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Haraldseid-Driftland C, Dombestein H, Le AH, Billett S, Wiig S. Learning tools used to translate resilience in healthcare into practice: a rapid scoping review. BMC Health Serv Res 2023; 23:890. [PMID: 37612671 PMCID: PMC10463810 DOI: 10.1186/s12913-023-09922-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 08/14/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Historically, efforts to improved healthcare provisions have focussed on learning from and understanding what went wrong during adverse events. More recently, however, there has been a growing interest in seeking to improve healthcare quality through promoting and strengthening resilience in healthcare, in light of the range of changes and challenges to which healthcare providers are subjected. So far, several approaches for strengthening resilience performance have been suggested, such as reflection and simulation. However, there is a lack of studies that appraise the range of existing learning tools, the purposes for which they are designed, and the types of learning activities they comprise. The aim of this rapid scoping review is to identify the characteristics of currently available learning tools designed to translate organizational resilience into healthcare practice. METHODS A rapid scoping review approach was used to identify, collect, and synthesise information describing the characteristics of currently available learning tools designed to translate organizational resilience into healthcare practice. EMBASE and Medline Ovid were searched in May 2022 for articles published between 2012 and 2022. RESULTS The review identified six different learning tools such as serious games and checklists to guide reflection, targeting different stakeholders, in various healthcare settings. The tools, typically, promoted self-reflection either individually or collaboratively in groups. Evaluations of these tools found them to be useful and supportive of resilience; however, what constitutes resilience was often difficult to discern, particularly the organizational aspect. It became evident from these studies that careful planning and support were needed for their successful implementation. CONCLUSIONS The tools that are available for review are based on guidelines, checklists, or serious games, all of which offer to prompt either self-reflection or group reflections related to different forms of adaptations that are being performed. In this paper, we propose that more guided reflections mirroring the complexity of resilience in healthcare, along with an interprofessional collaborative and guided approach, are needed for these tools to be enacted effectively to realise change in practice. Future studies also need to explore how tools are perceived, used, and understood in multi-site, multi-level studies with a range of different participants.
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Affiliation(s)
- Cecilie Haraldseid-Driftland
- Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway
| | - Heidi Dombestein
- Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway.
| | - Anh Hai Le
- School of Education and Professional Studies, Griffith University, Mount Gravatt, QLD, 4122, Australia
| | - Stephen Billett
- School of Education and Professional Studies, Griffith University, Mount Gravatt, QLD, 4122, Australia
| | - Siri Wiig
- Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway
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Lessinnes S, Köhler M, Ewers M. Evidence of Disaster Planning by Home Care Providers: An Integrative Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095658. [PMID: 37174176 PMCID: PMC10177767 DOI: 10.3390/ijerph20095658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023]
Abstract
The increasing risk of disasters worldwide poses challenges both to health care infrastructures and to home care providers, who must maintain decentralised services for those in need of long-term care for as long as possible, even under adverse circumstances. However, both the kind of organisational precautions that home care providers consider in preparation for disasters and the available evidence on the effectiveness of these precautions remain largely unclear. An integrative literature review was thus performed via a systematic search of several international databases in order to identify original research on organisational disaster planning by home care providers and to determine the evidence base of this research. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool. Of the 286 results, 12 articles met the inclusion criteria and presented results from nine studies on disaster planning. Three overarching types of activities carried out by home care providers were identified inductively. The overall scientific quality of the studies was moderate, and none investigated the effectiveness of disaster planning by home care providers. Despite the variety of possible activities that home care providers already consider, evidence on how to make organisational disaster planning effective and sustainable remains lacking.
