Friday, 20 January 2017 03:45

Emergency Management in Healthcare Issues Featured

Written by
Rate this item
(2 votes)

Emergency Management in Healthcare Issues



Abstract
The fundamental objective of emergency management is to safeguard life as well as prevent injury during dynamic situations. Various stages of emergency management are critical for government agencies, business, and private organizations as well as nonprofit groups. Emergency management processes, policies, and documents in healthcare organizations must ensure that each particular facility can respond adequately to incidents that could potentially create mass casualties. The significance of ensuring competent emergency management in a healthcare organization is to protect as well as be able to save the lives of patients, employees, and communities that a healthcare organization’ serves. Emergency management is however faced with various crucial healthcare concerns that adversely affect the processes and lead to adverse consequences. The paper explores four critical healthcare issues in emergency management namely mechanism of injury (MOI), communication and media relations, triage challenges and logistical issues. The paper also describes various improvements, measures, and strategies employed so as to minimize the adverse outcomes of the various healthcare concerns discussed in the paper.


 


Introduction
Emergency management processes, policies, and documents in healthcare organizations must ensure that each specific facility can respond adequately to incidents that could potentially create mass casualties. These events that could cause emergencies include natural catastrophes (earthquakes, hurricanes, tornadoes, fires, floods or blizzards), unintentional events (plane or train accidents, power failures or any accidents involving biological, nuclear or chemical contamination), or intentional incidents (terrorist attacks or domestic disturbances). It is critical that all the healthcare professionals in a healthcare facility get involved in creating emergency management processes, policies, and documents that are best suited to the facility’s specific needs based on its hazard vulnerability analysis. The significance of ensuring competent emergency management in a healthcare organization is to protect as well as be able to save the lives of patients, employees, and communities that a healthcare organization’ serves. In the event of a disaster, communities expect that healthcare facilities provide medical care to the injured. However, in some occurrences, the medical organizations and their employees fall victim of the events; therefore, should adequately prepare to cater for the community needs in these events as well as safeguard its staff and facilities. The emergency management standards needed healthcare organizations should take a holistic approach so as to manage an emergency that entails preparing a coordinated response and also anticipating challenges and ensuring self-sufficiency. The best practices of emergency management in care facilities require planning and preparation efforts as well as complete and total support from all the staff in the organization from the facility administration to frontline staff. Healthcare organization emergency management activities vary and can be grouped in various ways that include surge capacity, communication, volunteer management, security concerns, hazmat/CBRNE preparedness, volunteer management, collaboration and integration with public health, education and training, drills and exercises, trauma centers, emergency department disaster operations and drills and exercises. Emergency management is however faced with various crucial healthcare concerns that adversely affect the processes and lead to adverse consequences. The paper explores four critical healthcare issues in emergency management namely mechanism of injury (MOI), communication and media relations, triage challenges and logistical issues.



Mechanism of Injury (MOI)
MOI describes the manner in which a patient traumatic event took place that is the forces that act on the body to cause damage. It may include a high-speed motor vehicle crash, a gunshot wound to the torso, or a fall from a standing height. Assessing as well as evaluating MOI can assist in predicting the likelihood of various injuries having occurred and estimate its severity. Knowing the specific details about MOI of a patient can give insight into the energy forces involved and may assist trauma care providers to predict the injury types and in some instances, patient outcomes (Brown, et. al. 2011). Prehospital caregivers report MOI as a communication standard when handing off care to the emergency department and trauma personnel. Similarly, patients who present to the emergency department for emergency health treatment will often relate the MOI by describing the particular chain of the incidents that led to their injuries.



The most common injury producing mechanisms for patients are blunt trauma and penetrating trauma. Blunt trauma is caused by impact forces such as those sustained in a motor vehicle crash, a fall, a blast effect from an exploding bomb, and also an assault with kicks, fists or a baseball bat. The energy that gets transmitted from a blunt trauma mechanism, especially the rapid acceleration-deceleration forces entailed in high-speed crashes or fall from a great height, produces injury by tearing, shearing and also compressing anatomic structures. Trauma to blood vessels and soft tissues takes place. Penetrating trauma is as a result of injuries caused by sharp objects and projectiles. These kinds of injuries include wounds from ice picks, knives and other comparable implements and also bullets (gunshot wounds {GSWs} or pellets. The injuries can also be caused by fragments of metal, glass or other materials that become airborne on the event of an explosion (shrapnel). All the mechanisms have the risk for particular injury patterns and severity that the trauma providers take into consideration when planning diagnostic evaluation and management strategies. Specific injury mechanisms that include gunshot wound to the chest or abdomen or also a stab wound to the neck get highly linked to life-threatening outcomes that they automatically require the immediate intervention by a trauma team for a rapid and coordinated resuscitation response.



