Workforce preparedness for disasters: perceptions of clinical and non-clinical staff at the U.S. Department of Veterans Affairs

Aram Dobalian,Claudia Der-Martirosian,Michelle D Balut

doi:10.1186/s12889-020-09597-2

Abstract

BackgroundMost U.S. studies on workforce preparedness have a narrow scope, focusing primarily on perceptions of clinical staff in a single hospital and for one type of disaster. In contrast, this study compares the perceptions of workplace disaster preparedness among both clinical and non-clinical staff at all U.S. Department of Veterans Affairs (VA) medical facilities nationwide for three types of disasters (natural, epidemic/pandemic, and manmade).MethodsThe VA Preparedness Survey used a stratified simple random, web-based survey (fielded from October through December 2018) of all employees at VA medical facilities. We conducted bivariate and multivariate logistic regression analyses to compare the sociodemographic characteristics and perceptions of disaster preparedness between clinical and non-clinical VA staff.ResultsThe study population included 4026 VA employees (2488 clinicians and 1538 non-clinicians). Overall, VA staff were less confident in their medical facility’s ability to respond to epidemic/pandemics and manmade disasters. Depending on the type of disaster, clinical staff, compared to non-clinical staff, were less likely to be confident in their VA medical facility’s ability to respond to natural disasters (OR:0.78, 95% CI:0.67–0.93, p < 0.01), pandemics (OR:0.82, 95% CI:0.70–0.96, p < 0.05), and manmade disasters (OR: 0.74, 95% CI: 0.63–0.86, p < 0.001). On the other hand, clinicians, compared to non-clinicians, were 1.45 to 1.78 more likely to perceive their role in disaster response to be important (natural OR:1.57, 95% CI:1.32–1.87; pandemic OR:1.78, 95% CI:1.51–2.10; manmade: OR:1.45; 95% CI: 1.23–1.71; p’s < 0.001), and 1.27 to 1.29 more likely to want additional trainings to prepare for all three types of disasters (natural OR:1.29, 95% CI:1.10–1.51; pandemic OR:1.27, 95% CI:1.08–1.49; manmade OR:1.29; 95% CI:1.09–1.52; p’s < 0.01). Clinicians were more likely to be women, younger, and more educated (p’s < 0.001) than non-clinicians. Compared to clinicians, non-clinical staff had been employed longer with the VA (p < 0.025) and were more likely to have served in the U.S. Armed Forces (p < 0.001).ConclusionsThese findings suggest both a desire and a need for additional training, particularly for clinicians, and with a focus on epidemics/pandemics and manmade disasters. Training programs should underscore the importance of non-clinical roles when responding to disasters.

Highlights

Most U.S studies on workforce preparedness have a narrow scope, focusing primarily on perceptions of clinical staff in a single hospital and for one type of disaster
Some studies have found that healthcare workers are more willing to respond to natural disasters and mass casualty events, but less likely to respond to infectious outbreaks or epidemics and radiological or chemical events [12,13,14, 20,21,22]
The results indicate that, compared to clinicians, nonclinicians were more likely to be men (68.2% vs. 57%, p < 0.0001), slightly older (45 and older: 76.1% vs. 69.1%, p < 0.0001), less likely to have a graduate degree (26.8% vs. 39.1%, p < 0.0001), more likely to be employed at the Veterans Affairs (VA) for a longer period of time (10+ years: 40% vs. 35.5%, p < 0.05), and more likely to have served in the U.S Armed Forces (47.4% vs. 26.8%, p < 0.0001)

Summary

Introduction

Most U.S studies on workforce preparedness have a narrow scope, focusing primarily on perceptions of clinical staff in a single hospital and for one type of disaster. Many healthcare workers, including those who directly or indirectly deliver care and services to patients [1], report that they often feel unprepared to effectively respond to major disasters [2,3,4,5,6,7,8,9,10]. Most U.S studies on workforce preparedness, have a narrow scope, focusing on perceptions of clinical staff in a single hospital. Most existing studies examine one type of a disaster event. These limitations may hamper efforts to effectively plan for different types of hazards

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