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Affiliation(s)
- Sanne Lessinnes
- Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Health and Nursing Science, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Michael Köhler
- Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Health and Nursing Science, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Michael Ewers
- Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Health and Nursing Science, Augustenburger Platz 1, 13353 Berlin, Germany
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Der-Martirosian C, Wyte-Lake T, Balut M, Chu K, Heyworth L, Leung L, Ziaeian B, Tubbesing S, Mullur R, Dobalian A. Implementation of Telehealth Services at the US Department of Veterans Affairs During the COVID-19 Pandemic: Mixed Methods Study. JMIR Form Res 2021; 5:e29429. [PMID: 34477554 PMCID: PMC8462492 DOI: 10.2196/29429] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/20/2021] [Accepted: 05/31/2021] [Indexed: 12/15/2022] Open
Abstract
Background At the onset of the COVID-19 pandemic, there was a rapid increase in the use of telehealth services at the US Department of Veterans Affairs (VA), which was accelerated by state and local policies mandating stay-at-home orders and restricting nonurgent in-person appointments. Even though the VA was an early adopter of telehealth in the late 1990s, the vast majority of VA outpatient care continued to be face-to-face visits through February 2020. Objective We compared telehealth service use at a VA Medical Center, Greater Los Angeles across 3 clinics (primary care [PC], cardiology, and home-based primary care [HBPC]) 12 months before and 12 months after the onset of COVID-19 (March 2020). Methods We used a parallel mixed methods approach including simultaneous quantitative and qualitative approaches. The distribution of monthly outpatient and telehealth visits, as well as telephone and VA Video Connect encounters were examined for each clinic. Semistructured telephone interviews were conducted with 34 staff involved in telehealth services within PC, cardiology, and HBPC during COVID-19. All audiotaped interviews were transcribed and analyzed by identifying key themes. Results Prior to COVID-19, telehealth use was minimal at all 3 clinics, but at the onset of COVID-19, telehealth use increased substantially at all 3 clinics. Telephone was the main modality of patient choice. Compared with PC and cardiology, video-based care had the greatest increase in HBPC. Several important barriers (multiple steps for videoconferencing, creation of new scheduling grids, and limited access to the internet and internet-connected devices) and facilitators (flexibility in using different video-capable platforms, technical support for patients, identification of staff telehealth champions, and development of workflows to help incorporate telehealth into treatment plans) were noted. Conclusions Technological issues must be addressed at the forefront of telehealth evolution to achieve access for all patient populations with different socioeconomic backgrounds, living situations and locations, and health conditions. The unprecedented expansion of telehealth during COVID-19 provides opportunities to create lasting telehealth solutions to improve access to care beyond the pandemic.
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Affiliation(s)
- Claudia Der-Martirosian
- Veterans Emergency Management Evaluation Center, US Department of Veterans Affairs, North Hills, CA, United States.,Center for the Study of Healthcare Innovation, Implementation & Policy, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Tamar Wyte-Lake
- Veterans Emergency Management Evaluation Center, US Department of Veterans Affairs, North Hills, CA, United States
| | - Michelle Balut
- Veterans Emergency Management Evaluation Center, US Department of Veterans Affairs, North Hills, CA, United States
| | - Karen Chu
- Veterans Emergency Management Evaluation Center, US Department of Veterans Affairs, North Hills, CA, United States
| | - Leonie Heyworth
- Office of Connected Care/Telehealth Services, Veterans Health Administration, Washington, DC, United States.,Department of Medicine, University of California San Diego School of Medicine, San Diego, CA, United States
| | - Lucinda Leung
- Center for the Study of Healthcare Innovation, Implementation & Policy, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States.,Division of General Internal Medicine-Health Services Research, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Boback Ziaeian
- Center for the Study of Healthcare Innovation, Implementation & Policy, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States.,Division of Cardiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Sarah Tubbesing
- Center for the Study of Healthcare Innovation, Implementation & Policy, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States.,Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Rashmi Mullur
- Center for the Study of Healthcare Innovation, Implementation & Policy, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States.,Division of Diabetes, Endocrinology & Metabolism, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Aram Dobalian
- Veterans Emergency Management Evaluation Center, US Department of Veterans Affairs, North Hills, CA, United States.,Division of Health Systems Management and Policy, School of Public Health, University of Memphis, Memphis, TN, United States