One of the most common practices for victims of blunt or penetrating trauma who have experienced MOI forceful enough to damage the spinal column possibly is the prehospital spinal immobilization (Morrissey, 2013). All significant MOIs regardless of signs and symptoms of spine injury requires full-body immobilization that is typically defined as a cervical collar getting applied and the patient being secured to a backboard with head stabilizers in place. It’s however, problematic to use MOI alone as the key indicator for prehospital spinal immobilization. Besides, the harmful sequelae and potential harm of the spine immobilization require consideration in all field protocols. The spine injury assessment guidelines and algorithms that allow for the selective immobilization of injured patients need to be examined appropriately. In the event of a catastrophe, it is not only the community that gets affected but also communication infrastructure get damaged, and the healthcare organization’s power or facilities get destroyed leading to communication failure. It is, therefore, essential that healthcare facilities develop a plan to maintain communication pathways both within the care organization as well as with critical community resources.



Communication and Media Relations
Effective communication is fundamental t successful daily operations of medical facilities and becomes even more critical during crisis events. Excellent communication inside and outside of a healthcare facility during an emergency assists in ensuring the smooth implementation of Emergency Operations Plans. The success or failure of Emergency Operations Plans gets determined by the timely access to communication that allows for an efficient flow of critical information. Communication requires both the use of proper equipment in the event of a crisis as well as the verbal and written interaction with employees and the community. Public health officials, as well as journalists, play a significant role in disseminating information concerning the occurrence of events necessitating for emergency services. The media has been very informative about crisis situations that occur in different parts of the globe. For example, the media was the primary source of information about persons trapped after hurricanes Katrina and Rita slammed into the Gulf Coast of the US (Lowrey, et. al. 2007). Issues in healthcare relating to communication in disaster preparedness and response are associated with frustration and inadequacy to coordinate and execute disaster operation plans. Communication with the general public concerning emergencies should be in conjunction with the public relations department (Kapucu, Arslan & Demiroz, 2010).



Healthcare organizations get required to develop emergency communication strategies as part of the organization’s emergency operations plan and should include in the plan the manner in which it will sustain ongoing communication with employees, the public and the community throughout a crisis. Healthcare facilities should also strive to standardize its communication both internally as well as externally. In the facility, internal communication patterns develop and also change so as to fit the day-to-day needs of administration, management, and care. External communication in a healthcare organization entails the communication between the facility and external staff and private physicians, other healthcare organizations, public safety services (such as emergency medical services), medical testing laboratories, medical examiners and the general public seeking medical treatment or information.



Various problems associated with communication lead to shortfalls during disaster events. The failures are as a result of unpredictable nature of wire-based and cellular telephones and the incompatible radio frequencies when employing hand-held radios. Human errors can also lead to communication problems in health care organizations. Journalists and news organizations also contribute to the communication problem by disseminating inaccurate, incomplete and sensational coverage that may result in public misunderstanding the threats. Studies have determined that journalists covering crisis events lack sufficient expertise in science and medicine, therefore, are unprepared (Lowrey, et. al. 2007). Journalists focus on providing information to the public about health risks although they feel obligated to go beyond passive dissemination of the information. They, therefore, may adopt a wary and even skeptical stance about the government agencies and spokespeople. Public information officers in healthcare have also been faulted by journalism advisors to have contributed to the communication problem since they lack the authority to provide access to information and experts. The public information officers are not allowed by their seniors to give the journalists the information and experts they seek and also may not have adequate information about what information and experts are available or helpful.



