Description
Discussion Requirements
A substantive comment should be approximately 300 words or more for each of the responses (2 TOTAL).
Read the initial comments posted by your classmates and reflect upon them.
Before writing your comments:
- Review the Discussion grading rubric to see what is expected for an excellent discussion, in order to earn full credit.
- Review some resources to help you synthesize, such as the following:
Sullivan, J. (2011). Strategies for Synthesis Writing. Retrieved from http://www.findingdulcinea.com/features/edu/Strategies-for-Synthesis-Writing.html
NOTE: You are required to cite sources and include a reference list for the second post if it is simply your opinion. However, if your opinion is based on facts (as it should be), it is good practice to strengthen your position by citing sources.
Be sure to meet all of the criteria in the rubric, as noted in the instructions above.
Third post for each module discussion:
Read the initial and secondary comments posted by your classmates and reflect upon them.
Directly respond to at least one classmate in a way that extends meaningful discussions, adds new information, and/or offers alternative perspectives.
MY DISCUSSION (DO NOT RESPOND TO THIS POST PLEASE)
(DO NOT RESPOND TO THIS POST PLEASE)
(DO NOT RESPOND TO THIS POST PLEASE)
(DO NOT RESPOND TO THIS POST PLEASE)
Classmates and Professor,
Urban vs. Rural Surge Capacity
With disasters being unpredictable, in terms of when and the magnitude of their impact, countries need to ensure they have proper emergency response and surge capacity to help victims during the disaster. Hospitals and healthcare coalitions are being faced with the huge challenge of mitigating the disaster after a disaster has stricken. Health care facilities are recognizing the importance of surge planning as part of their emergency plan and response.
Challenges in preparing for medical surge capacity
One of the main challenges in medical surge capacity is funding. According to Casani & Romanosky (2006), in a bid to limit the rising health care cost, health economies in the United States are increasingly reducing acute care inpatient beds, which has contributed to the growth of home care and intermediate care facilities (Hsu, et al., 2006). As more hospitals seek to cut costs by reducing beds that are not used, this, in turn, affects the healthcare facilitys surge capacity. Since surge capacity encompasses the ability of health facilities to provide care to a surge of patients, this move of reducing hospital costs is going contrary to the objective of surge capability in the country. This challenge can be observed in both rural and urban health care facilities. Another challenge is that the fund provided by the federal government through the Hospital Preparedness Program and the CDC are strictly restricted. According to Smith (2009), the current grant programs given by health care facilities to improve surge capacity are strictly restricted as to how they use their funds.
For the country to develop an effective surge capacity, it required access to resources such as human, financial, and materials. During an emergency, the country requires staff who are specialized in emergency response. An example of specialist emergency staff includes the Rapid Response Team. These staffs are required to continually engage in training to improve their skills in managing disasters. This ensures that the team is well-skilled and prepared in the event of a disaster. In the rural areas, they may not get the opportunity to engage in training as much as the urban centers. With this consideration, disaster response teams in rural areas may not be well-equipped to handle a disaster. According to Adalja et al., (2014), following Hurricane Sandy, which adversely affected 14 United States and Washington DC. According to the authors, the States of New York and New Jersey were significantly hit by the hurricane. For this reason, New York City has significantly invested in disaster management and surge protection. The City suffered significant losses, which can be translated to why the state is investing significantly in surge capacity and disaster preparedness, compared to rural areas, which were not significantly impacted.
According to Rathnayake et al., (2019), healthcare providers are expected to prepare and anticipate any sudden increases in the number of patients due to the accelerated burden caused by disasters. The ability of health care providers to accommodate this sudden increase is referred to as surge capacity means. It is essential for countries and health care organizations to develop plans to mitigate disasters and emergencies to ensure that as many lives are saved from a disaster. The fact that rural facilities are not receiving the extra support urban facilities are receiving is disheartening. The United States government should ensure it puts as much effort into rural facilities as it is putting in urban areas.
Pedro
References
Adalja, A. A., Watson, M., Bouri, N., Minton, K., Morhard, R. C., & Toner, E. S. (2014). Absorbing citywide patient surge during Hurricane Sandy: a case study in accommodating multiple hospital evacuations. Annals of emergency medicine, 64(1), 66-73.
Hsu, E. B., Casani, J. A., Romanosky, A., Milin, M. G., Singleton, C. M., Donohue, J., . . . Kelen, G. D. (2006). Biosecurity and bioterrorism : biodefense strategy, practice, and science,. Are regional hospital pharmacies prepared for public health emergencies?, 4(3), 237243 DOI.org/10.1089/bsp.2006.4.237.