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Bell SA, Dickey S, Rosemberg MA. "You get three different hats on and try to figure it out:" home based care provision during a disaster. BMC Nurs 2021; 20:155. [PMID: 34461891 PMCID: PMC8406738 DOI: 10.1186/s12912-021-00676-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 08/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Home based care is a vital, and growing, part of the health care system that allows individuals to remain in their homes while still receiving health care. During a disaster, when normal health care systems are disrupted, home based care remains a vital source of support for older adults. The purpose of this paper is to qualitatively understand the barriers and facilitators of both patients and providers that influence the provision of home based care activities in two hurricane affected communities. METHODS Using qualitative inquiry informed by the social ecological model, five focus groups were conducted with home based care providers (n = 25) in two settings affected by Hurricane Irma and Hurricane Harvey. An open-source database of home health agencies participating in Centers for Medicare and Medicaid Services programs was used to identify participants. Data were manually coded and larger themes were generated from recurring ideas and concepts using an abductive analysis approach. RESULTS Twenty five participants were included in one of five focus groups. Of the 22 who responded to the demographic survey, 65 % were registered nurses, 20 % were Licensed Vocational Nurses (LVN), and 15 % were other types of health care providers. 12 % of the sample was male and 88 % was female. Five themes were identified in the analysis: barriers to implementing preparedness plans, adaptability of home based care providers, disasters exacerbate inequalities, perceived unreliability of government and corporations, and the balance between caring for self and family and caring for patients. CONCLUSIONS This study provides qualitative evidence on the factors that influence home based care provision in disaster-affected communities, including the barriers and facilitators faced by both patients and providers in preparing for, responding to and recovering from a disaster. While home based care providers faced multiple challenges to providing care during and after a disaster, the importance of community supports and holistic models of care in the immediate period after the disaster were emphasized. We recommend greater inclusion of home health agencies in the community planning process. This study informs the growing body of evidence on the value of home based care in promoting safety and well-being for older adults during a disaster.
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Affiliation(s)
- Sue Anne Bell
- University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI, 48109, USA.
| | - Sarah Dickey
- University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI, 48109, USA
| | - Marie-Anne Rosemberg
- University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI, 48109, USA
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Bell SA, Krienke LK, Dickey S, De Vries RG. "Helping fill that gap:" a qualitative study of aging in place after disaster through the lens of home-based care providers. BMC Geriatr 2021; 21:235. [PMID: 33832424 PMCID: PMC8033697 DOI: 10.1186/s12877-021-02159-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/16/2021] [Indexed: 11/18/2022] Open
Abstract
Background During a disaster, home-based care fills the critical need for continuation of health care. Home-based care is intended to function using existing care delivery models, continuing to provide care for patients wherever they are located, including in shelters and hotels. Home-based care providers are often the closest in contact with their patients —seeing them in place, even throughout a disaster— through which they develop a unique insight into aging in place during a disaster. The purpose of this study was to identify individual and community-level support needs of older adults after a disaster through the lens of home-based care providers. Methods Using qualitative inquiry, five focus groups were conducted with home-based care providers (n = 25) who provided in-home care during Hurricane Irma and Hurricane Harvey. Participants were identified by contacting home health agencies listed in an open-source database of agencies participating in Centers for Medicare and Medicaid Services programs. Data were coded using an abductive analytic approach, and larger themes were generated in light of existing theory. Results The results were distilled into eight themes that related to the importance of community and family, informal and formal supports throughout the disaster management cycle, maintaining autonomy during a disaster, and institutional and systemic barriers to obtaining assistance. Conclusions In this study, home-based care providers described the challenges aging adults face in the response and recovery period after a large-scale disaster including maintaining continuity of care, encouraging individual preparedness, and accessing complex governmental support. Listening to home-based care providers offers new and important insights for developing interventions to address social and health needs for older adults aging in place after a large-scale disaster. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02159-0.
