A total of 405 Corrective Actions identified • 118 from Events • 287 from Exercises • Created an Excel database and tool for recording, tracking, and analyzing AAR/IPs and CAs

  11. Methods • Reviewed, coded, and assigned by: • 1) Capability: PHP Capabilities & HCP capabilities, function (s), task (s), resource element (s) • 2) Theme: Macro-Theme, Needed Action, Unit of Improvement/Focal Point, Mezzo-Theme, Micro Theme, and Agency/Function Responsible • Capability and themes for CAs were determined by the context of the CA (i.e. what was trying to be accomplished) • Filters and pivot charts are used to analyze results and trends

  12. Macro Theme Definition • Staffing: Corrective Actions pertaining to issues regarding staffing (ex. Identifying additional staff, staff assignments, the management of staffing, etc.). • Training: Corrective Actions pertaining to the need for additional training (ex. training on roles and responsibilities, policies and procedures, equipment, systems/logistics, ICS, future exercises/drills, etc.). • Policies and Procedures: Corrective Actions pertaining to the planning and policies & procedures (ex. operational plans, systems/logistics, equipment, documentation & forms, etc.). • External Partners: Corrective Actions pertaining to partnering or communicating with external partners (identifying and developing partnerships/collaborations, MOUs, communication plans, etc.). • Internal Partners: Corrective Actions pertaining to communicating, coordinating and partnering with internal partners. • Equipment/Resource Need: Corrective Actions pertaining to the need for or standardization of equipment, systems, resources or supplies (ex. communications equipment, documentation & forms, systems/logistics, etc.).

  13. Theme Description

  14. Example using Themes • CA Description: Provide Additional basic and advanced training opportunities for CORES ESAR-VHP local System Administrators.

  15. Analysis Examples

  16. Corrective Actions by Macro Themes

  17. Corrective Actions by PHP Capabilities N = 405

  18. Examine Themes within Capabilities N=145

  19. Examine Trends within Agencies/Functions (ex. SMAT)

  20. Conclusion – Tool for Assessments • Monitor quality of evaluation process • Realization of the utility of corrective actions/reduce stigma associated with identifying corrective actions • Database to track capability improvement over time

  21. Conclusion – Tool for Prioritization • Assistance in conducting a needs assessment • Identify reoccurring & understated areas for improvement • Prioritize for future PHEP and HPP work plans

  22. Questions? Lisa McCormick, DrPH UAB School of Public Health lmccormick@uab.edu

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