IOM: Emergency health system unprepared for disasters

first_imgJun 20, 2006 (CIDRAP News) – The US emergency medical care system is woefully inadequate and unprepared for a pandemic, bioterrorist attack, natural disaster, or other national crisis, three recent reports from the Institute of Medicine (IOM) conclude.The nation’s emergency care system, the reports say, is overburdened, underfunded, and too fragmented to communicate and cooperate effectively across levels and geographic areas. It has little surge capacity to deal with a disaster. In addition, emergency care staff members are often not adequately trained to respond to large-scale disasters or to work with pediatric patients.The IOM report preceded by 2 days a Department of Homeland Security report that describes major shortcomings in the nation’s general preparedness for catastrophic events such as category 5 hurricanes.Emergency system needs comprehensive help”Unfortunately, the [emergency care] system’s capacity is not keeping pace with the increasing demands being placed on it,” said Gail L. Warden, MHA, in a Jun 14 news release from the National Academies, the IOM’s parent organization.”We need a comprehensive effort to shore up America’s emergency medical care resources and fix problems that can threaten the health and lives of people in the midst of a crisis,” added Warden, chair of the committee that wrote the reports and president emeritus of Henry Ford Health System in Detroit.To remedy this situation, the committee that wrote the reports recommends that:Congress appropriate at least $325.5 million toward shoring up the emergency care system—plus funding for readying the system for potential disasters.The emergency care system be “regionalized” so that neighboring hospitals, emergency medical services, and other agencies work together to provide care for all the people in their region.The Veterans Health Administration (VHA) be integrated into civilian disaster planning and management.Guidelines on overcrowding and redirecting ambulances away from packed emergency departments (EDs) be enforced, and coordination and communication between facilities improved.Streamlining tools, such as queuing theory, dashboard systems, and 23-hour observation units, be used to optimize patient treatment and flow.The IOM’s 26-member Committee on the Future of Emergency Care in the US Health System convened in September 2003. Its conclusions on problem areas and recommended solutions have just been published as a series of three reports: Hospital-Based Emergency Care: At the Breaking Point, Emergency Medical Services at the Crossroads, and Emergency Care for Children: Growing Pains.Concerning funding, an IOM overall summary of the three documents states, “Perhaps the area in which greater funding is most important is disaster preparedness. To date, despite their importance in any response to disaster, the various parts of the emergency care system have received very little of the funds that Congress has dispensed for disaster preparedness.”In part this is because the money tends to be funneled through public safety agencies that consider medical care to be a low priority. Congress should therefore make significantly more disaster-preparation funds available to the emergency system through dedicated funding,” the summary says.Hospital-Based Emergency Care: At the Breaking Point specifies the following preparedness funding priorities:Strengthening and sustaining trauma care systemsEnhancing ED, trauma center, and inpatient surge capacityImproving EMS response to explosivesDesigning evidence-based training programsIncreasing the availability of decontamination showers, standby intensive care unit capacity, negative-pressure rooms, and appropriate personal protective equipmentConducting international collaborative research on the civilian consequences of conventional-weapons terrorismIn addition to asking for more preparedness funding, the IOM committee says Congress should establish a pool of $50 million to reimburse hospitals for uncompensated emergency and trauma care.Also, in the next 5 years Congress should provide $88 million to foster coordination and “regionalization” of emergency care and $187.5 million to address shortcomings in emergency pediatric care, the reports conclude.Regional coordination urgedRegionalization would involve directing patients not to just the nearest medical center, but to the nearest facility in the region equipped to handle patients’ specific needs. It “can improve health outcomes, mitigate overcrowding, and reduce costs,” according to the IOM news release.Regionalization would also eliminate the need for every hospital to maintain on-call services for every specialty, which would help address staff shortages caused by decreasing numbers of specialists willing to take emergency calls, the news release said.Hospital-Based Emergency Care says the VHA is “well positioned to enhance regional response, particularly since its hospitals are required by law to maintain excess capacity.” Therefore, the report says, federal organizations should work with states to integrate the VHA into regional disaster planning.To remedy overcrowding and ambulance diversions, the committee asked that the Joint Commission on Accreditation of Healthcare Organization (JCAHO) reinstate strong guidelines to reduce crowding, “boarding” patients in halls or exam rooms until beds become available, and diverting ambulances when EDs are overcrowded. It also called on the Centers for Medicare and Medicaid Services to convene a working group to develop standards to address the situation.Further, the reports note, overcrowding and ambulance diversions are caused by lack of coordination and communication between facilities. Patient admission and transport should be better coordinated across municipalities, the reports conclude.In recommending using queuing theory to help improve efficiency, the committee highlighted its ability to smooth the peaks and valleys of patient admissions, which can eliminate bottlenecks, improve care, and lower costs.The 23-hour observation unit, or clinical decision unit, the reports say, can help ED staff with patient triage, which can help reduce ED crowding. And dashboard systems can help coordinate patient flow.DHS reports on preparedness for catastrophesIn another lengthy report, the Department of Homeland Security (DHS) on Jun 16 assessed the nation’s preparedness for catastrophes such as a major terrorist attack or a category 5 hurricane. The assessment included all 56 states and territories, as well as 75 urban areas.The assessment was ordered by President Bush and Congress in the wake of Hurricane Katrina, according to a DHS news release. Last February the agency released a report based on preparedness self-assessments by states and major cities; the new report represents the findings of expert “peer review teams” that visited the states and cities and checked their plans against national standards.Among the key findings in the Nationwide Plan Review for states and urban areas are:Most planning processes are not adequate as defined in the National Response Plan (NRP).A common deficiency in state and urban areas is the absence of a clearly defined command structure.The ability to give the public accurate, timely information should be strengthened.Significant weaknesses in evacuation planning are of profound concern.Resource management is the “Achilles heel” of emergency planning.Among the key findings for the federal government are:Clear guidance needs to be developed on how state and local governments can coordinate operations with federal partners according to the NRP.Collaboration between government and non-governmental organizations should be strengthened at all levels.Federal, state, and local governments should work with the private sector to optimize transportation of people with disabilities before, during, and after an emergency.The federal government should provide leadership, guidance, and resources necessary to build a shared national homeland security planning system.See also:IOM’s “Future of Emergency Care” seriesNational Academies Jun 14 press releaselast_img read more