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Affiliation(s)
- Sue Anne Bell
- University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI, 48109, USA.
| | | | - Sarah Dickey
- University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI, 48109, USA
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Mlinac ME, Smith RW, Siffert KJ, Richter LC, Steadman-Wood PL, Wetherell JL. Development of a Suicide Prevention Toolkit for VA Home-Based Primary Care Teams. Home Healthc Now 2021; 39:13-19. [PMID: 33417357 PMCID: PMC7927422 DOI: 10.1097/nhh.0000000000000922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The U.S. Department of Veterans Affairs Home-Based Primary Care program (HBPC) serves Veterans with multiple comorbid physical and psychological conditions that can increase suicide risk. HBPC teams are uniquely able to implement suicide risk assessment and prevention practices, and the team's mental health provider often trains other team members. An online suicide prevention toolkit was developed for HBPC mental health providers and their teams as part of a quality improvement project. Toolkit development was guided by a needs assessment consisting of first focus group and then data from surveys of HBPC program directors (n = 53) and HBPC mental health providers (n = 56). Needs identified by both groups included training specific to the HBPC patient population and more resources if mental health needs could not be fully managed by the HBPC team. HBPC mental health providers within integrated care teams play a key role in clinical intervention, policy development, and interprofessional team education on suicide prevention. HBPC teams have specific learning and support needs around suicide prevention that can be addressed with a feasible, easily accessible clinical and training resource.
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Katzburg JR, Bradley SE, Lind JD, Fickel J, Ripley DC, Ong MK, Bergman AA, Fleming M, Lee LB, Tubbesing SA. Using Geographic Information System Mapping in Emergency Management. Nurs Clin North Am 2020; 55:81-95. [DOI: 10.1016/j.cnur.2019.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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8
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Wyte-Lake T, Claver M, Johnson-Koenke R, Davis D, Dobalian A. Hurricanes Harvey, Irma, and Maria: Exploring the Role of Home-Based Care Programs. Disaster Med Public Health Prep 2020; 14:119-124. [PMID: 32014082 PMCID: PMC7064407 DOI: 10.1017/dmp.2019.158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The aim of this study is to determine the response of home-based primary care programs to the fall 2017 Atlantic hurricane season. METHODS This study examines the experiences of 9 Veterans Health Administration (VHA) Home-Based Primary Care (HBPC) programs in their responses to Hurricanes Harvey, Irma, and Maria. Thirty-four phone interviews with HBPC leadership and staff were conducted from April to July 2018. RESULTS The total census of impacted HBPC programs was 3118. No program reported loss of life due to these hurricanes. Early preparedness was key to an effective program response. Response included prompt tracking of the patients. In the most affected areas, respondents noted limited resources to support basic patient needs. CONCLUSIONS Medically complex patients served by programs such as the VHA's HBPC program represent a subset of the population, yet they have an outsized impact on health care resources that could be exacerbated by inadequate disaster preparedness. HBPC programs serve a unique role in supporting the "older old." They are tasked with supporting disaster preparedness activities of patients. Understanding what is involved in actualizing their requirements shows communities how to effectively engage with these programs.
