Medical groups announce agenda for improving disaster response

Jul 24, 2007 (CIDRAP News) – Eighteen medical groups, led by the American Medical Association (AMA) and the American Public Health Association (APHA), released a report at a recent conference in Washington, DC, that contains 53 recommendations for improving the nation's response to mass casualty events such as terrorist attacks, infectious disease outbreaks, and natural disasters.

The 55-page report reflects the priorities and strategies that representatives from the groups identified at AMA-APHA leadership summits held in Chicago in 2005 and New Orleans in 2006, the AMA said in a Jul 18 press release. The summits were sponsored by a cooperative agreement from the Centers for Disease Control and Prevention (CDC).

"Most disasters are unplanned, but the response shouldn't be," AMA President Ronald M. Davis, MD, said in the press release.

The recommendations highlight four main themes: funding, response system integration, health professional training and proficiency, and adequate legal protection for public health and healthcare responders.

Dedicated funding
Steady, dedicated funding is needed to ensure the emergency and critical infrastructure and capacity to respond to disasters, because the health system is already pressed beyond capacity, the groups wrote in the report. Governments and health systems must develop processes that enable local health systems to return to readiness as soon as possible after a disaster, and funding for economic recovery from disasters must make reestablishing public health and healthcare systems a priority.

The groups requested that the Institute of Medicine (IOM) be funded to perform a comprehensive study of healthcare surge capacity and develop recommendations to help health systems improve disaster response and recovery.

Integrating services and systems
Governments, health systems, and professional organizations should continue progress toward nationwide integration of emergency and trauma care services with emergency and disaster preparedness and healthcare systems. The groups pointed out that the IOM has already recommended that a lead agency should be established to oversee emergency and trauma care, and the federal government has issued a mandate that fosters interagency collaboration among emergency and trauma care services.

All aspects of governmental and health system emergency and disaster preparedness efforts should directly involve public health and healthcare professionals, the report said.

Georges Benjamin, MD, executive director of the APHA, said in the press release, "For too long public health and medicine have responded to emergencies in separate silos." Bridging the gap between the two groups will allow for rapid and efficient disaster response, he said.

Integration goals also require that health disaster communication and information networks be technologically interoperable with all government levels and health systems, the report said.

Educational institutions can help ensure that public health and healthcare professionals receive adequately training in incorporating competency-based disaster preparedness and response coursework into undergraduate, graduate, postgraduate, and continuing educational programs, the groups emphasized.

Governments, health systems, and professional groups must develop and distribute competencies for managing adult and pediatric patients in emergency and catastrophic settings, the report said. Educational accreditation agencies should then incorporate the competencies into educational materials and formal continuing education programs.

Legal protection
National and state legislation is needed to create adequate legal protection so that health and mental health practitioners can provide care in emergency and disaster settings outside of the location where they are licensed or accredited, the recommendations state.

Policies must also address medical liability, standards and altered standards of care, and license reciprocity to make it easier for volunteer health professionals to assist with disaster response, the report said.

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