Disaster Medicine and Pandemic Response: A Novel Curriculum to Improve Understanding of Complex Care Delivery During the COVID‐19 Pandemic

AbstractThis article captures the webinar narrative on March 31, 2020 of four expert panelists addressing three questions on the current coronavirus disease 2019 (COVID-19) pandemic. Each panelist was selected for their unique personal expertise, ranging from front-line emergency physicians from multiple countries, an international media personality, former director of the US Strategic National Stockpile, and one of the foremost international experts in disaster medicine and public policy. The forum was moderated by one of the most widely recognized disaster medical experts in the world. The four panelists were asked three questions regarding the current pandemic as follows:1.What do you see as a particular issue of concern during the current pandemic?2.What do you see as a particular strength during the current pandemic?3.If you could change one thing about the way that the pandemic response is occurring, what would you change?

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SUSTAIN: IMPROVING INTEGRATED CARE DELIVERY FOR OLDER PEOPLE WITH COMPLEX CARE NEEDS ACROSS EUROPE

Innovation in Aging ◽

10.1093/geroni/igy023.1464 ◽

2018 ◽

Vol 2 (suppl_1) ◽

pp. 392-393

Author(s):

S R de Bruin ◽

R Schreiber

Keyword(s):

Older People ◽

Integrated Care ◽

Care Delivery ◽

Complex Care ◽

Care Needs ◽

Complex Care Needs

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Disaster eHealth: Scoping Review

Journal of Medical Internet Research ◽

10.2196/18310 ◽

2020 ◽

Vol 22 (10) ◽

pp. e18310

Author(s):

Samaneh Madanian ◽

Tony Norris ◽

Dave Parry

Keyword(s):

Health Care ◽

Disaster Management ◽

Scoping Review ◽

Health Care Services ◽

Care Delivery ◽

Data Gathering ◽

Geographical Location ◽

Disaster Medicine ◽

Quality Health Care ◽

Efficiency And Effectiveness

Background Although both disaster management and disaster medicine have been used for decades, their efficiency and effectiveness have been far from perfect. One reason could be the lack of systematic utilization of modern technologies, such as eHealth, in their operations. To address this issue, researchers’ efforts have led to the emergence of the disaster eHealth (DEH) field. DEH’s main objective is to systematically integrate eHealth technologies for health care purposes within the disaster management cycle (DMC). Objective This study aims to identify, map, and define the scope of DEH as a new area of research at the intersection of disaster management, emergency medicine, and eHealth. Methods An extensive scoping review using published materials was carried out in the areas of disaster management, disaster medicine, and eHealth to identify the scope of DEH. This review procedure was iterative and conducted in multiple scientific databases in 2 rounds, one using controlled indexed terms and the other using similar uncontrolled terms. In both rounds, the publications ranged from 1990 to 2016, and all the appropriate research studies discovered were considered, regardless of their research design, methodology, and quality. Information extracted from both rounds was thematically analyzed to define the DEH scope, and the results were evaluated by the field experts through a Delphi method. Results In both rounds of the research, searching for eHealth applications within DMC yielded 404 relevant studies that showed eHealth applications in different disaster types and disaster phases. These applications varied with respect to the eHealth technology types, functions, services, and stakeholders. The results led to the identification of the scope of DEH, including eHealth technologies and their applications, services, and future developments that are applicable to disasters as well as to related stakeholders. Reference to the elements of the DEH scope indicates what, when, and how current eHealth technologies can be used in the DMC. Conclusions Comprehensive data gathering from multiple databases offered a grounded method to define the DEH scope. This scope comprises concepts related to DEH and the boundaries that define it. The scope identifies the eHealth technologies relevant to DEH and the functions and services that can be provided by these technologies. In addition, the scope tells us which groups can use the provided services and functions and in which disaster types or phases. DEH approaches could potentially improve the response to health care demands before, during, and after disasters. DEH takes advantage of eHealth technologies to facilitate DMC tasks and activities, enhance their efficiency and effectiveness, and enhance health care delivery and provide more quality health care services to the wider population regardless of their geographical location or even disaster types and phases.

