Healthcare Emergency Preparedness and Response

This assignment focuses on healthcare emergency preparedness and response. It emphasizes the critical role hospitals play in managing emergencies, outlining essential elements like well-equipped facilities, trained staff, effective evacuation procedures, robust communication systems, and considerations for psychological support. The document highlights the importance of flexibility and resilience in planning for diverse emergencies and addresses legal and ethical aspects related to patient care during such events.

Healthcare Policy and Law
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Essential public health services:
Inform, educate and empower people about health issues is the third essential service for
health. In this service initiatives should be taken for health education and communication.
There should be knowledge building and shaping positive attitude in patients and healthcare
staff during emergency. It would be helpful for patients to manage their health condition on
their own. For healthcare professional, training should be provided for handling mass
casualty event. Healthcare professionals should be trained for the emergency medicine
residency programs. There should be incorporation of topics on the disaster management in
the nursing journals. There should be proper decision making on distributing responsibility of
each department during emergency. Skills and behaviours should be developed in the
healthcare staff to handle emergency with ease. Collaboration with the community centres
should be there to provide health education and health promotion during emergency because
existing hospital staff might not be sufficient for handling emergency. Technological
advancements like media advocacy and social marketing should be incorporated to provide
health information to public and community members (Riegelman and Kirkwood, 2014).
Mobilize community partnerships to identify and solve health problems is the fourth essential
service for health. This service is mainly based on the community and public incorporation in
handling the emergency. Stakeholders from the community should be identified to improve
health related activities. There should be coalition development and formal and informal
partnerships should be developed for the promotion of the health services. It would be helpful
in drawing resources form the whole community to implement health improvement projects
and efforts. Develop policies and plans that support individual and community health efforts
is the fifth essential service for health. It is a guiding force for the public health practice.
Specific and achievable objectives should be developed and monitored. Objectives beyond
the capability of the organisation would put extra burden on the staff members and
management. There should be segmentation of leadership at each level. It would be helpful in
diversifying responsibility to different people and handling the situation more effectively.
Organisational health policies and guidelines should be developed to implement health
services in effective manner. Community and state level improvement in the healthcare
services should be designed and implemented. Emergency response planning should be
designed with the help of experts. Resources should be allocated to each department so that
there would not be any deficiency during emergency (Mullner, 2009).
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Link people to needed personal health services and assure the provision of healthcare when
otherwise unavailable is the seventh essential service for health. Population with barrier to
access healthcare services during emergency situations should be identified and assurance
should be given to them about the provision and supply of systematic clinical care. Entry for
this population should be made easy in accessing healthcare services. It would be helpful in
assessing the effectiveness of the programme. Specific efforts should be taken to
communicate with the population in culturally appropriate manner. There should be outreach
to culturally specific population and provide educational material. Ongoing care should be
continued and transportation and other facilities should be provided to the people to improve
accessibility to the healthcare services (Teitelbaum and Wilensky).
Emergency Medical Treatment and Active Labor Act:
Emergency Medical Treatment and Active Labor Act (EMTALA) prohibits any hospital from
delaying treatment due to payment method, insurance status and initial screening tests.
Emergency medical services should not be delayed due to the initial authorization like
screening tests. This law conflicts with many care plans as this law gives preauthorization for
the medical treatment. This may lead to the significant burden and challenge for the
emergency department. According to this law, patients can be evaluated and treated at any
place in the hospital during the emergency condition. Hence, there should be provision of
services like labor and delivery, hospital-owned clinics, urgent care facilities, outpatient
surgery centres, and psychiatric facilities during the emergency (Boumil and Hattis, 2011).
According to EMTALA, patient should be stabilized to medical condition whenever
presented to the emergency department. This medical stabilization of the patient should be
done within the availability of staff and facilities with the hospital. Otherwise, patient should
be transferred to the other hospital. For availing this medical stabilization, patient should be
qualified for the emergency medical condition (EMC). Patient should be evaluated to fix this
EMC. Recipient hospital should not refuse to accept patient with EMC, if this hospital
possesses all the facilities to treat that patient. Recipient hospital should not ask questions to
the patient about the insurance and financial status (Moffat, 2014).
Electronic medical record:
Electronic medical record has pivotal role in the maintaining patient safety by providing high
quality care and smooth workflow and transfer of data. Electronic medical records proved
valuable in reducing medical errors, however it is associated with few challenges which
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would affect quality and effectiveness of care. Hence, measures should be taken to reduce
these errors. Measures should be taken for smooth transfer of data between multiple artefacts,
between multiple locations and between multiple care providers in electronic medical record
in emergency. Paper record and telephone record are the two prominent artefacts used in the
emergency. Patients vital signs, medical history, current medications and health complaints
are generally captured in the paper record and transferred to the electronic medical record.
Some physicians believe more on their memory and collect very less data on paper. Some
physicians collect every detail meticulously and collect large proportion of data. Later,
duplication of large data for each to electronic medical record would be difficult. In both the
cases, insufficient data would be transferred to electronic medical record. It may lead to
wrong diagnosis and consequently wrong treatment (Pare et al., 2015).
Physicians prefer to use centrally located computer room to access electronic medical record.