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Affiliation(s)
- Tamar Wyte-Lake
- Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, North Hills, CA
- Department of Family Medicine, Oregon Health & Science University, Portland, OR
| | - Maria Claver
- Gerontology Program, California State University, Long Beach, CA
| | - Rachel Johnson-Koenke
- Denver-Seattle Center of Innovation, Rocky Mountain Regional VA Medical Center, U.S. Department of Veterans Affairs
| | - Darlene Davis
- Geriatrics and Extended Care, Home and Community Based Care, U.S. Department of Veterans Affairs (VA)
| | - Aram Dobalian
- Veterans Emergency Management Evaluation Center (VEMEC), U.S. Department of Veterans Affairs, North Hills, CA
- Division of Health Systems Management and Policy, University of Memphis School of Public Health, Memphis, TN
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Hempel S, O’Hanlon C, Lim YW, Danz M, Larkin J, Rubenstein L. Spread tools: a systematic review of components, uptake, and effectiveness of quality improvement toolkits. Implement Sci 2019; 14:83. [PMID: 31426825 PMCID: PMC6701087 DOI: 10.1186/s13012-019-0929-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 07/26/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective was to conduct a systematic review of toolkit evaluations intended to spread interventions to improve healthcare quality. We aimed to determine the components, uptake, and effectiveness of publicly available toolkits. METHODS We searched PubMed, CINAHL, and the Web of Science from 2005 to May 2018 for evaluations of publicly available toolkits, used a forward search of known toolkits, screened references, and contacted topic experts. Two independent reviewers screened publications for inclusion. One reviewer abstracted data and appraised the studies, checked by a second reviewer; reviewers resolved disagreements through discussion. Findings, summarized in comprehensive evidence tables and narrative synthesis addressed the uptake and utility, procedural and organizational outcomes, provider outcomes, and patient outcomes. RESULTS In total, 77 studies evaluating 72 toolkits met inclusion criteria. Toolkits addressed a variety of quality improvement approaches and focused on clinical topics such as weight management, fall prevention, vaccination, hospital-acquired infections, pain management, and patient safety. Most toolkits included introductory and implementation material (e.g., research summaries) and healthcare provider tools (e.g., care plans), and two-thirds included material for patients (e.g., information leaflets). Pre-post studies were most common (55%); 10% were single hospital evaluations and the number of participating staff ranged from 17 to 704. Uptake data were limited and toolkit uptake was highly variable. Studies generally indicated high satisfaction with toolkits, but the perceived usefulness of individual tools varied. Across studies, 57% reported on adherence to clinical procedures and toolkit effects were positive. Provider data were reported in 40% of studies but were primarily self-reported changes. Only 29% reported patient data and, overall, results from robust study designs are missing from the evidence base. CONCLUSIONS The review documents publicly available toolkits and their components. Available uptake data are limited but indicate variability. High satisfaction with toolkits can be achieved but the usefulness of individual tools may vary. The existing evidence base on the effectiveness of toolkits remains limited. While emerging evidence indicates positive effects on clinical processes, more research on toolkit value and what affects it is needed, including linking toolkits to objective provider behavior measures and patient outcomes. TRIAL REGISTRATION PROSPERO registration number: PROSPERO 2014: CRD42014013930 .
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Affiliation(s)
- Susanne Hempel
- Southern California Evidence-based Practice Center, RAND Corporation, Santa Monica, USA
- Southern California Evidence Review Center, University of Southern California, Los Angeles, USA
| | | | - Yee Wei Lim
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Margie Danz
- Southern California Evidence-based Practice Center, RAND Corporation, Santa Monica, USA
- Southern California Evidence Review Center, University of Southern California, Los Angeles, USA
| | - Jody Larkin
- Knowledge Services, RAND Corporation, Santa Monica, USA
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Subramaniam P, Villeneuve M. Advancing emergency preparedness for people with disabilities and chronic health conditions in the community: a scoping review. Disabil Rehabil 2019; 42:3256-3264. [PMID: 30907152 DOI: 10.1080/09638288.2019.1583781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Community-based service providers are optimally positioned to contribute to the inclusion of people with disability and chronic health conditions in community-level disaster risk reduction. However, little is known about how to enable emergency preparedness within existing community health care, disability, and rehabilitation service delivery.Purpose: This study synthesised findings from a scoping review of the literature on how community-based service providers can enable emergency preparedness for clients in the community. Emphasis was placed on the practice scope of service providers undertaking this emerging role, the knowledge, skills and attitudes required to enable preparedness in others, and the current tools and training available to support service providers.Method: Six electronic databases, hand and cited searches were undertaken to identify studies for inclusion. In total, 24 publications were included.Results: Providers have competencies in conducting functional assessments that make them well-suited to enabling emergency preparedness with clients. Findings revealed seven provider responsibilities associated with this role and eight tools and training resources to support providers.Conclusion: Whilst community-based service providers are willing and optimally placed to enact these roles, they require additional support to do so in a manner that espouses values of inclusion and enablement.Implications for RehabilitationA wide range of community-based service providers are willing to leverage their role to enable emergency preparedness with clients in the community.Research is needed to understand how to optimise the expertise of diverse health care, disability and rehabilitation providers in facilitating emergency preparedness with clients.Strengths-based tools are needed to increase client self-sufficiency in preparing for and responding to emergencies.Enablement processes should guide the development of emergency preparedness as a critically important and emerging role for community-based service providers.Disability and rehabilitation professionals can use this scoping review to self-assess their capacity and develop opportunities to embed emergency preparedness into routine practice with clients.
