Chapter 7: Essentials of Disaster Planning - Public Health Outbreak and Disaster Management PDF - PHC 372

Chapter 7: Essentials of Disaster Planning PHC 372: Public Health Outbreak and Disaster Management 1 Public Health Rose Use traditional planning principles in preparing for the delivery of public health and health care services during the impact and...

Chapter 7: Essentials of Disaster Planning PHC 372: Public Health Outbreak and Disaster Management 1 Public Health Rose Use traditional planning principles in preparing for the delivery of public health and health care services during the impact and postimpact phases Participate in the development of and serve as an integral part of a community’s disaster preparedness plans Participate in organizing all health partners in the community Coordinate efforts with state and federal planners (Landesman, 2012, p. 153) PHC 372: Public Health Outbreak and Disaster Management 2 Federal Planning Federal planning is organized into these four areas: Federal Emergency Support Function 8 (ESF-8) Playbooks are developed for each of the National Planning Scenarios Regional emergency coordination Regional emergency coordinators represent their region and collaborate with government officials at other levels in disaster preparedness (Landesman, 2012, p. 156) PHC 372: Public Health Outbreak and Disaster Management 3 Federal Planning, cont. State and local preparedness State and local planners develop disaster plans for their areas and integrate with federal plans Evaluate state and local preparedness programs that receive federal funding Chemical, biological, radiological/nuclear (CBRN) Offer their expertise to be used in CBRN playbooks Develop tools for CBRN event response (Landesman, 2012, p. 155-156) PHC 372: Public Health Outbreak and Disaster Management 4 Planning for Various Disasters Two strategies for disaster planning: Agent specific planning – communities only plan for threats most likely to occur in their regions All-hazards approach – communities plan for common problems and tasks that arise in the majority of disasters Assistant Secretary for Preparedness and Response Playbooks Cover specific disasters, such as hurricanes, aerosolized anthrax Advise states and localities on how to integrate their planning with federal response (Landesman, 2012, p. 158) PHC 372: Public Health Outbreak and Disaster Management 5 Playbooks, cont. Each playbook contains these five sections: Scenario Concept of Operations Action Steps/Issues Pre-Scripted Mission Assignment Subtasks Essential Elements of Information (Landesman, 2012, p. 158-159) PHC 372: Public Health Outbreak and Disaster Management 6 Common Tasks of Disaster Response Interorganizational coordination Triage Sharing information among organizations Casualty distribution Resource management Patient tracking Evacuation from areas of danger Caring for patients Search and rescue Management of volunteers and donations Using both mass and social media Organized improvisation (Landesman, 2012, p. 160-161) PHC 372: Public Health Outbreak and Disaster Management 7 Surge Capacity Community must inventory: Available sites of inpatient and ambulatory medical and mental health care; public health agencies; volume, location, and services delivered; and the geographic area served Determine projections for increasing capacity by estimating: Potential types of casualties and care needed by type of incident Volume, intensity, and different rates of morbidity among projected patients Available treatment and triage on-site at the incident Alternative sources for capacity Expected time frame, length of the response, and work schedules Types of public health and health care services to be added or increased (Adapted from Landesman, 2012, p. 164-165) PHC 372: Public Health Outbreak and Disaster Management 8 Chapter 8: Environmental and Occupational Health Issues PHC 372: Public Health Outbreak and Disaster Management 1 Public Health Role Provide technical assistance in addressing environmental threats and hazards Contain or remove sources of environmental contamination, or evacuate people to ensure that they are no longer exposed to the hazard Conduct quantitative monitoring of environmental services, including environmental sampling, ensuring the replacement or repair of existing sanitary barriers and waste management Provide guidance, education, and assurance of safe water, safe food, and safe shelter to compensate for disrupted sanitary environments (Landesman, 2012, p. 173-174) PHC 372: Public Health Outbreak and Disaster Management 3 Public Health Role, cont. Ensure that people have sufficient cooking utensils, equipment, and fuel to cook and store food safely Inspect temporary housing, mass feeding centers, drinking water distribution, and waste disposal Provide commercial toilets and handwashing stations Supervise construction of latrines, if toilets not available Protect worker safety by ensuring the use of protective measures and by monitoring illness and injury to inform modifications in the use of protective measures Provide regular advisories to the public and the medical community (Landesman, 2012, p. 173-174) PHC 372: Public Health Outbreak and Disaster