Develop Response Plans Research Articles

Hospital preparedness assessment for road traffic accidents with mass casualties: a cross-sectional study in Kurdistan Province, Iran

BackgroundRoad traffic accidents (RTAs) are predicted to become the world’s seventh leading cause of death by 2030. Given the significant impact of RTAs on public health, effective hospital preparedness plays a pivotal role in managing and mitigating associated health and life-threatening issues. This study aims to meticulously evaluate the preparedness of selected hospitals in western Iran to handle road traffic accidents with mass casualties (RTAs-MC).MethodsThe study employed a descriptive-analytical approach, utilizing a reliable and valid questionnaire to measure hospitals’ preparedness levels. Descriptive statistics (frequency distribution and mean) were utilized to provide an overview of the data, followed by analytical statistics (Spearman correlation test) to examine the relationship between hospital preparedness and its dimensions with the hospital profile. Data analysis, performed using SPSS software, categorized preparedness levels as weak, moderate, or high.ResultsThe study found that hospitals in Kurdistan province had a favorable preparedness level (70.30) to respond to RTAs-MC. The cooperation and coordination domain had the highest preparedness level (98.75), while the human resource management (59.44) and training and exercise (54.00) domains had the lowest preparedness levels. The analysis revealed a significant relationship between hospital preparedness and hospital profile, including factors such as hospital specialty, number of beds, ambulances, staff, and specialized personnel, such as emergency medicine specialists.ConclusionEnhancing preparedness for RTAs-MC necessitates developing response plans to improve hospital profile, considering the region’s geographic and topographic features, utilizing past experiences and lessons learned, implementing of Hospital Incident Command System (HICS), providing medical infrastructure and equipment, establishing communication channels, promoting cooperation and coordination, and creating training and exercise programs.

Background and Rationale - CDC Guidance for Communities Assessing, Investigating, and Responding to Suicide Clusters, United States, 2024.

To assist community leaders in public health, mental health, education, and other fields with developing a community response plan for suicide clusters or for situations that might develop into suicide clusters, in 1988, CDC published Recommendations for a Community Plan for the Prevention and Containment of Suicide Clusters (MMWR Suppl 1988;37[No. Suppl 6]:1-12). Since that time, the reporting and investigation of suicide cluster events has increased, and more is known about cluster risk factors, assessment, and identification. This supplement updates and expands CDC guidance for assessing, investigating, and responding to suicide clusters based on current science and public health practice. This report is the first of three in the MMWR supplement that describes an overview of suicide clusters, information about the other reports in this supplement, methods used to develop the supplement guidance, and the intended use of the supplement reports. The second report, CDC Guidance for Community Assessment and Investigation of Suspected Suicide Clusters - United States 2024, describes the potential methods, data sources and analysis that communities can use to identify and confirm suspected suicide clusters, and better understand the relevant issues. The final report, CDC Guidance for Community Response to Suicide Clusters - United States, 2024, describes how local public health and community leaders can develop a response plan for suicide clusters. The guidance in this supplement is intended as a conceptual framework that can be used by public health practitioners and state and local health departments to develop response plans for assessing and investigating suspected clusters that are tailored to the needs, resources, and cultural characteristics of their communities.

Prioritisation of quarantine pest list for the Caribbean using a multi-criteria decision approach