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The 25 Years of Experience Since Inauguration of All-Russian Center for Disaster Medicine “Zaschia” (Protection)

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19002024 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s99-s99

Author(s):

Gennady Kipor ◽

N. Baranova ◽

N. Pichugina ◽

S. Goncharov

Keyword(s):

Russian Federation ◽

Care Delivery ◽

Warning System ◽

Disaster Medicine ◽

Medical Emergency ◽

Time Of Arrival ◽

Field Hospital ◽

The Russian Federation ◽

International Event ◽

Medical Teams

Introduction:Main functions of the Russian Federation in disasters and emergencies are loaded on All-Russian Center for Disaster Medicine of Ministry Health (ARCDM). The principal strategies of the staff are to play leading roles in preparedness, emergency response, evacuation, recovery of health systems, and education.Methods:Our presentation includes selection, classification, analysis, and statistics. There about 80 territorial Disaster Medicine Centers working under the leadership of ARCDM. One experience from the Moscow Territory Disaster Medicine Center will be presented.Results:At the operational and informational department, there are nine special medical emergency teams (three with helicopters). Time of arrival takes between seven and ten minutes, and transport to the hospital takes about five to seven minutes with 33 landing places for helicopters. The operational and control department uses an early warning system. About 1,300 exercises were organized in these centers and hospitals. We will discuss the examples of medical care delivery to the injured in metro Slaviynskie, Basar park Pobedi, Narofominskay, two major fires, and hurricanes. The mobile field hospital worked in more than 12 countries and in many territories in the Russian Federation over 25 years.Discussion:The last year was very difficult due to the Football World Cup, working hard as a collaborating center in emergencies, and working in the framework of a memorandum with China. Preparedness for an international event next May, which includes a field drill with participants from emergency medical teams of Health Ministries of CIS Countries and from State Health of China. We invite others to observe or join this event. Thus, we have some difficulties and problems, but we must increase solidarity and collaboration due to the scale, frequency, and number of losses in emergencies and disasters. Humanity could be able to cope with emergencies if we take into account these issues.

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Main Conditions and Factors Affecting the Organization of Medical Care Delivery and Medical Evacuation in Terrorist Acts Involving Explosive Devices and Conventional Weapons

Disaster Medicine ◽

10.33266/2070-1004-2020-4-16-27 ◽

2020 ◽

pp. 16-27

Author(s):

B.V. Bobiy ◽

◽

S.F. Goncharov ◽

I.G. Titov ◽

◽

...

Keyword(s):

Medical Care ◽

Care Delivery ◽

Health Sector ◽

Disaster Medicine ◽

Terrorist Attacks ◽

Factors Affecting ◽

Medical Evacuation ◽

Conventional Weapons ◽

Terrorist Acts ◽

Explosive Devices

The purpose of the study is to identify and characterize the most typical conditions and factors affecting the organization of medical care and medical evacuation of victims of terrorist attacks based on the study and analysis of the experience of eliminating the medical and sanitary consequences of terrorist acts committed on the territory of Russia with the use of explosive devices and conventional weapons. Materials and methods of research. The materials of the study were: normative and methodological documents regulating the organization of medical care and medical evacuation during terrorist acts; dispatches and reports of the territorial centres for disaster medicine on the elimination of medical and sanitary consequences of 162 terrorist acts, including 6 terrorist attacks with the capture and holding of hostages committed in 1998-2010; documents of official correspondence of the All-Russian centre for disaster medicine Zashchita on issues of medical support of the population during terrorist acts; scientific papers and publications on the research problem. When performing the research, the following methods were used: historical, content analysis, statistical, and analytical. Research results and their analysis. The following issues were considered during the research: - means of conducting terrorist activities and their application specifics; - high degree of vulnerability and damage to the population; - the nature of the object where the terrorist act was committed; - sanitary losses and their characteristics; - psychological situation, capture and holding of hostages, the presence of a threat to their lives; - terms of elimination of medical and sanitary consequences of terrorist attacks; - the needs and capabilities of medical organizations (LMO) of the regions in delivery of medical assistance to victims of terrorist attacks; - needs and capabilities of LMO of the regions in medical evacuation; - features of the organization and conduct of measures to eliminate the consequences of terrorist acts. Based on the results of the analysis of the experience in liquidation of medical-sanitary consequences of terrorist attacks, as well as analysis of basic conditions and factors influencing the organization of medical care and conduct of medical evacuation, the methodical approaches are suggested: to comprehensive assessment of conditions and factors typical for terrorist attacks with use of explosive devices and conventional weapons; to use of medical-and-evacuation characteristics of victims in the organization of medical care and conduct of medical evacuation; to increase the readiness of the regional health sector in facing the challenges of liquidation of medical and sanitary consequences of terrorist attacks.