Management 4 Environmental Surveillance Three conditions that should be monitored to estimate the number of individuals whose environment is affected by a disaster: Access to excreta disposal facilities Number of people per latrine Availability of latrines Water consumption Depends on water availability and population’s ability to obtain water Concerns: container shortages, security concerns, long lines Officials should monitor how much water is collected Percentage of people consuming safe water If groundwater is safe to drink, officials should estimate the number of people using it Pipes and taps should be tested to ensure they are not contaminating originally safe water (Landesman, 2012, p. 174-175) PHC 372: Public Health Outbreak and Disaster Management 5 Water Supply Three sources of water: Groundwater – generally of good microbiological quality; but difficult to access Surface Water – usually microbiologically unsafe; but access is easy and predictable Rainwater – collection is unreliable; seldom used PHC 372: Public Health Outbreak and Disaster Management 8  Chapter 10: Vulnerable Populations ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 1  Public Health Role Ensure that communities include vulnerable groups and the organizations that serve them in the planning process. of needsthe accommodateplans preparednesscommunitythatEnsure vulnerable populations protect to takenbe can that actionsaboutcommunitytheEducate vulnerable individuals and groups in times of emergency healthcare in efforts preparednessvulnerability-specifictheCoordinate delivery sites, shelters, and distribution centers (Landesman, 2012, p. 230) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 4  Who is at Risk? At-risk individuals – “Those who ‘before, during, and after an incident,…may have additional needs in one or more of the following functional areas:” Maintaining independence: in daily activities when support is lost in a disaster Communication: Cannot receive or respond to emergency information. Transportation: Cannot drive because of disability or do not have transportation Supervision to make decisions such as children and cognitively impaired persons Medical care to manage unstable, terminal, or contagious conditions (Landesman, 2012, p. 229-230) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 5  Who is at Risk, cont. Other groups who are at risk include people with: Disabilities Limited to no proficiency in English Transportation disadvantages Chronic medical disorders Pharmacological dependency (Landesman, 2012, p. 229-230) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 6  Disaster Planning Councils for Vulnerable Populations Formed within communities as a disaster preparedness strategy to address the needs of people with disabilities. Should identify: What resources are needed during a disaster What strategies can be used to address needs Which agency/group will be responsible for providing specific services Councils should include: Governmental agencies, community providers, community-based organizations (CBOs), advocacy groups, congregate living centers, and local affiliates of national advocacy and disability organizations. (Landesman, 2012, p. 233) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 10  Potential Members of a Planning Council for Vulnerable Populations Government Agencies Community Providers Advocacy Groups Mayor’s office or county Visiting nurse service National Association of the Deaf executive committee on Meals on Wheels Hearing Loss Association of people with disabilities Residential and assisted America Telecommunications for the Department of health living facilities Deaf, Inc. and/or mental health Home health agencies National Organization on Board of education Ambulette a1n11d paratransit Disability Departments of businesses Local Chapters of the American rehabilitation and aging After-school programs Foundation for the Blind and Department of social Easter Seals Council for the Blind services and regional United Cerebral Palsy Alliance for Technology Access Parent Teacher Association centers Center for Independent Living (Adapted from Table 48, Landesman, 2012, p. 236) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 11  Registries As a part of community planning, Public health and community- based organizations (CBOs) should work together to create registries that identify at-risk individuals and groups in the community Once developed, registries help public health determine services needed during a disaster Issues: Labor-intensive to create Difficult to keep registries current Since participation is voluntary, some who don’t enroll won’t be counted Privacy concerns (Landesman, 2012, p. 237-238) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 14  Specific Strategies Vulnerable individuals should know where to go if they need shelter, ❑ transportation, and support services; keep needed assistive devices and equipment nearby; know their evacuation options; and repeatedly practice their plan. Preparedness tips are specific to the needs of particularly vulnerable groups: Blind Will need to be led to safety and might be hesitant to evacuate with strangers. Responders should be aware and prepared to assure safety Responders should be trained in interacting with service animals (e.g., guide dog) Children deliveryand preparations,drug equipment,specificrequirechildrenInjured systems – hospitals should prepare for these challenges Spend much of the day in school, so school preparedness is essential ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 15  Specific Strategies Bed-bound individuals Should have an emergency transportation plan Should have extra supplies of daily care items (e.g., bed pans, adult diapers, linens) Deaf and hard to hearing Should have necessary equipment (e.g., hearing aid batteries) Should plan for means to receive emergency warnings and communicate, such as using audible and visual alarms, text cell phone, paper, and pen. ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 16  Specific Strategies, cont. People on life support (dialysis, respirator, oxygen, suction, intravenous pump, or infusion therapy) can enhance their preparedness by the following: and solutions,tubing,(oxygen,equipmentor facilitiesalternativeforPlan medications) Register with a utility company as a customer dependent on powered life-support systems. Stock extra supply of oxygen and other supplies. Consider purchasing a generator. Older adults Are more likely to have health conditions, be dependent on caregivers, lack resources to prepare for disasters, and be hesitant to evacuate in issues these considershould adults older servethatorganizationsLocal preparedness plans affecting older adults. PHC 372: Public Health Outbreak and Disaster Management 17 an,2012, p. 239-244)‫قم‬m‫ي‬s‫د‬Restric(tLeadnd- e  Go Packs preparedkitIndividualized advancein (preferably housed in a waterproof plastic box) Include: At least one week of medication, rotated every week to ensure it hasn’t exceeded its expiration date Examples aid hearingnecessities:otherof batteries, ventilator, walker, or caneextra lightweight chair,evacuation emergency augmentative communication equipment, insulin supplies, food, and water for guide dogs. (Landesman, 2012, p. 244-245) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 18  Communication Emergency communication should: Be accessible for people with disabilities Be provided in languages other than English Provide additional education for vulnerable populations Consider individuals with cognitive disabilities media through informationemergencyfor closed-captioningInclude (required by the Federal Communications Commission) Utilize other resources, such as CDC-produced American sign language video clips that provide instructions on topics such as storm cleanup and food and water safety (Landesman, 2012, p. 246-247) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 20  Building Preparedness For People with Disabilities Key elements for organizations and buildings to consider: Evacuation plan –both staff and visitors that might have special needs or vulnerabilities. Organizations and buildings should develop an emergency committee whose first task is to understand general evacuation issues. Assessment of number of employees and their types of vulnerabilities, identify and train personnel who assist disabled, and conducting regular drills and assessing performance as a part of community preparedness plan. Detection of hazards (e.g., fires) should be ADA compliant ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 21  Building Preparedness, cont. Notification of emergencies – should be able to inform all building occupants, have built-in redundancy, and feature alternative, low-tech plans Tactile and audible signage – certain types of signs must feature provisions for hearing and vision-impaired people Evacuation – plans should include people with disabilities Special planning is necessary for buildings that house a high number of people with disabilities or elderly people on higher floors or in high-rise buildings (Landesman, 2012, p. 250-254) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 22  D Chapter 11: Public Health Response to Emerging Infections and Biological Incidents ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 1  Public Health Role Develop and use multidisciplinary protocols for collaboration activatingand infectionsmonitoringfor criteriaspecificEstablish surveillance systems Increase lab capacity and education microbiologists about reporting Develop and activate diagnostic clinical and treatment protocols to improve rapid reporting Plan for and respond to biological incidents ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 3  Response to Unknown Disease The public health department is the first responder in cases of identifying infectious disease Issues such as climate change, globalization, and inadvertent transport of vectors increase the likelihood of health systems facing new or uncommon diseases CBRNE (Chemical, Biological, Radiological, Nuclear, and high-yield Explosive) events differ from other types of disasters and require different preparedness approach Likelihood of shortage of medical services, equipment, hospital beds Prolonged demand for medical care as illness spreads High demand for mortuary/funeral services (Landesman, 2012, p. 260-261) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 5  Public Health Response to Unknown Disease Outbreaks Detection of unusual events Investigation and containment of potential threats Organization of care Laboratory Capacity Coordination and communication ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 6  Stages of a Pandemic (WHO, 2005) CharacteristicsPhase 1 Interpandemic No new influenza virus subtypes have been detected in humans. Flu virus subtype that has caused human period infection may be present in animals; if so, risk of human infection is low. 2 No new influenza virus subtypes have been detected in humans. Circulating animal influenza virus subtype poses substantial risk of human disease. 