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Psychological Effects of Patient Surge in Large-Scale Emergencies: A Quality Improvement Tool for Hospital and Clinic Capacity Planning and Response

Published online by Cambridge University Press:  28 June 2012

Lisa S. Meredith ,
James L. Zazzali ,
Sandra Shields ,
David P. Eisenman  and
Halla Alsabagh
Lisa S. Meredith*
Affiliation:
RAND Corporation, Santa Monica, California USA
James L. Zazzali
Affiliation:
Genentech, Inc., South San Francisco, California USA
Sandra Shields
Affiliation:
Los Angeles County Department of Health Services, Emergency Medical Services Agency, Los Angeles, California USA
David P. Eisenman
Affiliation:
RAND Corporation, Santa Monica, California USA Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California USA
Halla Alsabagh
Affiliation:
Los Angeles County Department of Mental Health, Los Angeles, California USA
*
Senior Behavioral Scientist RAND Corporation 1776 Main Street Santa Monica, California 90407 USA E-mail: lisa_meredith@rand.org
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Abstract

Although information is available to guide hospitals and clinics on the medical aspects of disaster surge, there is little guidance on how to manage the expected surge of persons needing psychological assessment and response after a catastrophic event. This neglected area of disaster medicine is addressed by presenting a novel and practical quality improvement tool for hospitals and clinics to use in planning for and responding to the psychological consequences of catastrophic events that create a surge of psychological casualties presenting for health care. Industrial quality improvement processes, already widely adopted in the healthcare sector, translate well when applied to disaster medicine and public health preparedness. This paper describes the development of the tool, presents data on facility preparedness from 31 hospitals and clinics in Los Angeles County, and discusses how the tool can be used as a benchmark for targeting improvement. The tool can serve to increase facility awareness of which components of disaster preparedness and response must be addressed through hospitals' and clinics' existing quality improvement programs. It also can provide information for periodic assessment and evaluation of progress over time.

Keywords

disastermental healthpublic health preparednessquality improvementsurge capacity
Type
Research Article
Information
Prehospital and Disaster Medicine , Volume 25 , Issue 2 , April 2010 , pp. 107 - 114
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2010

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