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Drug and Alcohol Related Patient Presentations to Emergency Departments during Sporting Mass-Gathering Events: An Integrative Review

Prehospital and Disaster Medicine ◽

10.1017/s1049023x20000357 ◽

2020 ◽

Vol 35 (3) ◽

pp. 298-304

Author(s):

Catherine Delany ◽

Julia Crilly ◽

Jamie Ranse

Keyword(s):

Health Services ◽

Emergency Departments ◽

Care Delivery ◽

Alcohol Intoxication ◽

Disaster Medicine ◽

Local Health ◽

Mass Gathering ◽

The Spectator ◽

The Impact ◽

Drug And Alcohol

AbstractBackground:Drug and alcohol consumption at sporting mass-gathering events (MGEs) has become part of the spectator culture in some countries. The direct and indirect effects of drug and alcohol intoxication at such MGEs has proven problematic to in-event health services as well as local emergency departments (EDs). With EDs already under significant strain from increasing patient presentations, resulting in access block, it is important to understand the impact of sporting and other MGEs on local health services to better inform future planning and provision of health care delivery.Aim:The aim of this review was to explore the impact of sporting MGEs on local health services with a particular focus on drug and alcohol related presentations.Method:A well-established integrative literature review methodology was undertaken. Six electronic databases and the Prehospital and Disaster Medicine (PDM) journal were searched to identify primary articles related to the aim of the review. Articles were included if published in English, from January 2008 through July 2019, and focused on a sporting MGE, mass-gathering health, EDs, as well as drug and alcohol related presentations.Results:Seven papers met the criteria for inclusion with eight individual sporting MGEs reported. The patient presentation rate (PPR) to in-event health services ranged from 0.18/1,000 at a rugby game to 41.9/1,000 at a recreational bicycle ride. The transport to hospital rate (TTHR) ranged from 0.02/1,000 to 19/1,000 at the same events. Drug and alcohol related presentations from sporting MGEs contributed up to 10% of ED presentations. Alcohol was a contributing factor in up to 25% of cases of ambulance transfers.Conclusions:Drug and alcohol intoxication has varying levels of impact on PPR, TTHR, and ED presentation numbers depending on the type of sporting MGE. More research is needed to understand if drug and alcohol intoxication alone influences PPR, TTHR, and ED presentations or if it is multifactorial. Inconsistent data collection and reporting methods make it challenging to compare different sporting MGEs and propose generalizations. It is imperative that future studies adopt more consistent methods and report drug and alcohol data to better inform resource allocation and care provision.

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UNLOCKING THE POWER OF DATA: INFORMATION TECHNOLOGY IMPLEMENTATION FOR SMARTER MANAGEMENT AND RESOURCE USE FOR TODAY'S COMPLEX CARE DELIVERY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(17)35885-0 ◽

2017 ◽

Vol 69 (11) ◽

pp. 2496

Author(s):

Thomas J. Lewandowski ◽

Joe Allen ◽

Anthony DeFranco ◽

Allen Seals ◽

Hector Fontanet ◽

...

Keyword(s):

Information Technology ◽

Resource Use ◽

Technology Implementation ◽

Care Delivery ◽

Complex Care

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The role of the registered nurse in supporting frailty in care homes

British Journal of Nursing ◽

10.12968/bjon.2019.28.13.833 ◽

2019 ◽

Vol 28 (13) ◽

pp. 833-837 ◽

Cited By ~ 1

Author(s):

Lynn Craig

Keyword(s):

Care Delivery ◽

Nutrition Status ◽

Complex Care ◽

Care Needs ◽

Crucial Component ◽

Unplanned Admissions ◽

Complex Care Needs ◽

The Impact ◽

Negative Health Outcomes

People in nursing and residential homes are more likely to suffer frailty. Registered nurses are a crucial component of the care delivery service and can offer support to patients who have complex care needs and comorbidities and are at risk of unplanned admissions to secondary care. This article explores frailty and the role of the nurse in assessing for frailty. Three aspects of patient care—nutrition status, polypharmacy and exercise and cognitive function—are discussed as areas where nurses can target their interventions in order to support those considered as frail, aiming to reduce the impact of frailty and negative health outcomes.