3 Pandemic alert Human infection(s) with a new subtype, but no human-to-human spread, or at most rare instances of period spread to a close contact. 4 Small cluster(s) with limited human-to-human transmission, but spread is highly localized, suggesting that the virus is not well adapted to humans. 5 Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans, but may not yet be fully transmissible (substantial pandemic risk). Pandemic 6 Pandemic: increased and sustained transmission in the general population period Postpandemic Return to the inter-pandemic period (Phase 1). period From WHO Pandemic Influenza Plan, Table 52, Landesman, 2012, p. 264 ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 8  Chemical or Biological Warfare Threat of chemical or biological warfare (CBW) attack is growing as terrorist activity increases. It can be overt or covert Covert releases – NO prior warning; biological agent presents as illness in the community Likely to be no immediate impact due to the incubation period of the disease Could spread to other geographical areas during the incubation period Public health response – will need to quickly determine that an attack has through casualtiesmore preventand organism,the identifyoccurred, prevention strategies. Overt releases of CBW are those where a threat assessment is possible before a response is initiated because the threat is announced (such as hoaxes). (Landesman, 2012, p. 270-271) I B I ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 9  Critical Biological Agents CDC identifies three major categories of high-priority agents: ❑ Category A– pose the highest risk because they include organisms or toxins that pose the highest risk to the public and national security because they can be easily spread from person to person, result in high death rates, might cause public panic, and require special action for public health preparedness E.g., anthrax, botulism, smallpox, pneumonic plague. Category B– the second highest priority agents as they are moderately easy to spread, result in moderate illness and low death rates, and require specific enhancements of CDC’s laboratory capacity and enhanced disease monitoring E.g., Ricin, typhus fever, encephalitis, salmonella ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 10  Critical or Biological Agents, cont. Category C– the third-highest-priority agent, includes emerging pathogens that could be engineered for mass spread in the future because they are easily available, easily produced and spread, and have the potential for high morbidity and mortality rates and major health impact Preparedness for Category C agents requires ongoing research to improve disease detection, diagnosis, treatment, and prevention. (Landesman, 2012, p. 271-272) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 11  Biological Incident Response Plan Biologica Incident Annex (BIA)– outlines federal response ❑ framework, including actions, roles, and responsibilities, to bioterrorism or to a naturally occurring disease outbreak with a known or novel pathogen: Threat detection/assessment using disease surveillance and environmental monitoring Procedures to identify and notify at-risk populations Investigation and response procedures Epidemic control Recovery activities (Landesman, 2012, p. 274) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 12  Federal Response Response Chronology– U.S. Department of Health and Human Services (HHS): to a biological terrorism attack or naturally occurring outbre Notification of threat of biological incident or disease outbreak and situationassessto partnersagencyrelevantwithCollaboration determine appropriate actions. Identification affected population and geographic scope Initiation of protective measures for everyone affected Targeted epidemiological investigation (e.g., contact tracing) Dissemination of safety information and necessary medical precautions Intensified syndromic surveillance Organization and potential deployment of federal public health and medical response assets (e.g., personnel, medical, and veterinary supplies,) (Landesman, 2012, p. 277-279) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 13  Controlling the Epidemic U.S. Department of Health and Human Services (HHS) will: Assist with epidemic surveillance and coordination Assess the need for increased surveillance Make recommendations regarding the need for: Isolation Quarantine Social-distancing (Landesman, 2012, p. 278-279) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 