scholarly journals State Preparedness for Crisis Standards of Care in the United States: Implications for Emergency Management

2020 ◽  
pp. 1-3
Author(s):  
Annie E. Ingram ◽  
Attila J. Hertelendy ◽  
Michael S. Molloy ◽  
Gregory R. Ciottone
Keyword(s):  
United States ◽  
Health Care ◽  
Hurricane Katrina ◽  
Local Level ◽  
The United States ◽  
Health Care Facilities ◽  
Legal Responsibility ◽  
Standards Of Care ◽  
Clear Understanding ◽  
State And Local

Abstract State governments and hospital facilities are often unprepared to handle a complex medical crisis, despite a moral and ethical obligation to be prepared for disaster. The 2019 novel coronavirus disease (COVID-19) has drawn attention to the lack of state guidance on how hospitals should provide care in a crisis. When the resources available are insufficient to treat the current patient load, crisis standards of care (CSC) are implemented to provide care to the population in an ethical manner, while maintaining an ability to handle the surge. This Editorial aims to raise awareness concerning a lack of preparedness that calls for immediate correction at the state and local level. Analysis of state guidelines for implementation of CSC demonstrates a lack of preparedness, as only five states in the US have appropriately completed necessary plans, despite a clear understanding of the danger. States have a legal responsibility to regulate the medical care within their borders. Failure of hospital facilities to properly prepare for disasters is not a new issue; Hurricane Katrina (2005) demonstrated a lack of planning and coordination. Improving disaster health care readiness in the United States requires states to create new policy and legislative directives for the health care facilities within their respective jurisdictions. Hospitals should have clear directives to prepare for disasters as part of a “duty to care” and to ensure that the necessary planning and supplies are available to their employees.

Challenges of Designing and Implementing High Consequence Infectious Disease Response

2018 ◽  
Vol 12 (5) ◽  
pp. 563-566 ◽  
Author(s):  
Joan M. King ◽  
Chetan Tiwari ◽  
Armin R. Mikler ◽  
Martin O’Neill
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health Care ◽  
Spatial Configuration ◽  
The United States ◽  
Health Care Facilities ◽  
Disease Response ◽  
Response Planning ◽  
Care Facilities ◽  
State And Local

AbstractEbola is a high consequence infectious disease—a disease with the potential to cause outbreaks, epidemics, or pandemics with deadly possibilities, highly infectious, pathogenic, and virulent. Ebola’s first reported cases in the United States in September 2014 led to the development of preparedness capabilities for the mitigation of possible rapid outbreaks, with the Centers for Disease Control and Prevention (CDC) providing guidelines to assist public health officials in infectious disease response planning. These guidelines include broad goals for state and local agencies and detailed information concerning the types of resources needed at health care facilities. However, the spatial configuration of populations and existing health care facilities is neglected. An incomplete understanding of the demand landscape may result in an inefficient and inequitable allocation of resources to populations. Hence, this paper examines challenges in implementing CDC’s guidance for Ebola preparedness and mitigation in the context of geospatial allocation of health resources and discusses possible strategies for addressing such challenges. (Disaster Med Public Health Preparedness. 2018;12:563–566)

Life Without Parole Sentencing

2019 ◽  
Author(s):  
Christopher Seeds
Keyword(s):  
United States ◽  
Lived Experience ◽  
Death Penalty ◽  
Public Discourse ◽  
Crime Control ◽  
Local Level ◽  
The United States ◽  
Life Without Parole ◽  
The Subject ◽  
State And Local

Life without parole sentencing refers to laws, policies, and practices concerning lifetime prison sentences that also preclude release by parole. While sentences to imprisonment for life without the possibility of parole have existed for more than a century in the United States, over the past four decades the penalty has emerged as a prominent element of U.S. punishment, routinely put to use by penal professionals and featured regularly in public discourse. As use of the death penalty diminishes in the United States, life without parole serves as the ultimate punishment in more and more U.S. jurisdictions. The scope with which states apply life without parole varies, however, and some states have authorized the punishment even for nonviolent offenses. More than a punishment serving purposes of retribution, crime control, and public safety, and beyond the symbolic functions of life without parole sentencing in U.S. culture and politics, life without parole is a lived experience for more than 50,000 prisoners in the United States. Life without parole’s increasing significance in the United States points to the need for further research on the subject—including studies that directly focus on how race and racial prejudice factor in life without parole sentencing, studies that investigate the proximate causes of life without parole sentences at the state and local level, and studies that examine the similarities and differences between life without parole, the death penalty, and de facto forms of imprisonment until death.

scholarly journals Three Unsuspected CT Diagnoses of COVID-19

2020 ◽  
Author(s):  
David Vu ◽  
Maryanne Ruggiero ◽  
Woo Sung Choi ◽  
Daniel Masri ◽  
Mark Flyer ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Severe Acute Respiratory Syndrome ◽  
The United States ◽  
Health Care Facilities ◽  
Ground Glass ◽  
Imaging Findings ◽  
Adequate Supply ◽  
Imaging Characteristics ◽  
Care Facilities

