Making Disaster Care Count: Consensus Formulation of Measures of Effectiveness for Natural Disaster Medical Response

AbstractIntroductionNo standard exists for provision of care following catastrophic natural disasters. Host nations, funders, and overseeing agencies need a method to identify the most effective interventions when allocating finite resources. Measures of effectiveness are real-time indicators that can be used to link early action with downstream impact.HypothesisGroup consensus methods can be used to develop measures of effectiveness detailing the major functions of post natural disaster acute phase medical response.MethodsA review of peer-reviewed disaster response publications (2001-2011) identified potential measures describing domestic and international medical response. A steering committee comprised of six persons with publications pertaining to disaster response, and those serving in leadership capacity for a disaster response organization, was assembled. The committee determined which measures identified in the literature review had the best potential to gauge effectiveness during post-disaster acute-phase medical response. Using a modified Delphi technique, a second, larger group (Expert Panel) evaluated these measures and novel measures suggested (or “free-texted”) by participants for importance, validity, usability, and feasibility. After three iterations, the highest rated measures were selected.ResultsThe literature review identified 397 measures. The steering committee approved 116 (29.2%) of these measures for advancement to the Delphi process. In Round 1, 25 (22%) measures attained >75% approval and, accompanied by 77 free-text measures, graduated to Round 2. There, 56 (50%) measures achieved >75% approval. In Round 3, 37 (66%) measures achieved median scores of 4 or higher (on a 5-point ordinal scale). These selected measures describe major aspects of disaster response, including: Evaluation, Treatment, Disposition, Public Health, and Team Logistics. Of participants from the Expert Panel, 24/39 (63%) completed all rounds. Thirty-three percent of these experts represented international agencies; 42% represented US government agencies.ConclusionExperts identified response measures that reflect major functions of an acute medical response. Measures of effectiveness facilitate real-time assessment of performance and can signal where practices should be improved to better aid community preparedness and response. These measures can promote unification of medical assistance, allow for comparison of responses, and bring accountability to post-disaster acute-phase medical care. This is the first consensus-developed reporting tool constructed using objective measures to describe the functions of acute phase disaster medical response. It should be evaluated by agencies providing medical response during the next major natural disaster.DaftaryRK, CruzAT, ReavesEJ, BurkleFMJr, ChristianMD, FagbuyiDB, GarrettAL, KapurGB, SirbaughPE. Making disaster care count: consensus formulation of measures of effectiveness for natural disaster acute phase medical response. Prehosp Disaster Med. 2014;29(5):1-7.

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Lessons Learned from a Medical Response Team 45 Days Post-Hurricane Maria in Puerto Rico

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2019.98 ◽

2019 ◽

pp. 1-6

Author(s):

Jessica M. Gordon ◽

Deidre Orriola ◽

Mary Unangst ◽

Federico Gordon ◽

Yazmin E Rodriguez Vellon

Keyword(s):

Public Health ◽

Puerto Rico ◽

Lived Experience ◽

Natural Disaster ◽

Public Health Intervention ◽

Living Conditions ◽

Lessons Learned ◽

Medical Response ◽

Field Note ◽

Home Visitations

AbstractIntroduction:Describe the lived experience of a grassroots, nongovernmental disaster medical team (DMT) through a research lens and share practical lessons learned based on the DMT’s experience to support and inform future response teams.Method:Forty-five days after Hurricane Maria, a nongovernmental DMT provided primary medical care by means of community-based pop-up clinics and home visitations in 5 different areas of Puerto Rico. Observational data, photo images, and debriefing notes were collected and documented in the response team’s daily activity log. Field notes were coded using a descriptive coding method and then categorized into 2 domains specific to public health and medical diagnosis.Results:Medical aid was provided to nearly 300 (N = 296) residents. Field note observations identified exhaustion related to living conditions and the exacerbation of underlying conditions, such as reactive airway diseases, diabetes, hypertension, and depression due to the compounding effects of multiple post-disaster triggers. During home visitations, feelings of sadness and helplessness were identified secondary to natural disaster trauma and current living conditions.Conclusion:Our nongovernmental DMT displayed similar characteristics demonstrated by federal DMTs post-natural disaster. Several strategic lessons learned emerged from the public health intervention important to future nongovernmental DMTs.