14  Defining Biological Events “A possible bioterrorism event includes one of the following: A single, definitively diagnosed, or strongly suspected case of an illness caused by a recognized bioterrorism agent occurring in a patient without a plausible explanation for his or her illness. A cluster of patients presenting with a similar clinical syndrome with either unusual characteristics (age distribution) or unusually high morbidity or mortality without an obvious etiology or explanation An unexplained increase in the incidence of a common syndrome above seasonally expected levels” (Landesman, 2012, p. 283) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 16  Active Surveillance and Epidemiological Investigations For rapid surveillance, tools, and materials must be prepared in advance, including: Questionnaires to determine care and risk exposure Sampling strategy Centralized database Mechanism to call and deploy teams to conduct surveillance epidemiological performand cases trackwillhealthPublic investigations Implement active hospital-based surveillance Enhance passive surveillance Contact tracing Coordination with poison control (Landesman, 2012, p. 286) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 18  Laboratory Response Network (LRN) Function is to assist in U.S. response to biological and chemical terrorism Network of approximately 169 biological and 54 chemical laboratories with capacity to respond to acts of CBW, emerging infectious diseases, and other public health threats and services,referenceand direct providingdiseases,identifyingby assistsLRN conducting rapid testing Has three levels of organization: based on the types of tests a laboratory can perform and how it handles infectious agents to protect workers and the public Sentinel– hospital-based labs might be the first to identify the suspicious specimen Reference – can perform tests to detect and confirm the presence of a threat agent. It can be city, county, or major state public health laboratories National– part of the CDC and USAMRIID; handle the most dangerous agents which have the highest risk of life-threatening disease. They can perform research on and development of new techniques that are disseminated to other levels of the network. (Landesman, 2012, p. 291-292) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 22  Chapter 12: Public Health Considerations in Recovery and Reconstruction ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 1  Public Health Role Restore the public health and healthcare delivery infrastructures Organize communitywide programs for the delivery of healthcare and public health services, including functional needs and medical shelters. Provide community education to enhance public awareness (e.g., injury control), aid community adjustment, form the basis for future disaster mitigation, and educate the community about likely health risks and how to deal with them. Assess health needs in the community to determine necessary services to meet the long-term physical and behavioral health needs of affected populations. (Landesman, 2012, p. 295) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 4  Principles of Disaster Recovery and Reconstruction m ogovernment Sd fford Act – U.S. legislation that requires the federal to assist states and localities in disaster relief. Factors that influence recovery planning: Accuracy of needs assessments Intense pressure by citizens to rebuild as soon as possible to allocatedresourcesand timeofAmount andproblem-solving recovery Conflicting preferences of affected groups ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 5  Principles of Disaster Recovery and Reconstruction, cont. Factors that influence recovery planning: (cont.) Community participation is essential because local residents better understand their own needs and the problems that create those needs. Aid agencies must consider short and long-term positive and negative impacts e.g., aid should be provided in such a way that allows people should be able to stay in their homes and resume normal activities when possible. (Landesman, 2012, p. 295-296) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 6  Phases of Recovery and Reconstruction Three phases – emergency, transition or recovery, and reconstruction Emergency Focus on saving lives through search and rescue, first aid, emergency medical assistance, and overall disaster assessment. Rebuilding efforts begin immediately for critical facilities transportation and communicationsrestoreto effortsImmediate networks Immediate efforts to evacuate residents from areas still vulnerable to further disaster (Landesman, 2012, p. 296) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 9  Phases of Recovery and Reconstruction, cont. Transition or recovery People return to work Repair begins on damaged buildings and infrastructure experience may some and recovery,emotionalbeginVictims depression or post-traumatic stress disorder projects and Constructioncredit).