Governor Wolf and Pa. National Guard Senior Leaders Commend Soldiers Headed to the Middle East

first_img Press Release Governor Tom Wolf commended about 900 soldiers with the Pennsylvania National Guard’s 28th Expeditionary Combat Aviation Brigade (ECAB) for their sacrifices as they prepare to deploy to the Middle East in support of U.S. Central Command (CENTCOM). The soldiers are based in Lebanon and Cambria counties.In order to protect the health of the soldiers, Gov. Wolf, Maj. Gen. Anthony Carrelli, Pennsylvania’s adjutant general and head of the Pennsylvania Department of Military and Veterans Affairs, and other senior leaders provided video messages of support for the troops.“When the majority of this state, the country and the world temporarily shut down because of the virus, you continued to serve,” said Gov. Wolf. “You put your families and careers on hold. And now, we are asking you to do just that again. I know in my heart that you will complete this mission with the same level of dedication and commitment that you have demonstrated in previous deployments, domestic operations and your intense training.”“These past few months have been so difficult for these soldiers and their families. While most of the world was under quarantine during the worst of this pandemic, the ECAB was training every day,” said Carrelli. “You all put your nation first and we appreciate your sacrifice and hard work to get the ECAB to this point. We are proud of your service and look forward to your safe return following another successful deployment.”Wolf and Carrelli also addressed the families of the soldiers, saying that they also experience incredible sacrifice when their loved ones are deployed, and that Pennsylvania is here to help families through these challenging times.The ECAB will deploy with 500 soldiers from other states to provide Army air operations, including transport and medivac services in support of CENTCOM. The unit will head to Texas in July before an approximately nine-month tour of duty overseas.“They have endured so much to get ready for this deployment but they are some of the finest, well-trained, resilient, professional soldiers that I have ever experienced in my 37 years as an enlisted soldier and officer,” said Col. Howard Lloyd, ECAB commander.To view the video messages and learn more about this deployment, go to https://www.dvidshub.net/unit/28CAB.Ver esta página en español. Governor Wolf and Pa. National Guard Senior Leaders Commend Soldiers Headed to the Middle East June 27, 2020center_img SHARE Email Facebook Twitterlast_img read more

