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Emergency management program operational responses to weapons of mass destruction: Veterans Health Administration, 2001–2004
Author(s) -
Hodgson Michael J.,
Bierenbaum Arnold,
Mather Susan,
Brown Mark A.,
Beatty John,
Scott Margie,
Brewster Peter
Publication year - 2004
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.20090
Subject(s) - medicine , mandate , health care , work (physics) , public health , audit , hazard , risk analysis (engineering) , medical emergency , public relations , operations management , nursing , business , engineering , mechanical engineering , chemistry , accounting , organic chemistry , political science , law , economics , economic growth
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. Am. J. Ind. Med. 46:446–452, 2004. Published 2004 Wiley‐Liss, Inc.