Quarantine plant pests are socially, economically and environmentally important due to their impact on food security, human health, global trade and crop production costs. The increase in global trade and tourism, frequent occurrence of natural disasters and climate changes have exacerbated the rate of entry, establishment and spread of plant pests regionally and globally. It has, therefore, become exigent to develop a list of pests of quarantine importance at the regional and national levels to prioritise and allocate the limited available resources to manage the associated risks. In the present study, the Technical Committee on the Formulation and Prioritisation of a Regional Priority Pest List for the Caribbean, in collaboration with the National Plant Protection Organisation of the Caribbean countries and the United States Department of Agriculture - Animal and Plant Health Inspection Service (USDA-APHIS), developed and prioritised a quarantine pest list using a multi-criteria decision-making approach. The technical committee successfully evolved the process in 2014 and 2018 and developed a list of the top 10 pests of quarantine importance for the Caribbean Region, employing the Delphi Technique (DT) and Analytical Hierarchy Process (AHP) through the assignment of criteria that are relevant to the region. The Mediterranean fruit fly (Ceratitis capitata), frosty pod rot (Moniliophthora roreri) and the tomato leaf miner (Tuta absoluta), listed as top quarantine pest threats, were subsequently detected in the region. This exercise guided the authorities in advance to allocate resources and to develop response plans including capacity building for surveillance and detection of priority pests. This has demonstrated the significance and appropriateness of the multi-criteria decision approach to determine priority pest lists and prepare the region for development of better management practices.

The COVID-19 Pandemic and Landspitali's Operating Room and Intensive Care Unit

The COVID-19 pandemic, one of the most serious public health hazards of recent times, led to a high number of hospitalisations. The pressure on intensive care units has been significant. In many countries, including Iceland, there was a need to increase the capacity of these units to meet the growing demand for intensive care spaces, especially at the start of the pandemic. At Landspitali, the National University Hospital of Iceland (hereafter referred to as Landspitali), increasing unit capacity was a large-scale and extensive project where project management methodologies were utilised to assess risks and develop response plans. Using information gathered from interviews, this study explores the experience of managers in Landspitali’s surgical and intensive care unit in preparing for the pandemic and their evaluations of the project\'s success. The interviews were conducted in the autumn of 2020 after the first wave of the pandemic had passed in Iceland. The study utilised a qualitative methodology. Eight managers from Landspitali’s surgical and intensive care unit participated in semi-structured interviews. The study employs thematic analysis to analyse the findings. The data analysis reveals four themes. The first theme, ‘dealing with the unknown’, illustrates the uncertainty that was prevalent at the beginning of the pandemic. The second, ‘one step ahead’, reveals how the managers utilised resources both within and outside the hospital to prepare the intensive care unit for COVID-19 patients. The third theme, ‘fighting the virus’, highlights the challenges the managers encountered throughout the process. Lastly, the ‘in this together’ theme focuses on how the staff came together to accomplish the project. The initial uncertainty during the preparation phase posed difficulties for the managers. Working in accordance with existing response plans and utilising the findings of the situation analysis made it possible for managers to organise how space, personnel, and supplies would be utilised and thus increase the surge capacity of the units. The respondents\' main challenges were facility adaptation and ensuring adequate staffing. Cooperation and solidarity among the staff, along with well-timed preventive measures implemented by the authorities, proved crucial to the success of Landspitali’s intensive care unit in dealing with the pandemic.

Disaster planning approaches in Iran's health system: A mixed-methods study.

Disaster planning and management pose a serious challenge to most countries. These challenges point to insufficient planning to deal with these events. Therefore, it is necessary to pay attention to the methods and characteristics of the decision-making approaches in these events. In this study, we tried to identify most appropriate approaches for the Iranian health system by studying disaster planning approaches. This study was conducted using mixed methods in 2020-2021 in two phases: qualitative and quantitative. First, we reviewed at the research literature. Our goal was to identify studies that suggested approaches to disaster planning. The next step in this study was a qualitative study using semi-structured interviews. Participants in qualitative phase included managers and employees from different parts of the Iranian health system from the provinces of Golestan, Fars, Khuzestan, Lorestan, Kerman, Sistan, and Baluchestan. By combining approaches taken from literature reviews and qualitative study, four main approaches were identified. The results of our study have shown that disaster response planning approaches include function, risk assessment, capability, and futuristic base. This study provides complete overview of disaster planning approaches that enable health professionals to use them to develop response plans. Our findings indicate that in complex and large-scale events such as floods and pandemics, it is necessary to combine the introduced methods for operational planning.