Various measures can be undertaken to enhance effective communication during emergencies. By identifying the vulnerabilities in the current healthcare communication systems, steps can be implemented to address the challenges and enhance the health system preparedness. Infrastructure support is also an essential consideration when examining whether adequate safeguards have been implemented to support the supports we will use during crisis occurrences. It is also important to reduce turnover in the media and news organizations as the seasoned journalists able to effectively communicate healthcare issues during emergencies leave to join other fields. Different communications modes that include paging, radio, television, email and mobile phones can be employed to provide information during disasters. The integration of social media and networking sites such as Twitter and Facebook in communication during emergencies can assist the emergency management community that includes the medical and public health professionals in responding adequately to catastrophes and other occurrences (Merchant, Elmer & Lurie, 2011). Networking sites get used by an extended part of the society hence can effectively help individuals, communities, and healthcare agencies to share emergency plans and develop emergency networks. Location-based service applications that include Foursquare and Loopt provide an opportunity to enhance preparedness by improving the public awareness of crisis situations in their geographic area. Social media has also become a critical component in recovery efforts after the occurrence of crisis events. An example of the effective use of social media in crisis situations is the 2010 Haiti’s earthquake in which Ushahidi an open source web platform that uses crowdsourced information to support emergency management linked medical providers requiring supplies to those who had them (Merchant, Elmer & Lurie, 2011). Also, victims of the earthquake used Facebook to reach out for help after the disaster had occurred.



Triage Challenges
Triage describes the process that places the right patient in the right place at the right time to receive the right level of care. The process of triage prioritizes the patients to receive care first and is regarded as the cornerstone of good disaster management. Accurate triage enables disaster nurses to do the greatest good for the greatest number of casualties (Aacharya, Gastmans & Denier, 2011). Triage is necessary for managing causalities both in peace and wartime. Appropriate triage decision assists in saving the lives as well as the limbs of a vast number of patients. Although the fundamentals of triage remain consistent wherever it is carried out, undertaking triage in a disaster situation presents unique challenges, and the success of the process may be highly dependent on the competence and experience of the nurse and the other healthcare professionals. The critical point of triage is that not every patient who requires a particular form of medical care that includes medicine, therapy, surgery, intensive care bed, transplantation can gain immediate access to it. The triage nurse must accurately make a decision which patients require care, in what order should they be treated, and in situations of severely constrained resources, the patients who should not receive care at all. Some of the competencies and personality traits of a good triage provider are clinically experienced, calm and cool under stress, sense of humor, good judgment, and leadership, decisive, creative problem-solver, knowledgeable of available resources and experienced and knowledgeable concerning anticipated casualties.



Various challenges take place if patients are rapidly discharged from triage. One, the patients may fail to complete the registration process. Two, the lack of education delivered to the patient concerning the diagnosis. Three, the perception on the part of the patient that not being examined in a medical room with a gurney implies they are being kicked to the curb without adequate treatment.



Logistical issues
Emergency logistics management has emerged as a prominent global theme as catastrophes, either artificial or natural may take place anytime around the globe with enormous impacts. Unlike business logistics, the definition of emergency logistics remains ambiguous. Logistics in business is described as the process of planning, implementing and controlling the efficient, effective flow and storage of goods, services, and related information from the point of origin to the point of consumption for the aim of conforming to consumers’ requirements at the lowest total cost. Logistics in emergency management hence can be adapted from the above definition. It gets described as the process of planning, managing as well as controlling the efficient flows of relief, information and services from the points of origin to the points of destination to meet the urgent needs of the affected individuals under crisis circumstances (Sheu, 2007).



Extreme calamity incidents pose severe logistical challenges to emergency as well as aid organizations active in planning, preparation, response and recovery operations since the disturbances they cause have the potential to turn normal conditions suddenly into chaos. Under the circumstances, the delivery of the critical supplies that include food, water, and medical supplies becomes a tough task. It is as a result of the severe damage to the physical and virtual infrastructure as well as the limited or nonexistent transportation capacity. The recovery process is made quite challenging by the prevailing lack of knowledge concerning the nature and problems of emergency supply chains. Hence causing the design of reliable emergency logistics systems to be hampered by insufficient knowledge concerning formal and informal supply chains operate and interact, techniques to analyze and coordinate the flows of priority and nonpriority goods, as well as scientific methods to analyze logistic systems under extreme conditions.