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Affiliation(s)
| | - Michelle Villeneuve
- Centre for Disability Research and Policy, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
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11
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Wyte-Lake T, Claver M, Tubbesing S, Davis D, Dobalian A. Development of a Home Health Patient Assessment Tool for Disaster Planning. Gerontology 2019; 65:353-361. [PMID: 30731470 DOI: 10.1159/000494971] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 10/30/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Historically, older adults have been disproportionately affected by disasters. In particular, homebound adults are especially at risk. As one facet of bolstering community resilience, home health agencies have been tasked with improving their patients' disaster preparedness. However, home health practitioners often lack the information necessary to fulfill these requirements. Providing resources about disaster preparedness will allow these practitioners, often seen as trusted advisors, to better prepare their patients. OBJECTIVE This study explores the utility of implementing a checklist-style assessment tool to guide Veterans Health Administration (VHA) Home-Based Primary Care (HBPC) practitioners in disaster preparedness assessments of their patients. METHODS The HBPC Patient Assessment Tool for Disaster Planning ("Tool") was fielded by practitioners at 10 VHA HBPC programs with all patients seen over the course of a 3-week period. Descriptive statistics and bivariate analysis of the data collected via the Tool were used to understand the baseline levels of preparedness education provided by practitioners to their patients. Data from a follow-up survey and follow-up interviews with Program Managers were analyzed, the latter using content analysis methods. RESULTS 754 surveys were returned for analysis. We examined how frequently practitioners reviewed the included preparedness items with their patients. Of those patients on oxygen, adherence ranged from 67 to 94% for practitioners covering a discussion about smoking materials/open flame, despite strong efforts to achieve high compliance on this measure as reported by several program managers. Of those items applicable to the general population, certain items were more frequently discussed than others. How to activate 911 services was most frequently reviewed (87%). Providing information about emergency shelter registration and specialty transport was the item least frequently reviewed (44%). Strengths about the Tool included its ease of use, flow, comprehensiveness, and that it fits on one page. CONCLUSION Home-based care programs, such as the VHA HBPC program, are tasked with supporting the emergency preparedness of their patients, but often do not have the expertise to do so. This study shows that the checklist-like structure of an assessment tool can assist with this role by encouraging practitioners to cover key points with patients and their caregivers.
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Affiliation(s)
- Tamar Wyte-Lake
- US Department of Veterans Affairs, Veterans Emergency Management Evaluation Center (VEMEC), North Hills, California, USA,
| | - Maria Claver
- US Department of Veterans Affairs, Veterans Emergency Management Evaluation Center (VEMEC), North Hills, California, USA
| | - Sarah Tubbesing
- US Department of Veterans Affairs, Greater Los Angeles VA Healthcare System, Home-Based Primary Care, Los Angeles, California, USA
| | - Darlene Davis
- US Department of Veterans Affairs, Geriatrics and Extended Care, Washington, District of Columbia, USA
| | - Aram Dobalian
- US Department of Veterans Affairs, Veterans Emergency Management Evaluation Center (VEMEC), North Hills, California, USA
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12
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Wyte-Lake T, Claver M, Der-Martirosian C, Davis D, Dobalian A. Education of Elderly Patients About Emergency Preparedness by Health Care Practitioners. Am J Public Health 2018; 108:S207-S208. [PMID: 30192665 DOI: 10.2105/ajph.2018.304608] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Tamar Wyte-Lake