Joint Commission on Accreditation of Healthcare Organizations. (2006). Surge Hospitals: Providing Safe Care in Emergencies. Retrieved from https://www.jointcommission.org/-/media/deprecated…
Rathnayake, D., Clarke, M., & Jayasooriya, L. (2019). Hospital surge capacity: The importance of better hospital pre-planning to cope with patient surge during dengue epidemicsA systematic review. International Journal of Healthcare Management, 1-8.
Smith, W. M. (2009, June). Financing surge capacity and preparedness. In Presented June (pp. 10-11).
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RESPONSE 1
Good morning everyone,
In the medical and public health system, the United States and other Countries must prepare for these major emergencies, natural and man-made disasters, that have casualties. These events will severely challenge the ability of healthcare systems to adequately care for large numbers of patients (surge capacity) and/or victims with unusual or highly specialized medical needs (surge capability). With the strain on the medical and public health systems, they can expect incidents of great magnitude, that will impact their day-to-day operation, as it did Hurricane Andrew Hurricane Katrina, Hurricane Sandie. The mass effect events can have dire consequences for medically fragile segments of society and those living with chronic health conditions. Limited or no access to routine healthcare services can cause these populations to rapidly decompensate, producing a downstream surge of demand for acute care that can overwhelm local capabilities. One of the first areas to address is a medical surge and medical system resiliency is to implement systems that can effectively manage medical and health response, as well as the development and maintenance of preparedness programs.
The Medical Surge Capacity and Capability (MSCC) Management System describes a management methodology based on valid principles of emergency management and the Incident Command System (ICS) Citi. The MSCC Management System has six Tiers. Management of Individual Healthcare Assets (Tier 1) is having a well orchestrate ICS plans. Management of a Healthcare Coalition (Tier 2) is the coordination among the healthcare profession to provide critical care affected areas. Jurisdiction Incident Management (Tier 3) is the ICS that integrates healthcare assets, with all the different disciplines needed to maximize MSCC. Management of State Response (Tier 4), The government of the state, which is affected, will participate in medical incident response across a range of capacities, depending on the specific event. Interstate Regional Management Coordination (Tier 5), effective communication is essential to promote e incident management coordination between affected States. Federal Support to State, Tribal, and Jurisdiction Management (Tier 6), effective management processes at the State (Tier 4) and jurisdiction (Tier 3) levels facilitate the request, receipt, and integration of Federal public health and medical resources to maximize MSCC.
Isaiah
References:
Services, U. D. (2009). Medical Surge Capacity and Capability: The Healthcare Coalition in Emergency Response and Recovery, 01-202.
U.S. Department of Health and Human Services. (2007). Medical Surge Capacity and Capability:. A Management System for Integrating Medical and Health Resources During Large-Scale Emergencies, 01-274.
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RESPONSE 2
Good evening,
Any incident that can cause a mass casualty event has the ability to overwhelm the medical capabilities of that respective area. Urban areas are commonly better equipped and staffed as well having access to additional resources from around the community. A rural area will have limited staff and equipment, they will also not always have access specialized medical practitioners and care. In the event of an incident the approving local official calls for a surge hospital to be setup and the state Governor will appoint a medical person as leadership to lead that hospital. The ability for rural a community to operate a surge hospital will greatly limited as they will commonly not have closed hospitals or wards that can be reopened. These types of rural communities will have to make do with facilities of opportunity like meeting halls, high school gyms, or other areas that can be converted to house patients. The rural community must make considerations for obtaining medication not just for immediate response but also for the treatment of chronic illnesses. The chronically ill are commonly over looked following an incident and should be considered an at-risk demographic. Proper incident planning and mutual aid agreements for rural communities will be vitally important as the chances of them needing outside support will increase as the surge hospital stays operational.
The urban community will have different challenges, they will have a greater number of staff on-site or available but will also have a greater overall influx of patients to handle depending on population size. Urban communities will have specialized resources and medical practitioners but those number will still be limited and can easily be overwhelmed. The stock of supplies in an urban setting will require greater care and logistical support to manage, this also includes medication. Urban hospitals depending on time of year will also have a higher standard number of calls for medical response to include accidents and assaults then that of a rural community this. If the medical capabilities of the urban hospital are already stretched thin then adding the need to support a surge requirement could result in a reduction of the standard of care patients will receive.
The urban and rural communitys healthcare system will have their own unique challenges; however, both will benefit from many of the same opportunities. The Joint commission on Accreditation of Healthcare Organizations, identified a program run by the Center for Disease Control (CDC) called the National Stockpile that had medications and medical supplies, such as airway maintenance, IV maintenance, and medical surgical items to be used in public health emergencies. (2006, p. 7) This type of program could be used in both urban and rural communities in the event that a surge hospital needed to be established. While programs similar to the one that the CDC has created is critical, planning and coordination is the key piece that brings the various parts together. The Medical Surge Capacity and Capability (MSCC) handbook, outlines how to integrate surge planning into a tiered incident management system. The incident management system in the MSCC handbook is made up of 6 tiers that depicts the various levels of public health and medical asset management during response to mass casualty and/or mass effect incidents. (2007, p. 1-8) The tiers effectively work together with one another but also internally as well:
Tier 1- These are made up of individual healthcare assets for example hospitals, healthcare systems, and private owned medical businesses.