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The Role of Physical Therapists in the Medical Response Team Following a Natural Disaster: Our Experience in Nepal

Journal of Orthopaedic and Sports Physical Therapy ◽

10.2519/jospt.2015.0108 ◽

2015 ◽

Vol 45 (9) ◽

pp. 644-646 ◽

Cited By ~ 1

Author(s):

Keyword(s):

Natural Disaster ◽

Physical Therapists ◽

Medical Response ◽

Response Team

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Lessons Learned from a Medical Response Team 45 Days Post Hurricane Maria in Puerto Rico

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2019.65 ◽

2019 ◽

Vol 14 (1) ◽

pp. 28-33

Author(s):

Jessica M. Gordon ◽

Deidre Orriola ◽

Mary Unangst ◽

Federico Gordon ◽

Yazmin E. Rodriguez Vellon

Keyword(s):

Public Health ◽

Puerto Rico ◽

Lived Experience ◽

Natural Disaster ◽

Public Health Intervention ◽

Living Conditions ◽

Lessons Learned ◽

Medical Response ◽

Field Note ◽

Home Visitations

ABSTRACTObjective:Describe the lived experience of a grassroots, non-governmental disaster medical team (DMT) through a research lens and share practical lessons learned, based on the DMT’s experience to support and inform future response teams.Methods:Forty-five days after Hurricane Maria, a non-governmental DMT provided primary medical care via community based pop-up clinics and home visitations in 5 different areas of Puerto Rico. Observational data, photo images, and debriefing notes were collected and documented in the response team’s daily activity log. Field notes were coded using a descriptive coding method and then categorized into 2 domains specific to public health and medical diagnosis.Results:Medical aid was provided to nearly 300 (N = 296) residents. Field note observations identified exhaustion related to living conditions and the exacerbation of underlying conditions such as reactive airway diseases, diabetes, hypertension, and depression due to the compounding effects of multiple post-disaster triggers. During home visitations, feelings of sadness and helplessness were identified secondary to natural disaster trauma and current living conditions.Conclusion:Our non-governmental DMT displayed similar characteristics demonstrated by federal DMTs post natural disaster. A number of strategic lessons learned emerged from the public health intervention important to future non-governmental DMTs.

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(A24) An Disaster Education Framework to Bridge Natural Disaster Medical Response and Primary Care Development in Developing Countries

Prehospital and Disaster Medicine ◽

10.1017/s1049023x11000379 ◽

2011 ◽

Vol 26 (S1) ◽

pp. s7-s7

Author(s):

E.Y.Y. Chan ◽

S.Y. Wong ◽

S.M. Griffiths ◽

C.A. Graham

Keyword(s):

Public Health ◽

Primary Care ◽

Natural Disaster ◽

Disaster Mitigation ◽

Academic Training ◽

Public Health Response ◽

Humanitarian Emergency ◽

Emergency Relief ◽

Medical Response ◽

Academic Researchers

IntroductionNatural disasters cannot be prevented but their human impact can be mitigated. Effective medical and public health mitigation and responses require multidisciplinary efforts and appropriate training. Whilst Asia is currently ranked as the most natural disaster prone area globally, limited disaster medical and public health response training opportunities are available in the region. Our paper reports efforts to identify the training gaps and ways to fill them to prepare frontline practitioners and academic researchers in disaster and medical humanitarian emergency relief efforts in Asia.MethodsGrounded on the disciplinary principles of academic training in public health, emergency & disaster medicine and primary care, our paper reviews the current disaster related academic training offered in these disciplines and maps out the training and knowledge gaps in disaster mitigation and response for frontline practitioners and academic researchers. We suggest ways to fill such gaps.ResultsA two-dimensional (clinical versus non-clinical), three-tier education training framework (Entrant level, Continuous medical education needs and Expertise level) is developed. Experiences and key training needs in Asia are highlighted.ConclusionThe proposed framework identifies areas for comprehensive training for medical and public health practitioners who are interested to engage in medical disaster relief. The proposed framework also aims to strengthen mitigation and response capacities in health systems.

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International Medical Response to a Natural Disaster: Lessons Learned from the Bam Earthquake

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00013042 ◽

2005 ◽

Vol 20 (S1) ◽

pp. 51-51 ◽

Cited By ~ 1

Author(s):

M.H. Radfar ◽

H. Abolghasemi ◽

S.M. Briggs ◽

M. Saghafinia ◽

A. Amid

Keyword(s):

Natural Disaster ◽

Lessons Learned ◽

International Medical ◽

Bam Earthquake ◽

Medical Response

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When Mother Earth Rises Up

Social Psychology ◽

10.1027/1864-9335/a000112 ◽

2013 ◽

Vol 44 (4) ◽

pp. 271-277 ◽

Cited By ~ 4

Author(s):

Simona Sacchi ◽

Paolo Riva ◽

Marco Brambilla

Keyword(s):

Free Will ◽

Natural Disasters ◽

Natural Disaster ◽

Mental States ◽

Disaster Victims ◽

Willingness To Help ◽

Mother Earth

Anthropomorphization is the tendency to ascribe humanlike features and mental states, such as free will and consciousness, to nonhuman beings or inanimate agents. Two studies investigated the consequences of the anthropomorphization of nature on people’s willingness to help victims of natural disasters. Study 1 (N = 96) showed that the humanization of nature correlated negatively with willingness to help natural disaster victims. Study 2 (N = 52) tested for causality, showing that the anthropomorphization of nature reduced participants’ intentions to help the victims. Overall, our findings suggest that humanizing nature undermines the tendency to support victims of natural disasters.

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