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Military Response to Medical Crises—Consensus Recommendations for Military–Civilian Transitions of Care

Published online by Cambridge University Press:  12 December 2022

Craig Goolsby ,
Keke Schuler ,
Laura Tilley ,
Alexis Zebrowski ,
Nicole Dacuyan-Faucher ,
Claire Kim  and
Michael Redlener
Craig Goolsby*
Affiliation:
Department of Emergency Medicine, Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Torrance, CA, USA
Keke Schuler
Affiliation:
National Center for Disaster Medicine and Public Health Medicine, Rockville, MD, USA The Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
Laura Tilley
Affiliation:
Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, National Center for Disaster Medicine and Public Health, Bethesda, MD, USA
Alexis Zebrowski
Affiliation:
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Nicole Dacuyan-Faucher
Affiliation:
National Center for Disaster Medicine and Public Health Medicine, Rockville, MD, USA The Henry M Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
Claire Kim
Affiliation:
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Michael Redlener
Affiliation:
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
*
Corresponding author: Craig Goolsby, Email: cgoolsby@dhs.lacounty.gov.
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Abstract

Objective:

The threat that New York faced in 2020, as the COVID-19 pandemic unfolded, prompted an unprecedented response. The US military deployed active-duty medical professionals and equipment to NYC in a first of its kind response to a “medical” domestic disaster. Transitions of care for patients surfaced as a key challenge. Uniformed Services University and the Icahn School of Medicine at Mount Sinai hosted a consensus conference of civilian and military healthcare professionals to identify care transition best practices for future military-civilian responses.

Methods:

We performed individual interviews followed by a modified Delphi technique during a two-day virtual conference. Patient transitions of care emerged as a key theme from pre-conference interviews. Twelve participants attended the two-day virtual conference and generated best practice recommendations from an iterative process.

Results:

Participants identified 19 recommendations in 10 “sub-themes” related to patient transitions of care: needs assessment and capability analysis; unified command; equipment; patient handoffs; role of in-person facilitation; dynamic updates; patient selection; patient tracking; daily operations; and resource typing.

Conclusions:

The COVID-19 pandemic resulted in an unprecedented military response. This study created 19 consensus recommendations for care transitions between military and civilian healthcare assets that may be useful in future military-civilian medical engagements.

Keywords

disaster medicinemilitary medicinepandemicscivil defense
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e281
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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