Assignment: healthcare emergency management standards

Assignment: healthcare emergency management standards ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Assignment: healthcare emergency management standards I’m working on a Health & Medical question and need guidance to help me study. Assignment: healthcare emergency management standards Overview of a regulatory agency healthcare emergency management standards and/or regulations (choose one). Don’t just provide background. Be sure to take a deep dive and describe the importance of the regulatory agency and how their regulations have impacted healthcare. oCenters for Medicare & Medicaid Services (CMS) oThe Joint Commission (TJC) ( Please use normal, natural American language ) (APA Style ) the_joint_commission__tjc_.pdf tjc_accreditation_program__hospital_emergency_management.pdf centers_for_medicare___medicaid_services__cms_.pdf Health Care at the Crossroads S tr a t e g i e s f o r C r e a ti n g a n d S u st a i n i n g C o m m u n it y- w i d e E m e r g e n c y Pr e p a r e d n e ss S y st e m s Joint Commission on Accreditation of Healthcare Organizations © Copyright 2003 by the Joint Commission on Accreditation of Healthcare Organizations. All rights reserved. No part of this book may be reproduced in any form or by any means without written permission from the publisher. Request for permission to reprint: 630-792-5631. Health Care at the Crossroads Strategies for Creating and Sustaining Co m m unity-wide E m ergency Preparedness Syste ms Joint Commission on Accreditation of Healthcare Organizations Joint Commission Public Policy Initiative This white paper is the second work product of the Joint Commission’s new Public Policy Initiative. Launched in 2001, this initiative seeks to address broad issues that have the potential to seriously undermine the provision of safe, high-quality health care and, indeed, the health of the American people. These are issues which demand the attention and engagement of multiple publics if successful resolution is to be achieved. For each of the identified public policy issues, the Joint Commission already has state-of-the-art standards in place. However, simple application of these standards, and other unidimensional efforts, will leave this country far short of its health care goals and objectives. Thus, this paper does not describe new Joint Commission requirements for health care organizations, nor even suggest that new requirements will be forthcoming in the future. Rather, the Joint Commission has devised a public policy action plan that involves the gathering of information and multiple perspectives on the issue; formulation of comprehensive solutions; and assignment of accountabilities for these solutions. The execution of this plan includes the convening of roundtable discussions and national symposia, the issuance of this white paper, and active pursuit of the suggested recommendations. This paper is a call to action for those who influence, develop or carry out policies that will lead the way to resolution of the issue. This is specifically in furtherance of the Joint Commission’s stated mission to improve the safety and quality of health care provided to the public. Health Care at the Crossroads: Strategies for Creating and Sustaining Co m m unity-wide E m ergency Preparedness Syste ms Table of Contents Preamble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Part I. Enlist the Community in Preparing the Local Response . . . . . . . . . . . . . . . . . . . . . . 10 Enlisting the Community . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Forging New Partnerships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 An Exemplary Effort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Lessons Learned . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Getting There . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Part II. Focus on the Key Aspects of the Preparedness System that Will Preserve the Ability of Community Health Care Organizations to Care for Patients, Protect Staff and Serve the Public . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Define Surge Capacity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Preserve the Organization – Protect the Staff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Ensure Care for the “Other” Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Manage the Incident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Consider the Threat to Mind, as well as Body . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Assignment: healthcare emergency management standards . 28 Enlist the Public . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Identify Communication and Information Needs and Meet Them . . . . . . . . . . . . . . 31 Test, Learn, Improve and Be Ready . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Part III. Establish Accountabilities, Oversight, Leadership and Sustainment of Community Preparedness Systems . . . . . . . . . . . . . . . . . . . . . . . . . . 37 A Question of Accountability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Sustainable Funding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Guiding the Effort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Knowing What Works . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 End Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 3 Health Care at the Crossroads: Strategies for Creating and Sustaining Co m m unity-wide E m ergency Preparedness Syste ms Preamble But now, in the face of an atrophied public health infrastructure and lack of leadership and coordination among other emergency preparedness constituencies, hospitals and other health care organizations are being asked to step up their level of emergency preparedness involvement. This unfortunately is occurring at a time when many of those entities face severe resource constraints and may not always be able to manage current day-to-day patient care demands. It does not take long for complacency to settle in. Eighteen months after the September 11, 2001 attacks and the subsequent, insidious, selected and deliberate dispersion of anthrax spores, there are clear signs that the focus of American attention has long since moved on. The sense of urgency to prepare has now become a wait-and-see sense. Vigilance eventually gives way to ambiguity. Indeed, the two occasions during the past six months in which the national terrorism level has been raised to Orange (high threat) have generally provoked public mysticism as to what individuals should do to prepare. This confused state of non-readiness is what terrorists lay in wait for. And, the world in which we carry out our daily lives can change in an instant. At a recent national symposium on emergency preparedness, Jerome Hauer, acting assistant secretary of the Office of Public Health Emergency Preparedness of the Department of Health and Human Services (DHHS), remarking on the strong likelihood of another terrorist attack in the near future, said,“At the end of the day, it is medical care that will be needed.” But if medical care capacity is already in variable and sometimes scarce supply, planning for unexpected surges in demand becomes all the more critical. So, too, does funding and federal leadership for these efforts. This is not our world as we once knew it. It is no longer sufficient to develop disaster plans and dust them off if a threat appears imminent. Rather, a system of preparedness across communities must be in place everyday. Such systems make effective responses to emergencies possible, and they also serve as deterrents to actual attacks. And, they are needed – whatever the level of our sense of security – to facilitate the management of crises that seem to be becoming everyday occurrences. The purpose of this report is to frame the issues that must be addressed in developing community-wide preparedness and to delineate federal and state responsibilities for eliminating barriers, and for facilitating and sustaining — through leadership, funding and other resource deployment – community-based emergency preparedness across the United States. The concept of community-wide preparedness systems is new to most health care organizations. Assignment: healthcare emergency management standards While most have long prepared and tested disaster plans, health care organizations have operated in isolation, and their disaster plans reflect this mindset. 