Emergency Training Can Give Workers a Leg Up

The type of disaster doesn't matter. Preparation does. There could be power outages or floods - internal emergencies. Or a bus crash or mass attack could send dozens or hundreds of people to emergency rooms.

"As a nation, we have accepted the fact that large-scale disasters - whether man-made, natural or terrorist - have become more commonplace in our society and pose a special threat to largely dense populations," Walter Cassity, corporate director of environmental safety and emergency management at Baylor Health Care System said. "We react to these threats when we are notified to be on heightened alert, and it is not uncommon for the anniversary of 9/11 to be such a time."

Disaster training has become an integral part of health care. Most clinicians are now required to have a certain level of experience in this realm. And health care workers can expect to have an advantage in the job market if they've received such training.

Such positions are more common in hospitals of 100 beds or larger, he said, or in rural facilities where an emergency department serves a large geographic area. The public tends to take for granted that when disaster strikes, there will be enough doctors and nurses to care for the wounded.

But a report by PricewaterhouseCoopers' Health Research Institute reveals the opposite, the shortage of health care workers coupled with inadequate preparation could leave victims unattended. The report comments that "A disaster occurs every week in the US, and the numbers are increasing. Yet despite increased federal and state funding since 2001 and lessons learned following 9/11 and natural disasters like large-scale hurricanes and floods, disaster planning in the healthcare arena remains sporadic, disconnected and under-funded."

"Any problem in our health delivery system is exacerbated during a disaster," said Sandy Lutz, the institute's managing director. "Nursing and physician shortages become more critical. Because of the current staffing shortages, training for disaster preparedness is squeezed out." Ms. Lutz, who is based in Dallas, noted that according to an institute survey, primary care physicians are the least likely to receive disaster training and the least likely to be prepared.

Fewer than 20 percent of those surveyed said they were "well-prepared" to act in a disaster. Training can help almost any health care worker's career paths. "We call them disaster masters in the report," Ms. Lutz said. The report is entitled, "Closing the Seams: Developing an Integrated Approach to Health System Disaster Preparedness". "Some colleges are developing programs to train these individuals who can make the many difficult decisions regarding evacuation, standards of care, resource rationing, and guidance for staff during a disaster," she said.

Most local hospitals have become involved with community efforts spurred by the introduction of federal grant money in 2002, said Wes Dunham, director of emergency management for Methodist Health System in Dallas. Disaster roles tend to be extensions of existing positions. Almost every hospital has an emergency preparedness coordinator, but some also double as emergency room workers, engineering directors or security officers.

Other hospitals have full-time emergency management directors but little if any support staff. Multidisciplinary committees, led by the coordinator, generate response plans and preparedness activity, Mr. Dunham said. "For positions like these, a bachelor's degree seems to be the norm, but experience varies widely," he said. "Because it's still such a young field, emergency managers in the hospital world come from all sorts of backgrounds, including fire/EMS, military, police, safety, administration, nursing and ER."

During the past few years, a trend has emerged: Facilities are more apt to hire professional emergency managers who are not trained in health care but possess the specialized skills for disaster response, said Chris Noah, emergency management officer at Parkland Health & Hospital System in Dallas.

Mr. Noah, 38, has worked in public safety for more than 19 years, including stints in police, fire, EMS and decontamination of hazardous materials. He has a bachelor's degree in emergency administration and disaster planning from the University of North Texas (which had one of the first such programs in the nation).

"I also see a more professional degreed workforce in emergency management in the near future," he said, "as more and more health care systems recognize the need and payoff."

Better benchmarks are needed to determine a common level of disaster preparedness at the federal, state and local levels, say experts in the field. No standard definition of preparedness exists, and requirements have shifted in recent years.

In Dallas, health officials from public and private facilities have worked hard to coordinate efforts, said Sandy Lutz of PricewaterhouseCoopers' Health Research Institute. Yet in many communities, she said, "planning remains sporadic and disconnected." "For example, hospitals and public health workers are the focal points of disaster response but rarely work together, and other frontline caregivers, such as primary care physicians, are often not included in planning efforts."

Source: Dallas Morning News, Susan Kreimer, 8/31/8