Hence, physician need to move frequently between patient room, nurse station and centrally
located computer room. It may lead to physical and mental efforts to physician and
possibility of errors. Healthcare providers working in the emergency department need to
access data from other functional units. Therefore, other care providers need to send data to
emergency department in timely manner. Considering these three measures in implementing
electronic medical record would be useful in the better diagnosis, less expensive care and
better-quality care. These measures also would be useful in providing coded information,
maximizing clinical decision, maximizing data analysis and report generation, integrating
with other databases, increasing clinical work and reducing clerical work (Raymond et al.,
2015).
Health insurance:
Accepting health insurance during emergency would be beneficial for the hospital. During
emergency, it would not be possible to recover fees form each and every patient. However,
by accepting health insurance, all the fees can be recovered from the insurance policy
provider. Therefore, there would not be burden on the hospital to generate resources for the
management of more number of patients. Most of the health insurance policies cover
maximum amount of bill. However, patients need to pay deductible or pay a co-pay. This can
lead to higher amount of bills which would be beneficial for the hospital. I would prefer to
allocate more number of private rooms to the patients with medical insurance. Patients would
be ready to care due to availability of insurance, extra charge form the rent of private room
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can be recovered form the patient. As there are very less health insurance policies, which
would provide insurance to outpatients. Hence, most of the patients with medical insurance
would prefer to have long stay at hospital as inpatients. This would provide more residential
charges and it would be beneficial to the hospital (Rushing, 2012). I prefer to accept
insurance because it would be helpful in market share and consequently profitability of the
hospital. Acceptance of insurance would be helpful in implementing new services, which
would be helpful in improving market share. I would prefer to remain firm with specific
insurance company because it would be helpful in building good reputation with the company
and negotiating price for the products for emergency services (DeAngelis, 2013). Examples:
1) Tornado is the natural emergency situation in United States. Accepting health insurance
during the Tornado situation helped hospitals to improve income. This Tornado was more
violet in year 2011. 2) Hurricane Katrina produced landfall along Mississippi coast in year
2005. This emergency resulted in the more acceptance of health insurance by hospitals and
raise income. 3) In 1993, India had most disastrous earthquake, it ever had. It proved
beneficial for hospitals to increase their income by accepting insurance.
Operation of the organization:
In emergency situations, there would not be much time with hospitals to recover from the
errors which occurs while providing care. Hence, healthcare professionals should work with
high level accuracy during emergency situations. Centralized supply of resources may not
work efficiently during emergency situations; hence hospital management should rely on de-
centralized supply of resources for providing efficient medical services. Hospital healthcare
staff should be well trained for handling emergency situations. Hospital staff and
management should be in close coordination with the civil and government agencies. It may
put extra burden on them of coordination with external agencies. Critical care unit of the
hospital should work round the clock with availability of enough resources and well qualified
staff (Barbera et al., 2009).
Hospital should have well planned evacuation system for the patients. Along with the
evacuation of the patients, hospitals should be well prepared for the evacuation of critical
machineries like life support system. Robust communication tree need to be prepared for
communication during emergency situations because communication failure may occur
during emergency situations. Emergency may occur at any geographic region. Healthcare
staff from the affected geographic area by emergency may not join the services due to lack of
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transportation. In such scenario, alternative arrangement for the healthcare staff should be
made. Healthcare staff should be ready to work on unusual notification. In emergency, most
of the people may not get injured, however they may need general health check-up.
Healthcare staff should not ignore such people. Hospital staff should be prepared for the
management of illness along with injury. Health care workers working in the initial phase of
the emergency may face physical and psychological injury. Planning for handling emergency
should be flexible and resilient (Davidson et l., 2009; Falcone and Detty, 2015).
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References:
Barbera, J.A., Yeatts, D.J., and Macintyre, A.G. (2009). Challenge of hospital emergency
preparedness: Analysis and recommendations. Disaster Medicine and Public Health
Preparedness, 3(S1), S74–S82.
Boumil, M., and Hattis, P. (2017). Boumil and Hattis' Medical Liability in a Nutshell. West
Academic.
Davidson, J.E., Sekayan, A., Agan, D., et al. (2009). Disaster dilemma: Factors affecting
decision to come to work during a natural disaster. Advanced Emergency Nursing
Journal, 31, 248–257.
DeAngelis, C. D. (2013). Patient Care and Professionalism. Oxford University Press.
Falcone, R.E., and Detty, A. (2015). Man-made disaster: In-hospital management. Trauma
Reports, 16, 1-16.
Moffat, J. C. (2014). Emtala Answer Book, 2014 Edition. Wolters Kluwer Law and Business.
Mullner, R. M. (2009). Encyclopedia of Health Services Research. SAGE.
Pare, G., Raymond, L., Guinea, A.O., Poba-Nzaou, P., et al. Electronic health record usage
behaviors in primary care medical practices: A survey of family physicians in Canada.
International Journal of Medical Informatics, 84(10), 857-67.
Raymond, L., Pare, G., Ortiz de, G., Poba-Nzaou, P., et al. (2015). Improving performance in
medical practices through the extended use of electronic medical record systems: a
survey of Canadian family physicians. BMC Medical Informatics and Decision
Making, 4, 27. doi: 10.1186/s12911-015-0152-8.
Riegelman, R., and Kirkwood, B. (2014). Public Health 101. Jones & Bartlett Publishers.
Rushing, W. A. (2012). Social Functions and Economic Aspects of Health Insurance.
Springer Science & Business Media.
Teitelbaum, J. B., and Wilensky, S. E. (2016). Essentials of Health Policy and Law. Jones &
Bartlett Publishers.
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