Prevalence of and risk factors for depressive and anxiety symptoms in a large sample of Chinese adolescents in the post-COVID-19 era

BackgroundDepressive and anxiety symptoms are widespread among adolescents today, creating a large social problem. However, few previous studies have addressed depression and anxiety among adolescents in Chinese cohorts. The aim of this study was to evaluate the prevalence of and risk factors for depressive and anxiety symptoms among Chinese middle school adolescent students in the post-COVID-19 era.MethodsA total of 22,380 middle school students from Jiangsu Province were surveyed online, and their general demographic data were collected. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms, and the seven-item Generalized Anxiety Disorder (GAD-7) scale was used to measure anxiety symptoms.ResultsOf these participants (aged 12–17 years), 25.6% had depressive symptoms, 26.9% had anxiety symptoms, and 20.6% had a combination of depression and anxiety symptoms. The prevalence of depressive symptoms was higher in female adolescents (27.6%) than in male adolescents (23.7%; χ2 = 45.479, P = 0.000), and the proportion with anxiety symptoms was higher among female adolescents (28.6%) than among male adolescents (25.4%; χ2 = 29.390, P = 0.000). Furthermore, binary logistic regression analysis showed that gender, region, and parental relationship were significantly associated with depressive symptoms among adolescents, while age, gender, region, and parental relationship were significantly associated with anxiety symptoms.ConclusionsOur findings demonstrated that the prevalence of reported depressive and anxiety symptoms in Chinese adolescents are high. Female gender, urban region, and poor parental relationship may be risk factors for depressive and anxiety symptoms. Furthermore, policy makers, schools, and families need to pay more attention to the psychological health of adolescents, develop response plans and take early intervention measures to reduce the prevalence of adolescent depression and anxiety.

Oil Spill Modeling to Develop Response Plans for Guyana

Oil Spill Modeling to Develop Response Plans for Guyana

Preventing the Spread: A Comprehensive Cancer Center's Journey to Prevent the Spread of Coronavirus Disease (Covid-19) During the 2020 Pandemic.

Background:On March 11, 2020, the World Health Organization (WHO) declared Coronavirus Disease (COVID-19) a pandemic. Hospitals around the world began to implement infection prevention and control (IPC) measures to stop further spread and prevent infections within their facilities. Healthcare organizations were challenged to develop response plans, procure personal protective equipment (PPE) that was in limited supply while continuing to provide quality, safe care.Methods:As a comprehensive cancer center with immunocompromised patients, our efforts began immediately. Preventative measures were established and, as of September 2020, over 14,000 patients have been tested within the facility. From March 2020 through September 2020, only one case of hospital acquired (HA) COVID-19 was identified among our patients. Two cases of suspected community acquired (SCA) cases were also identified. Following the Centers for Disease Control (CDC) guidance, IPC measures were implemented within the facility as information science about the virus developed. This article addresses the IPC measures taken, such as enhancing isolation precautions, implementing screening protocols, disinfecting and reusing N95 respirators, by the center throughout the pandemic as well as the challenges that arouse with a new and emerging infectious disease.Conclusions:The infection control measures implemented at our comprehensive cancer center during the COVID-19 pandemic allowed our center to continue to provide world class cancer care with minimal COVID-19 infection transmission among patients and team members.

The Coronavirus Pandemic: Experience From a Rural West Virginia Tertiary Care Hospital

The coronavirus epidemic has taken the world by storm and has overwhelmed health systems in a number of first world countries. As a consequence, individual communities in the United States and the world have had to develop response plans to meet this extreme challenge. In these circumstances and in an effort to best prepare for the community's needs, it becomes necessary to critically analyze the specific and unique aspects of individual regions, their population characteristics and demographics, and the geography of the area. Once assessed, these data may be applied to formulating best practices for a given community and resource pool. The following manuscript describes how this challenge was met in a large tertiary care teaching hospital located in rural West Virginia.

Species prioritization index for oiled wildlife response planning in New Zealand.