Obafemi dreams of emulating Bale,Oxlade-Chamberlain

first_img Loading… ‘He likes sailing,’ the young forward begins. ‘So we went sailing as a team.’ Staff versus players, it was an attempt by Southampton’s manager to build morale and unity among his squad. The staff won, and on this day the prankster gets his way, too. Obafemi’s concentration drifts as outside Nathan Redmond distracts his team-mate with comedic gestures. ‘I’m laughing at him, sorry,’ Obafemi says. In the 19-year-old’s short senior career, Redmond has become something of a mentor and older brother. He advises the Republic of Ireland international on ‘simple stuff,’ such as where he should be on the pitch and what he should eat off it. On Boxing Day they combined to down Chelsea, netting either side of half-time to secure a valuable three points at Stamford Bridge. ‘It was a sweet feeling, for sure,’ Obafemi tells Sportsmail. ‘To get such an important goal for the team was incredible. It was a huge win for us. I was so happy for Nathan, too, as he has been a big influence for me.’ It was Obafemi’s second Premier League goal — and his first for more than a year. Now the forward, who stopped playing for a year after being released by Watford, stands among them. ‘I want to carry on going, make my family proud and do as much as I can.’ Obafemi, who is not 20 until July, has always been in a hurry. Promoted ContentYou’ve Only Seen Such Colorful Hairdos In A Handful Of AnimeWhat Happens When You Eat Eggs Every Single Day?10 Risky Jobs Some Women DoFantastic-Looking (and Probably Delicious) Bread ArtEverything You Need To Know About Asteroid ArmageddonTop 10 Most Romantic Nations In The World10 Phones That Can Work For Weeks Without Recharging8 Superfoods For Growing Hair Back And Stimulating Its Growth10 Places On Our Planet Where The Most People Live2020 Tattoo Trends: Here’s What You’ll See This YearThe Very Last Bitcoin Will Be Mined Around 2140. Read More14 Hilarious Comics Made By Women You Need To Follow Right Now Southampton’s rising star, Michael Obafemi is dreaming  of emulating Gareth Bale, Alex Oxlade-Chamberlain and Adam Lallana: ‘If they can do it, why not me?’ ‘I remember when I was at nursery all the other kids used to ride bicycles around, but I just sprinted round in circles,’ he says. ‘I think that’s when I knew I was fast.’ By secondary school, other students were at least trying to join in. ‘We used to do little 100m races and I remember on my sports day, we had like an announcer,’ he recalls before impersonating her high-pitch voice. ‘When I was sprinting, she was like: “Is it a bird? Is it a plane? No it’s Michael Obafemi!”‘ In his mid-teens he was crowned the fastest boy in his borough with a time of 10.8 seconds. For context, when Dina Asher-Smith broke her own British Championship record back in August, she ran 10.96sec. ‘I never trained. I used to just turn up,’ admits Obafemi. That was until football became his sole focus. Hasenhuttl has given Obafemi and other young players crucial game time even as the club battle to stay in the Premier League. Now, after an injury-ravaged year, he is firmly back in the manager’s plans. Read Also:Southampton confirm Obafemi’s blackout against Crystal Palace ‘He’s been a big influence on my career. He’s believed in me, he thinks I’m a “cool guy” as he said to the media,’ Obafemi says. So would he return the compliment? ‘Yeah,’ Obafemi laughs. ‘I’d say so, we have a good relationship!’ Last month, however, the Saints boss warned his young charge that the road remains long. ‘He still has a lack of professionalism in his whole life,’ Hasenhuttl said. FacebookTwitterWhatsAppEmail分享 last_img read more

Gold Cup legend dies

first_imgThe horse was put down after suffering pelvis and neck injuries as the result of a fall.Kauto Star, who had been retired since 2012, also won the King George the Sixth Chase at Kempton a record five times.last_img