Various studies have been undertaken with the aim of determining the different critical logistical issues that have plagued the response to certain disasters. The research on the response of Hurricane Katrina determined various logistical issues. They include collapse of the communication infrastructure, magnitude of the requirements, lack of integration between federal as well as state logistics systems, understaffing and lack of adequate training, inefficiencies in prepositioning resources, lack of planning for the handling and distribution of donations, limited asset visibility as well as procurement (Holguín-Veras, et. al. 2007). The logistical issues following Hurricane Katrina that in August 2005 devastated the US Gulf Coast give a perfect example of the importance of enhancing the efficiency of supply chains to the site of a hazard. These logistic issues led to the formulation of certain improvements so as to better respond to future risks. The improvements include executing measures to enhance asset visibility, developing a comprehensive emergency logistics training program, developing regional blanket purchasing agreements, executing proactive donation coordination plans, and developing regional compacts for prepositioning of critical supplies.



Conclusion
In emergency management, it is essential to evaluate the MOI of a patient as it assists in predicting the likelihood of various injuries having occurred and estimate its severity. Communication in emergency management is critical as it plays various roles that range from developing a competent media relations during contingencies to controlling rumors to balancing the public’s right to information with the organization’s need to safeguard its interests. Also, importantly, communication and public relations maintain, monitor as well as prioritize relations with the various organization stakeholders. Triage is a very challenging health issue associated with managing clinical and support activities. It is, however, important as a management tool and also in enhancing reliability and consistency in emergency management during a crisis. A comprehensive emergency management plan must address the aspect of logistical responsiveness across all the four phases of emergency management namely planning, preparedness, response, and recovery. All the stages of emergency management entail of an element of logistical readiness and intervening measures that can be carried out to stave off some of the effects of a disaster. The logistics staff must acknowledge the complexity of crisis response and need to appreciate interdisciplinary solutions based on lateral thinking as well as concerted strategies.




References
Aacharya, R. P., Gastmans, C., & Denier, Y. (2011). Emergency department triage: an ethical analysis. BMC emergency medicine, 11(1), 1: DOI: 10.1186/1471-227X-11-16
Brown, J. B., Stassen, N. A., Bankey, P. E., Sangosanya, A. T., Cheng, J. D., & Gestring, M. L. (2011). Mechanism of injury and special consideration criteria still matter: an evaluation of the National Trauma Triage Protocol. Journal of Trauma and Acute Care Surgery, 70(1), 38-45: doi: 10.1097/TA.0b013e3182077ea8
Holguín-Veras, J., Pérez, N., Ukkusuri, S., Wachtendorf, T., & Brown, B. (2007). Emergency logistics issues affecting the response to Katrina: a synthesis and preliminary suggestions for improvement. Transportation Research Record: Journal of the Transportation Research Board, (2022), 76-82. DOI: 103141/2022-09
Kapucu, N., Arslan, T., & Demiroz, F. (2010). Collaborative emergency management and national emergency management network. Disaster Prevention and Management: An International Journal, 19(4), 452-468: DOI: http://dx.doi.org/10.1108/09653561011070376
Lowrey, W., Evans, W., Gower, K. K., Robinson, J. A., Ginter, P. M., McCormick, L. C., & Abdolrasulnia, M. (2007). Effective media communication of disasters: pressing problems and recommendations. BMC Public Health, 7(1), 1: DOI: 10.1186/1471-2458-7-97
Merchant, R. M., Elmer, S., & Lurie, N. (2011). Integrating social media into emergency-preparedness efforts. New England Journal of Medicine, 365(4), 289-291: DOI: 10.1056/NEJMp1103591
Morrissey, J. (2013). Research Suggests Time for Change in Pre-hospital Spinal Immobilization. Journal of Emergency Medical Services.
Sheu, J. B. (2007). Challenges of emergency logistics management. Transportation research part E: logistics and transportation review, 43(6), 655-659.

 

Read 1272 times Last modified on Friday, 20 January 2017 03:52

Leave a comment

Make sure you enter all the required information, indicated by an asterisk (*). HTML code is not allowed.

2014 Emergency Management in Healthcare Issues.
Powered by Joomla 1.7 Templates