Birds are extremely vulnerable to the effects of oil pollution. For wildlife, prevention of oiling is the best response option, however if not feasible, the fastest response gives the highest chance of survival. Therefore, the development of an oiled wildlife preparedness plan based on analysis of areas at risk, vulnerable species and potential response options is critical. This research developed an area based, species priority index (SPI) for New Zealand birds to guide oiled wildlife planning. The SPI shows significant areas of New Zealand's shoreline and offshore islands have many highly vulnerable species that need careful consideration given restricted response options available. Identification of these areas and species allows priority planning for placement of personal and equipment. This SPI can be adapted for other species (marine mammals and reptiles) and for other geographical areas to help develop response plans for oil pollution and oiled wildlife response worldwide.

Insights from the fifth International One Health Congress, 2018, Saskatoon, Canada.

The recent outbreaks of diseases including Ebola reemergence in the Democratic Republic of Congo (DRC), Nipah virus outbreak in India, Lassa virus in Nigeria and the continued Influenza pandemic show that we cannot predict outbreaks, however, developing response plans could help alleviate the burden of diseases. Developing response plans involves strategies such as creating a repository of microbial agents as well as the implementation of the plans. In addition, zoonotic experts and policy makers should work together in order to succeed in fighting against any disease outbreaks. We should also not forget about the importance of vaccination because of the benefits it has brought to humankind preventing disease occurrence. Furthermore, the challenges that come with vaccination including vaccine delivery and vaccine uptake need to be overcome to make sure that this public health tool continues to be effective. Overcoming these vaccination challenges would play a significant role in decreasing the overuse of antimicrobials, hence avoiding resistance. The One Health Community (OHC) therefore has the responsibility to advocate for the use of vaccines and show that it has costs benefits; this strategy has the potential to fight against antimicrobial resistance.

Risk communication during disease outbreak response in post-Ebola Liberia: experiences in Sinoe and Grand Kru counties.

IntroductionLessons learned from the Ebola virus disease (EVD) outbreak enabled Liberia to develop a health plan for strengthening public health capacity against potential public health threats. risk communication is one of the core pillars that provide life-saving information and knowledge for the public to take preventive and proactive actions against public health threats. These were applied in response to the post-ebola meningococcal septicemia and meningitis outbreaks in Sinoe and Grand Kru counties. This paper documents risk communication experiences in these post-ebola outbreaks in Liberia.MethodsRisk Communication and health promotion strategies were deployed in developing response plans and promptly disseminating key messages to affected communities to mitigate the risks. Other strategies included engagement of community leaders, partnership with the media and dissemination of messages through the community radios, active monitoring community risk perceptions and compliance, rumor management, mobile stage and interpersonal communication (IPC) during the Meningococcal disease outbreaks in Sinoe and Grand Kru counties.ResultsIn Sinoe, about 36,891 households or families in 10 health districts were reached through IPC and dialogue. Circulating rumors such as “Ebola” was the cause of deaths was timely and promptly mitigated. There was increased trust and adherence to health advice including prompt reporting of sick people to the nearest health facility in the two counties.ConclusionRisk communication and health promotion encouraged community support and involvement in any response to public threats and events. No doubt, risk communication and health promotion play an important role in preparedness and response to public health emergencies.

Metro disruption management: Optimal initiation time of substitute bus services under uncertain system recovery time

Determining the initiation time of substitute bus (SB) services is critical for metro disruption management, especially under uncertain recovery time. This study develops a mathematical formulation to determine the optimal initiation time (OIT) of SB services by trading-off their initiation cost and passenger delay cost, thereby minimizing the total system cost. Given the probability distribution of metro disruption duration, we determine the OIT by formulating an optimization problem to minimize the expected total system cost. We then conduct sensitivity analyses of the initiation cost of SB services, passenger value of time, and SB services rate. The results show that SB services ought to be activated only if the metro incident lasts longer than a certain time interval, depending on the factors mentioned earlier, and the OIT should advance with the predicted incident duration. This paper derives analytical results for the case of linear passenger arrival, and determines the results numerically for the case of non-linear passenger arrival when analytical closed-form solutions are not available. The findings will facilitate transit operators to develop response plans in the aftermath of a metro disruption.