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Disaster eHealth: Scoping Review (Preprint)

10.2196/preprints.18310 ◽

2020 ◽

Author(s):

Samaneh Madanian ◽

Tony Norris ◽

Dave Parry

Keyword(s):

Health Care ◽

Disaster Management ◽

Scoping Review ◽

Health Care Services ◽

Care Delivery ◽

Data Gathering ◽

Geographical Location ◽

Disaster Medicine ◽

Quality Health Care ◽

Efficiency And Effectiveness

BACKGROUND Although both disaster management and disaster medicine have been used for decades, their efficiency and effectiveness have been far from perfect. One reason could be the lack of systematic utilization of modern technologies, such as eHealth, in their operations. To address this issue, researchers’ efforts have led to the emergence of the disaster eHealth (DEH) field. DEH’s main objective is to systematically integrate eHealth technologies for health care purposes within the disaster management cycle (DMC). OBJECTIVE This study aims to identify, map, and define the scope of DEH as a new area of research at the intersection of disaster management, emergency medicine, and eHealth. METHODS An extensive scoping review using published materials was carried out in the areas of disaster management, disaster medicine, and eHealth to identify the scope of DEH. This review procedure was iterative and conducted in multiple scientific databases in 2 rounds, one using controlled indexed terms and the other using similar uncontrolled terms. In both rounds, the publications ranged from 1990 to 2016, and all the appropriate research studies discovered were considered, regardless of their research design, methodology, and quality. Information extracted from both rounds was thematically analyzed to define the DEH scope, and the results were evaluated by the field experts through a Delphi method. RESULTS In both rounds of the research, searching for eHealth applications within DMC yielded 404 relevant studies that showed eHealth applications in different disaster types and disaster phases. These applications varied with respect to the eHealth technology types, functions, services, and stakeholders. The results led to the identification of the scope of DEH, including eHealth technologies and their applications, services, and future developments that are applicable to disasters as well as to related stakeholders. Reference to the elements of the DEH scope indicates what, when, and how current eHealth technologies can be used in the DMC. CONCLUSIONS Comprehensive data gathering from multiple databases offered a grounded method to define the DEH scope. This scope comprises concepts related to DEH and the boundaries that define it. The scope identifies the eHealth technologies relevant to DEH and the functions and services that can be provided by these technologies. In addition, the scope tells us which groups can use the provided services and functions and in which disaster types or phases. DEH approaches could potentially improve the response to health care demands before, during, and after disasters. DEH takes advantage of eHealth technologies to facilitate DMC tasks and activities, enhance their efficiency and effectiveness, and enhance health care delivery and provide more quality health care services to the wider population regardless of their geographical location or even disaster types and phases.

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Palliative care in catastrophic disasters and humanitarian crises

10.1093/med/9780198821328.003.0096 ◽

2021 ◽

pp. 1020-1026

Author(s):

Anne Wilkinson ◽

Marianne Matzo

Keyword(s):

Palliative Care ◽

Vulnerable Populations ◽

Care Delivery ◽

Disaster Medicine ◽

Care Services ◽

Dying Patients ◽

Humanitarian Crises ◽

Health Related ◽

Palliative Care Services ◽

Negative Impacts

Both catastrophic disasters and humanitarian crises can have widespread, long-term, and often unpredictable negative impacts, causing shortages of safe water, food, shelter, transportation, and sanitation as well as the displacement of large numbers of people and the loss of many lives. Routinely ignored in disaster and humanitarian planning are those socially and medically vulnerable populations living in the affected community who are dependent on the existing healthcare system for survival, making them particularly predisposed to the risk of harm or death due to the event. Because of their unique needs, extra steps need to be taken in order to reduce the likelihood that vulnerable populations will suffer injury, disease, or even death. Serious health-related suffering resulting from illness or injury stemming from a natural or man-made crisis could be ameliorated by the inclusion of palliative care services in planning and response activities. While the primary goal of disaster medicine is to maximize the number of lives saved and to ensure the best outcomes for the community as a whole, a holistic and fully compassionate response necessitates a secondary goal of minimizing the physical and psychological suffering of those whose lives may be shortened by a crisis event. In order to effectively provide palliative care services in crisis situations, all care delivery sites, especially triage and alternative care sites, will need clearly articulated protocols, trained staff (including personnel with palliative care, mental health, and spiritual counselling skills), supplies (including those necessary for appropriate pharmacological treatment), and appropriate space for dying patients.

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