Members of faith-based organizations (FBOs) are in a unique position to provide support and services to their local communities during disasters. Because of their close community ties and well-established trust, they can play an especially critical role in helping communities heal in the aftermath of a mass-fatality incident (MFI). Faith-based organizations are considered an important disaster resource and partner under the National Response Plan (NRP) and National Response Framework; however, their level of preparedness and response capabilities with respect to MFIs has never been evaluated. The purpose of this study was threefold: (1) to develop appropriate measures of preparedness for this sector; (2) to assess MFI preparedness among United States FBOs; and (3) to identify key factors associated with MFI preparedness.

New metrics for MFI preparedness, comprised of three domains (organizational capabilities, operational capabilities, and resource sharing partnerships), were developed and tested in a national convenience sample of FBO members.

Data were collected using an online anonymous survey that was distributed through two major, national faith-based associations and social media during a 6-week period in 2014. Descriptive, bivariate, and correlational analyses were conducted.

One hundred twenty-four respondents completed the online survey. More than one-half of the FBOs had responded to MFIs in the previous five years. Only 20% of respondents thought that roughly three-quarters of FBO clergy would be able to respond to MFIs, with or without hazardous contamination. A higher proportion (45%) thought that most FBO clergy would be willing to respond, but only 37% thought they would be willing if hazardous contamination was involved. Almost all respondents reported that their FBO was capable of providing emotional care and grief counseling in response to MFIs. Resource sharing partnerships were typically in place with other voluntary organizations (73%) and less likely with local death care sector organizations (27%) or Departments of Health (DOHs; 32%).

The study suggests improvements are needed in terms of staff training in general, and specifically, drills with planning partners are needed. Greater cooperation and inclusion of FBOs in national planning and training will likely benefit overall MFI preparedness in the US.

ZhiQ, MerrillJA, GershonRR. Mass-Fatality Incident Preparedness Among Faith-Based Organizations. Prehosp Disaster Med.2017;32(6):596–603.

To assess the preparedness of the US mass fatality infrastructure, we developed and tested metrics for 3 components of preparedness: organizational, operational, and resource sharing networks.

In 2014, data were collected from 5 response sectors: medical examiners and coroners, the death care industry, health departments, faith-based organizations, and offices of emergency management. Scores were calculated within and across sectors and a weighted score was developed for the infrastructure.

A total of 879 respondents reported highly variable organizational capabilities: 15% had responded to a mass fatality incident (MFI); 42% reported staff trained for an MFI, but only 27% for an MFI involving hazardous contaminants. Respondents estimated that 75% of their staff would be willing and able to respond, but only 53% if contaminants were involved. Most perceived their organization as somewhat prepared, but 13% indicated “not at all.” Operational capability scores ranged from 33% (death care industry) to 77% (offices of emergency management). Network capability analysis found that only 42% of possible reciprocal relationships between resource-sharing partners were present. The cross-sector composite score was 51%; that is, half the key capabilities for preparedness were in place.

The sectors in the US mass fatality infrastructure report suboptimal capability to respond. National leadership is needed to ensure sector-specific and infrastructure-wide preparedness for a large-scale MFI. (Disaster Med Public Health Preparedness. 2016;10:87–97)

Public health agencies have been participating in emergency preparedness exercises for many years. A poorly designed or executed exercise, or an unevaluated or inadequately evaluated plan, may do more harm than good if it leads to a false sense of security, and results in poor performance during an actual emergency. At the time this project began, there were no specific standards for the public health aspects of exercises and drills, and no defined criteria for the evaluation of agency performance in public health.

The objective of this study was to develop defined criteria for the evaluation of agency performance.

A Delphi panel of 26 experts in the field participated in developing criteria to assist in the evaluation of emergency exercise performance, and facilitate measuring improvement over time. Candidate criteria were based on the usual parts of an emergency plan and three other frameworks used elsewhere in public health or emergency response.

The response rate from the expert panel for Delphi Round I was 74%, and for Delphi Round II was 55%. This final menu included 46 public health-agency level criteria grouped into nine categories for use in evaluating an emergency drill or exercise at the local public health level.

Use of the public health-specific criteria developed through this process will allow for specific assessment and planning for measurable improvement in a health agency over time.