Crisis communications management on digital platforms

Trust, loyalty and brand image are challenging and precious commodities for companies to earn. A controversy, crisis or misunderstanding played out in public can cripple an organisation. Managing a crisis is not easy, and the way a crisis is handled can make or break a company’s reputation. Companies that are proactive in crisis management — that train a crisis management team and develop response plans before they are ever needed — are more likely to minimise damage and maintain good standing. By following certain pre-crisis, mid-crisis and post-crisis recommendations, organisations can take back control of the conversation surrounding their brands and navigate the crisis more effectively. This paper discusses how a company must be ready to respond to crises.

The Gillette Stadium Experience: A Retrospective Review of Mass Gathering Events From 2010 to 2015.

Mass gathering events can substantially impact public safety. Analyzing patient presentation and transport rates at various mass gathering events can help inform staffing models and improve preparedness. A retrospective review of all patients seeking medical attention across a variety of event types at a single venue with a capacity of 68,756 from January 2010 through September 2015. We examined 232 events with a total of 8,260,349 attendees generating 8157 medical contacts. Rates were 10 presentations and 1.6 transports per 10,000 attendees with a non-significant trend towards increased rates in postseason National Football League games. Concerts had significantly higher rates of presentation and transport than all other event types. Presenting concern varied significantly by event type and gender, and transport rate increased predictably with age. For cold weather events, transport rates increased at colder temperatures. Overall, on-site physicians did not impact rates. At a single venue hosting a variety of events across a 6-year period, we demonstrated significant variations in presentation and transport rates. Weather, gender, event type, and age all play important roles. Our analysis, while representative only of our specific venue, may be useful in developing response plans and staffing models for similar mass gathering venues. (Disaster Med Public Health Preparedness. 2018;12:752-758).

Exposure to weather risk: a new information paradigm

When forecasting the weather, simple outcome statements do not always adequately describe what could eventuate for a particular location. Importantly, some weather situations are finely balanced, and cannot be forecast five days in advance; sometimes forecasting 24 hours ahead is difficult, particularly if tropical cyclones are present. To address these weather forecasting complexities, the Bureau of Meteorology is moving towards providing more probability based guidance, such as more information on potential rainfall ranges, wind speed probabilities, wave height probabilities, tropical cyclone formation risk and potential tropical cyclone tracks. For response planning purposes these changes will bring their own challenges. For example, previous chances of a tropical cyclone impact have been described with yes or no forecasts. In the future these risks could be described in percentages. Responding to a 5% risk suggests that 19 out of 20 responses could be perceived to be unnecessary, while on the other hand not responding to a 5% risk could be assessed as dangerous. Developing these new information types is only part of the process. To achieve better practice, it will also be critical to create presentation strategies that express the content in a usable manner, work with clients so they gain maximum benefit from the guidance, and enable clients to develop response plans that are aligned with the forecasts. The Bureau of Meteorology is seeking to work in a closer partnership with the resource sector on this to help maximise operational efficiencies, while ensuring a safe working environment.

Are we prepared for Ebola and other viral haemorrhagic fevers?

Are we prepared for Ebola and other viral haemorrhagic fevers?

Implementation and modeling of a Regional Hub Reception Center during mass evacuation operations.