Tier 2- These are made up of facilities and other medical ventures that work together to function as a healthcare coalition.
Tier 3- These are the areas Emergency Management capabilities that can help fully integrate an effective response through resource allocation and planning.
Tier 4- This is the states ability to support tier 3 assets for incident response.
Tier 5- This allows for interstate support for emergency assistance through funding, intelligence, and jurisdictional authority.
Tier 6- This federal support to the state in the form of the Stafford Act or other congressional legislation that allows for a state declare a disaster incident or potential disaster incident prior to the incident happening.
Each on of these tiers supports the other and depending on the incident may become more vital to operational success and recovery of a community as the incident draws to an end. There are many factors that will be faced by urban and rural communities in the event that they have to deal with a mass casualty event, type of attack, time of day and year, resources, and planning. Another data metric that has to looked at is peak need for medical care, Stratton and Tyler identified that on September 11th, 2001 over 70% of the survivors were treated for medical care in the first 12 hours following the incident. (2006) Peak need for medical care among many other factors must be taken into consideration by medical planning officials when developing Emergency Response Plans. In areas rural or urban known to have an increased potential for seasonal disaster incidents, failure to plan is a plan that will ultimately fail.
Noska
References
Stratton, S. & Tyler, R., (2006). Characteristics of Medical Surge Capacity Demand for Sudden-impact
Disasters. Retrieved from https://onlinelibrary.wiley.com/doi/epdf/10.1197/j…
Medical Surge Capacity and Capability:
U.S. Department of Health and Human Services, (2007). A Management System for Integrating Medical
and Health Resources During Large-Scale Emergencies, p. 1-8. Retrieved from
https://www.phe.gov/preparedness/planning/mscc/han…
Joint Commission on Accreditation of Healthcare Organizations, (2006). Surge Hospitals: Providing Safe
Care in Emergencies, p.7. Retrieved from https://www.jointcommission.org/-/media/
deprecated-unorganized/imported-assets/tjc/system-folders/topics-library/
surge_hospitalpdf.pdf?db=web&hash=43EAC6444DE45A9528AEC0E346D32ACB
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Module 3 – Background
SURGE CAPACITY AND THE ROLE OF HOSPITALS
Required Reading
Adalja, A. A., Watson, M., Bouri, N., Minton, K., Morhard, R. C., & Toner, E. S. (2014). Absorbing citywide patient surge during Hurricane Sandy: A case study in accommodating multiple hospital evacuations. Annals of Emergency Medicine, 64(1) 66. Available at Trident Online Library.
Cagliuso, N. (2014). Stakeholders experiences with US hospital emergency preparedness: Part 1. Journal of Business Continuity & Emergency Planning, 8(2) 156168. Available at Trident Online Library.
Cagliuso, N. (2014). Stakeholders experiences with US hospital emergency preparedness Part 2. Journal of Business Continuity & Emergency Planning, 8(3) 263279. Available at Trident Online Library.
DHHS (2007). Medical surge capacity and capability: A management system for integrating medical and health resources during large-scale emergencies. Retrieved from https://www.phe.gov/Preparedness/planning/mscc/han…
Dichter, J.R., Kanter, R.K., Dries, D., Luyckx, V., Lim, M.L., Wilgis, J., . . . & Kisson, N. (2014). System-level planning, coordination, and communication. Chest, 146(4) e87Se102S. Available at Trident Online Library.
Joint Commission on Accreditation of Healthcare Organizations (2006). Surge hospitals: Providing safe care in emergencies. Retrieved from https://www.jointcommission.org/assets/1/18/surge_…
On your mark, get set, triage! (n. d.). Emergency Physicians Monthly. Retrieved from http://epmonthly.com/article/on-your-mark-get-set-…
Ugarte, C. et al. (n. d.). Planning and triage in the disaster scenario. AAP.org. Retrieved from https://www.aap.org/en-us/Documents/disasters_dpac…
Required Websites
CDC.gov. Strategies for Optimizing the Supply of N95 Respirators. COVID-19. https://www.cdc.gov/coronavirus/2019-ncov/hcp/resp…
Healthcare Executives Role in Emergency Preparedness. American College of Healthcare Executives. https://www.ache.org/about-ache/our-story/our-comm…
Topic Collection: Hospital Surge Capacity and Immediate Bed Availability. HHS.gov. https://asprtracie.hhs.gov/technical-resources/58/…