Abstract PURPOSE: Coronavirus disease 2019 (COVID-19) is caused by a novel strain of coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that has quickly spread around the globe. Health care facilities in the United States currently do not have an adequate supply of COVID-19 tests to meet the growing demand. Imaging findings for COVID-19 are nonspecific but include pulmonary parenchymal ground-glass opacities in a predominantly basal and peripheral distribution.METHODS: Three patients imaged for non-respiratory related symptoms with a portion of the lungs in the imaged field.RESULTS: Each patient had suspicious imaging findings for COVID-19, prompting the interpreting radiologist to suggest testing for COVID-19. All 3 patients turned out to be infected with COVID-19 and one patient is the first reported case of the coincident presentation of COVID-19 and an intraparenchymal hemorrhage.CONCLUSION: Using imaging characteristics of COVID-19 on abdominal or neck CT when a portion of the lungs is included, patients not initially suspected of COVID-19 infection can be quarantined earlier to limit exposure to others.

scholarly journals High Reliability Care: At the Intersection of Policy and Practice

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
United States ◽  
Health Care ◽  
Patient Care ◽  
Health Care Policy ◽  
High Reliability ◽  
Local Level ◽  
The United States ◽  
Joint Commission ◽  
Local Health ◽  
Quality And Safety

Health care organizations in the United States struggle to maintain safety and provide quality patient care. In a complex policy environment, the Joint Commission has directed its efforts toward helping health systems achieve high reliability health care. Heath care organizations, facing both accreditation imperatives and political challenges, are mired in the uncertainty of resource availability. The challenges of high reliability in a high stakes industry elude even the most seasoned CEOs and administrators. In particular, it is essential at this time is to pinpoint how public health policy, when coupled with development of high reliability culture, informs implementation of quality and safety at the local level and advances Joint Commission directives related to high reliability care. This theoretically focused paper explores the phenomena of quality and safety from the vantage of two differing lenses, practice and policy. The theoretical analysis of high reliability health care (policy, organizational structure, and actors) contributes to further understanding the challenges facing high reliability patient care implementation throughout hospital systems in the United States. Discussion highlights appropriateness of model fit, whether a top down approach to patient care is realistic, and possible challenges of a centralized policy in an inherently decentralized industry environment. Conclusions reinforce the need for local health care systems and administrators to adopt and adapt the Joint Commission’s high reliability model to their system to correct industry failures.

scholarly journals Population-Level Interest and Telehealth Capacity of US Hospitals in Response to COVID-19: Cross-Sectional Analysis of Google Search and National Hospital Survey Data (Preprint)

2020 ◽  
Author(s):  
Young-Rock Hong ◽  
John Lawrence ◽  
Dunc Williams Jr ◽  
Arch Mainous III
Keyword(s):  
United States ◽  
Health Care ◽  
Population Level ◽  
The United States ◽  
Health Care Facilities ◽  
Care Providers ◽  
Internet Search ◽  
American Hospital ◽  
Search Volume ◽  
Google Search

BACKGROUND As the novel coronavirus disease (COVID-19) is widely spreading across the United States, there is a concern about the overloading of the nation’s health care capacity. The expansion of telehealth services is expected to deliver timely care for the initial screening of symptomatic patients while minimizing exposure in health care facilities, to protect health care providers and other patients. However, it is currently unknown whether US hospitals have the telehealth capacity to meet the increasing demand and needs of patients during this pandemic. OBJECTIVE We investigated the population-level internet search volume for telehealth (as a proxy of population interest and demand) with the number of new COVID-19 cases and the proportion of hospitals that adopted a telehealth system in all US states. METHODS We used internet search volume data from Google Trends to measure population-level interest in telehealth and telemedicine between January 21, 2020 (when the first COVID-19 case was reported), and March 18, 2020. Data on COVID-19 cases in the United States were obtained from the Johns Hopkins Coronavirus Resources Center. We also used data from the 2018 American Hospital Association Annual Survey to estimate the proportion of hospitals that adopted telehealth (including telemedicine and electronic visits) and those with the capability of telemedicine intensive care unit (tele-ICU). Pearson correlation was used to examine the relations of population search volume for telehealth and telemedicine (composite score) with the cumulative numbers of COVID-19 cases in the United States during the study period and the proportion of hospitals with telehealth and tele-ICU capabilities. RESULTS We found that US population–level interest in telehealth increased as the number of COVID-19 cases increased, with a strong correlation (<i>r</i>=0.948, <i>P</i>&lt;.001). We observed a higher population-level interest in telehealth in the Northeast and West census region, whereas the proportion of hospitals that adopted telehealth was higher in the Midwest region. There was no significant association between population interest and the proportion of hospitals that adopted telehealth (<i>r</i>=0.055, <i>P</i>=.70) nor hospitals having tele-ICU capability (<i>r</i>=–0.073, <i>P</i>=.61). CONCLUSIONS As the number of COVID-19 cases increases, so does the US population’s interest in telehealth. However, the level of population interest did not correlate with the proportion of hospitals providing telehealth services in the United States, suggesting that increased population demand may not be met with the current telehealth capacity. Telecommunication infrastructures in US hospitals may lack the capability to address the ongoing health care needs of patients with other health conditions. More practical investment is needed to deploy the telehealth system rapidly against the impending patient surge.

Washington View

2017 ◽  
Vol 98 (6) ◽  
pp. 72-73
Author(s):  
Maria Ferguson
Keyword(s):  
United States ◽  
United Kingdom ◽  
Local Level ◽  
The United States ◽  
The State ◽  
The United Kingdom ◽  
State And Local ◽  
Policy Proposals ◽  
The U.S

Seismic shifts in both the United States and the United Kingdom during the 2016 elections have introduced changes in the education space as well. Worries about jobs, immigration, and shifting demographics underlie policy proposals in both countries. Where the U.S. is trying to drive change to the state and local level, however, Britain is moving toward centralization.

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