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The key to resilience after disasters is the provision of coordinated care and resource distribution to the affected community. Past research indicates that the general public lacks an understanding regarding agencies’ roles and responsibilities during disaster response.
This study’s purpose was to explore the general public’s beliefs regarding agencies or organizations’ responsibilities related to resource management during disasters. In addition, the public’s attitudes towards the management and use of community disaster assistance centers were explored.
Qualitative interviews were conducted with members of the general public. Interviews were audio-recorded and transcribed verbatim. Content analysis was used to analyze the data and identify themes that describe the public’s expectations of disaster response agencies and the use of community disaster assistance centers.
A total of 28 interviews were conducted. Half of the participants (n=14) were black, 57% (n=16) were female, and the mean age was 49 years. The general public has developed trust and distrust toward response organizations and governmental agencies based on past experiences during disasters. The public wishes to have local agencies to help lead disaster response, but expects a collaboration between all response organizations, including the government. The managing agency overseeing community disaster assistance centers was not perceived as important, but the proximity of these centers to community members was considered critical.
The general public prefers that local agencies and leaders manage disaster response, and they expect collaboration among response agencies. Community assistance centers need to be located close to those in need, and be managed by agencies trusted by the general public. (Disaster Med Public Health Preparedness. 2018;12:446–449)
The public's expectations of hospital services during disasters may not reflect current hospital disaster plans. The objective of this study was to determine the public's expected hospital service utilization during a pandemic, earthquake, and terrorist bombing.
A survey was distributed to adult patients or family members at 3 emergency departments (EDs). Participants identified resources and services they expect to need during 3 disaster scenarios. Linear regression was used to describe factors associated with higher expected utilization scores for each scenario.
Of the 961 people who participated in the study, 66.9% were women, 47.5% were white, and 44.6% were black. Determinants of higher pandemic resource utilization included persons who were younger (P < .01); non-white (P < .001); had higher ED visits (P < .01), hospitalization (P = .001), or fewer primary care provider visits (P = .001) in the past year; and did not having a reunification plan (P < .001). Determinants of higher earthquake resource utilization included persons who were non-white (P < .001); who were a patient or spouse (vs parent) participating in the study (P < .05 and P = .001); and had higher ED visits in the past year (P = .001). Determinants of higher bombing resource utilization included persons who were female (P = .001); non-white (P < .001); had higher ED (P = .001) or primary care provider (P < .01) visits in past year; and experienced the loss of home or property during a past disaster (P < .05).
Public expectations of hospitals during disasters are high, and some expectations are inappropriate. Better community disaster planning and public risk communication are needed. (Disaster Med Public Health Preparedness. 2013;0:1–8)
Facilitating efficiency and safety, triage is the process by which multiple patients are rapidly assessed for risk and queued for care by the emergency department (ED) providers. Before conducting an assessment and formulating a treatment plan with psychiatric patients in the ED, clinicians are encouraged to obtain pre-arrival patient information whenever possible. Ambulatory patients with psychiatric complaints may present to triage alone or arrive with family or friends. It is advisable to have a protocol for determining the location of initial triage based on the circumstances of arrival. Continual reassessment of patient status is critical for clinical care. At various points in this chapter, the movement of patients from one clinical environment to another is discussed. Each transition includes an attendant hand-off between clinical providers. At times, a patient is sent to the emergency department en route to an inpatient psychiatric unit, for example, from a psychiatric clinic.
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