Citation

Hodgson MJ, Bierenbaum A, Mather S, Brown MA, Beatty J, Scott M, Brewster P. Am. J. Ind. Med. 2004; 46(5): 446-452.

Affiliation

Office of Public Health and Environmental Hazards (including Occupational and Environmental Health Strategic Healthcare Group, Environmental Hazards and Occupational Health Programs, Washington, District of Columbia 20420, USA. muh7@mail.va.gov

Copyright

(Copyright © 2004, John Wiley and Sons)

DOI

10.1002/ajim.20090

PMID

15490478

Abstract

BACKGROUND: Despite the recognition of chemical emergencies, terrorist events, and ongoing threats, little practical guidance exists for healthcare facilities. METHODS: An approach and materials developed by the Veterans Health Administration in a five-element program over the last 2 years to enhance the existing emergency management program is outlined. Nine steps to the development of a comprehensive all-hazards, emergency plan and program, with auditing and improvement tools are offered. RESULTS: Cognitive aids for clinical use are available on-line and in hard copy. A hazard assessment modeled patients as emission sources documenting the operations strategies under which level C personal protective equipment will protect healthcare workers. The development of this response program appears to support a broader, long-standing VHA approach to problem solving. This involves bringing together individual talented field staff, representing specific skills, geographic regions, and work styles; investing in face-to-face consensus development; and developing programs with extensive internal peer-review ("field-based," "bottom-up and top-down," and external reviews). CONCLUSIONS: Comprehensive and effective programs can be constructed at low cost with reasonable speed within large systems with a public mandate, leading to responsible use of public funds internally, and as models for private sector programs. It is the long-term operational cost implications, under budget constraints in health care, which often present the true challenge.

Language: en