- Tamar Wyte-Lake, Claudia Der-Martirosian, Maria Claver, and Aram Dobalian are with the Veterans Emergency Management Evaluation Center, Office of Patient Care Services, US Department of Veterans Affairs, Los Angeles, CA. Maria Claver is also with the Gerontology Program, California State University, Long Beach. Darlene Davis is with Geriatrics and Extended Care, Veterans Health Administration, Washington, DC. Aram Dobalian is also with the Division of Health Systems Management and Policy, School of Public Health, University of Memphis, Memphis, TN
| | - Maria Claver
- Tamar Wyte-Lake, Claudia Der-Martirosian, Maria Claver, and Aram Dobalian are with the Veterans Emergency Management Evaluation Center, Office of Patient Care Services, US Department of Veterans Affairs, Los Angeles, CA. Maria Claver is also with the Gerontology Program, California State University, Long Beach. Darlene Davis is with Geriatrics and Extended Care, Veterans Health Administration, Washington, DC. Aram Dobalian is also with the Division of Health Systems Management and Policy, School of Public Health, University of Memphis, Memphis, TN
| | - Claudia Der-Martirosian
- Tamar Wyte-Lake, Claudia Der-Martirosian, Maria Claver, and Aram Dobalian are with the Veterans Emergency Management Evaluation Center, Office of Patient Care Services, US Department of Veterans Affairs, Los Angeles, CA. Maria Claver is also with the Gerontology Program, California State University, Long Beach. Darlene Davis is with Geriatrics and Extended Care, Veterans Health Administration, Washington, DC. Aram Dobalian is also with the Division of Health Systems Management and Policy, School of Public Health, University of Memphis, Memphis, TN
| | - Darlene Davis
- Tamar Wyte-Lake, Claudia Der-Martirosian, Maria Claver, and Aram Dobalian are with the Veterans Emergency Management Evaluation Center, Office of Patient Care Services, US Department of Veterans Affairs, Los Angeles, CA. Maria Claver is also with the Gerontology Program, California State University, Long Beach. Darlene Davis is with Geriatrics and Extended Care, Veterans Health Administration, Washington, DC. Aram Dobalian is also with the Division of Health Systems Management and Policy, School of Public Health, University of Memphis, Memphis, TN
| | - Aram Dobalian
- Tamar Wyte-Lake, Claudia Der-Martirosian, Maria Claver, and Aram Dobalian are with the Veterans Emergency Management Evaluation Center, Office of Patient Care Services, US Department of Veterans Affairs, Los Angeles, CA. Maria Claver is also with the Gerontology Program, California State University, Long Beach. Darlene Davis is with Geriatrics and Extended Care, Veterans Health Administration, Washington, DC. Aram Dobalian is also with the Division of Health Systems Management and Policy, School of Public Health, University of Memphis, Memphis, TN
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Abstract
INTRODUCTION The Veterans Health Administration (VHA), the largest integrated healthcare delivery system in the United States, is charged with ensuring timely access to high-quality care for veterans during disasters, and supporting national, state, local, and tribal emergency management and homeland security efforts. In 2008, the VHA Office of Public Health (OPH) sponsored the first VHA Emergency Management Research Agenda-setting conference to develop research priorities that address the needs of veterans and to position VHA as a national leader in emergency management by having VHA serve as a "laboratory" for the development of evidence-based emergency management practices. METHODS We focused on four steps: #1: Appraising the emergency management research portfolio of VHA-based researchers; #2: Obtaining systematic information on VHA's role in emergency management and the healthcare needs of veterans during disasters; #3: Based upon gaps between the current research portfolio and the existing evidence base, identifying strategic priorities using a research agenda-setting conference; and #4: Laying the groundwork to foster the conduct of emergency management research within VHA. RESULTS Identified research priorities included how to prevent and treat behavioral health problems related to a disaster, the efficacy of training programs, crisis communication strategies, workforce resilience, and evacuating veterans from health care facilities. Conclusion: VHA is uniquely situated to answer research questions that cannot be readily addressed in other settings. VHA should partner with other governmental and private entities to build on existing work and establish shared research priorities.
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