When developing response plans in the aftermath of a catastrophic incident, jurisdictions often fail to conduct the necessary interdisciplinary planning needed to fully address the needs across jurisdictional borders. The Purdue Homeland Security Institute (PHSI) was selected by the City of Chicago Office of Emergency Management and Communications (OEMC) in 2010 to lead an effort to address planning across jurisdictional borders during mass evacuations following a catastrophic incident. Specifically, PHSI was chosen to lead the effort in developing a planning and implementation guide for standing up a conceptual Regional Hub Reception Center (RHRC). A major component within the mass evacuation and sheltering continuum, the RHRC is designed to provide evacuees with quickresponse mass care and emergency assistance while their other needs are assessed and appropriate shelter locations are identified. The RHRC also provides a central location to leverage governmental, nongovernmental, and private sector resources and is the first point in the evacuation, mass care, and sheltering concept of operations where more comprehensive support (food, shelter, medical, psychological, household pet sheltering, reunification, etc) can be expected. PHSI undertook this lead role working within the Illinois-Indiana-Wisconsin (IL-IN-WI) Combined Statistical Area (CSA) as part of the US Department of Homeland Security Regional Catastrophic Planning Grant Program. Coordinating closely with the City of Chicago OEMC and IL-IN-WI CSA Regional Catastrophic Planning Team, PHSI lead the research effort using resource and capability data compiled from all 17 jurisdictions within the IL-IN-WI CSA and validated the RHRC concept using three tabletop exercises. Upon completion, the PHSI team published the RHRC planning guide complete with procedures and processes that define the roles and responsibilities of government, nongovernment organizations, and private sector for providing RHRC mass care functions and RHRC capability and capacity assessments. This article further examines the potential for using simulation modeling as a cost-effective means to rapidly evaluate any facility for potential use as a RHRC and to measure and maximize RHRC operational efficiency. Using AnyLogic simulation software, PHSI developed a first-ever model of a theoretical RHRC capable of simulating, measuring, and manipulating RHRC operations under specified conditions/scenarios determined by the emergency management planner. Future simulation modeling research promises to promote the Whole Community Approach to response and recovery by reinforcing interdisciplinary planning, enhancing regional situational awareness, and improving overall jurisdictional coordination and synchronization.

A Framework for Responding to Coral Disease Outbreaks that Facilitates Adaptive Management

Predicted increases in coral disease outbreaks associated with climate change have implications for coral reef ecosystems and the people and industries that depend on them. It is critical that coral reef managers understand these implications and have the ability to assess and reduce risk, detect and contain outbreaks, and monitor and minimise impacts. Here, we present a coral disease response framework that has four core components: (1) an early warning system, (2) a tiered impact assessment program, (3) scaled management actions and (4) a communication plan. The early warning system combines predictive tools that monitor the risk of outbreaks of temperature-dependent coral diseases with in situ observations provided by a network of observers who regularly report on coral health and reef state. Verified reports of an increase in disease prevalence trigger a tiered response of more detailed impact assessment, targeted research and/or management actions. The response is scaled to the risk posed by the outbreak, which is a function of the severity and spatial extent of the impacts. We review potential management actions to mitigate coral disease impacts and facilitate recovery, considering emerging strategies unique to coral disease and more established strategies to support reef resilience. We also describe approaches to communicating about coral disease outbreaks that will address common misperceptions and raise awareness of the coral disease threat. By adopting this framework, managers and researchers can establish a community of practice and can develop response plans for the management of coral disease outbreaks based on local needs. The collaborations between managers and researchers we suggest will enable adaptive management of disease impacts following evaluating the cost-effectiveness of emerging response actions and incrementally improving our understanding of outbreak causation.

Views of GPs and practice nurses on support needed to respond to pandemic influenza: a qualitative study

Five years ago Australia, and the world, placed itself on heightened alert for pandemic influenza, based on concerns about the potential spread of the avian influenza virus. This prompted a flurry of preparation activity involving general practice, with information from various sources; government, colleges and divisions of general practice. To assess how general practitioners and practice nurses perceive this information, practice nurses and general practitioners were interviewed as part of a larger project exploring the role of the Australian general practice sector in an influenza pandemic. Results were validated by two focus groups and scenario sessions. Participants perceived that non-government organisations rarely gave useful information during a pandemic outbreak. Local divisions were perceived as having a practical and useful role, providing hands-on support to practices during a pandemic outbreak. Our participants did not perceive any coordination in the delivery of information sent by all the organisations involved in a pandemic response and therefore rejected our second hypothesis. More planning needs to go into the coordinated response of the general practice sector to a pandemic, and such a response should include the support of local Divisions, both as a conduit for information and to assist practices to develop response plans.