(cash,providedis assistanceExternal other types of job creation are the most appropriate types of aid Recovery Ensuring access to adequate shelter, medical services, infrastructure, utilities, business, economic activity, and social networks (Landesman, 2012, p. 296) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 10  Phases of Recovery and Reconstruction, cont. Reconstruction the and roads, utilities,communications,of reorderingPhysical general physical environment Repairs or rebuilding of residential housing and agricultural activities Reconstruction may last years, especially for the restoration of housing and other buildings The timing of phases varies according to the type and location of the disaster and the capacity of the affected community to mend (Landesman, 2012, p. 296) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 11  Post-disaster Assessments Needs assessments (provide the information required to begin recovery) Determine the path to recovery Emergency needs – first priority, more apparent Long-term needs – less apparent than emergency needs; can vary over time. Needs assessment steps: Assess community capacities and vulnerabilities, including: Physical environment (such as intact infrastructure and resources), Social conditions (such as existing organizations and support networks) Population’s attitude toward recovery Population’s motivation to recover (Landesman, 2012, p. 297) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 12  Needs Assessment Steps, cont. Needs assessment steps (continue): Needs are determined by: Visiting representative areas Talking to groups in affected communities Conducting rapid health assessments (e.g., percentage of familiesNeeds should be quantified when possible without running water) After baseline capacities and vulnerabilities are assessed, information ✓ must be continually gathered and reevaluated (Landesman, 2012, p. 297) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 13  Shelters Postimpact shelters: Emergency or temporary shelters should be located in a facility capable of withstanding a disaster, and that has: Access to communication, power, running water, and the ability to care for people with functional needs health mental exams, physicalregistration,for areasSeparate treatment, childcare, sleeping, eating, recreation Comply with the Red Cross standards and provide at least 40 square feet per person if shelter stay exceeds 72 hours. ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 17  Chapter 13: Evaluation Methods for Assessing Public Health and Medical Response to Disasters Essay questions MCQ MCQ & EASSY ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 1  Public Health Role Conduct systematic reviews of public health and medical aspects of disaster response to improve efforts to reduce morbidity and mortality. Use professionally recognized measures of process and outcome directto and programsmedicaland healthpublicmonitorto resources in all phases of disaster response and recovery. ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 3  Evaluation Methods Purpose: “to determine the extent to which an organization, program, or unit achieves its clearly stated and measurable objectives in responding to a disaster.” )Landesman, 2012, p. 305-306) Uses: Adjustment of disaster plans Practice drills Improvement of rapid assessment planning, management of daily response operations Data for hypothesis-driven research ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 5  Evaluation Methods, cont. What evaluations examine: Structure of the public health and health care system’s response to the disaster Allocation of medical and public health resources Sequence of events and impact of the program at various stages Issues that arose during disaster response Limitations of response Policy lessons (Landesman, 2012, p. 306) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 6  Evaluation Methods, cont. Steps in developing and implementing an evaluation plan: Defining goals of what is being evaluated Selecting measures Determining how the data will be collected Collecting and reviewing the data (Landesman, 2012, p. 306) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 7  Conducting an Evaluation In the process of conducting an evaluation, assessments are ❑ directed for five domains of activity: 1. organization, needed resources,examine responseStructure – and available resources. e.g., How were patients transported to the hospital? To what extent was the ambulance system overloaded? What equipment shortages were experienced? 2. Process – identify how the system functioned during disaster and postimpact, individual preparedness, and problems that occurred. Process questions to ask for a mass casualty incident, i.e., How effectively was the triage function performed? What, if any, factors interfered? ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 9  Conducting an Evaluation, cont. 3- Outcomes – identification of what was/was not achieved as a result of disaster response (impact of care) 4- Response adequacy – assess the extent to which response systems were able to meet community needs during the disaster 5- for cost the saved,life per cost cost, effortrelieftotal–Costs subsystems that operated during a disaster, cost of preparedness (Landesman, 2012, p. 308-310) ‫ديقم‬Restricted - PHC 372: Public Health Outbreak and Disaster Management 10