4 Health Care at the Crossroads: Strategies for Creating and Sustaining Co m m unity-wide E m ergency Preparedness Syste ms Introduction apparent, priority brought into sharp relief fundamental new needs for emergency preparedness that would call for leadership and coordination at the community level, which did not then, and largely does not now, exist. On the day that America experienced its worst violation at the hands of terrorists, the many “first responders” involved in rescuing, treating and protecting the thousands of people who were victimized, or had the potential to be, valiantly performed their jobs. But for many, their efforts were futile in the face of such enormous destruction. Emergency medical personnel and health care workers from nearby and far away were drawn to these scenes of destruction to lend their support and expertise. Hospitals in the vicinity of the World Trade Center, despite being overwhelmed by power outages, disabled telecommunications, and the rush of the injured and those fleeing the smoke-choked streets for shelter, were nevertheless able to summon a response. This does not gainsay the continuing extraordinary efforts of the three public safety agencies that this country has long relied on – law enforcement, fire and rescue, and emergency medical services. Nor does it ignore the sometimes heroic efforts of underfunded public health agencies and health care provider organizations in managing extremely challenging situations. But in most communities there is no team, nor teamwork, among all of these players and other municipal and county leaders. And, there is no community emergency preparedness plan, nor program, nor system. And then, while the country was still reeling from the September 11 attack, a different kind of attack, this time with a biological agent, anthrax, unfolded in Florida, New York, New Jersey,Washington D.C. and Connecticut.These disasters, wrought by terrorism, rapidly focused the nation’s attention on national security – the need to protect American ideals and resources, and most fundamentally, the very safety and health of the American people. Both for America’s leaders and for this nation’s communities, this compelling new, or newly While the cast of emergency preparedness players in a given community can lengthen rapidly, there is no denying the central role that hospitals can and must play in these efforts. However, these are difficult and occasionally overwhelming times for hospitals, even without this expanded responsibility. In fact, many hospitals are struggling to meet the daily demands for their health care services. It is no longer sufficient to develop disaster plans and dust them off if a threat appears imminent. Rather, a system of preparedness across communities must be in place everyday. 5 Health Care at the Crossroads: Strategies for Creating and Sustaining Co m m unity-wide E m ergency Preparedness Syste ms Add to this brewing cataclysm the need for “surge capacity” – the ability to care for perhaps hundreds to thousands more patients at a given time – in hospitals already full, already stressed, and already searching for more resources to provide care, and the challenge of preparedness becomes even more daunting. As a matter of public policy, this country has purposefully shrunk the installed capacity of its health care delivery system over the past two decades. This has translated into the closure of many hospitals and even more emergency departments, despite the escalating demands for services. In addition, many hospitals now are experiencing severe shortages of nurses and other essential health care personnel. Assignment: healthcare emergency management standards This is further reducing the capacity of these hospitals to deliver care, including emergency care. Today’s hard reality is that hospital emergency departments across the country are overcrowded and, even absent any external disaster, likely to be diverting patients on any given day. Since the Fall 2001 terrorism attacks, there has been a flurry of activity focused on the preparation of emergency preparedness plans.The emphasis on plans substantially understates what are really needed – emergency preparedness programs. According to a recent report,“Preparedness at home plays a critical role in combating terrorism by reducing its appeal as an effective means of warfare.”4 However, this level of preparedness implies a tightly knit system among the key emergency preparedness participants that simply does not exist in most communities today. “All emergencies are local” is a truism that conveys the responsibility of the community to plan, prepare and respond to an emergency. But as this paper points out, that truism is today far more a call to action than a reality. This paper is a call to action for federal and state governments as well, for weaving the tightly knit system of preparedness also takes resources, leadership and guidance. Adding to these problems are sky-high liability insurance premiums for physicians that are limiting the availability of critical specialists in certain jurisdictions. Further, most states in the country, with strapped budgets, are reducing the numbers of people on their Medicaid rolls.1 Medicare too is threatening more cuts in hospital reimbursement2 and the numbers of uninsured are on the rise.3 All of these factors promise to further undermine the ability of hospitals to meet the routine, let alone the extraordinary, needs of their communities. 6 Health Care at the Crossroads: Strategies for Creating and Sustaining Co m m unity-wide E m ergency Preparedness Syste ms none yet that present evidence-based models which are likely to be adaptable to the varied urban, suburban and sparsely populated communities that make up the United States. Since the events of September 11 and the subsequent anthrax attacks, the federal government has stepped forward to fund the rehabilitation of the public health system, and to a significantly lesser extent, the preparedness efforts of the nation’s hospitals. However, although the federal plan enlisted state governments to allocate federal funds to their hospitals well over a year ago, the money has not yet reached hospitals and some local public health agencies. There unfortunately is an oft-repeated refrain of money not making it from Washington to the trenches where it is needed.5 The money may eventually make it, but the funds are a small sum in comparison to what is actually needed.6 Given the urgency for community-based emergency preparedness and the obvious barriers to achieving this goal across the country, the Joint Commission convened an expert Public Policy Roundtable to discuss emergency preparedness issues and to frame specific recommendations, fulfillment of which would permit achievement of a level of preparedness that could truly offer protection and assurances to the American public. Among the specific issues addressed by the Roundtable were the resources and requirements for community-based response systems; the need for collaboration between the medical care and public health establishments, as well as other new partnerships that must be forged; issues of accountability and mechanisms for validating readiness; and the appropriate roles of federal and state governments. In addition to the disputes and confusion over meeting what remains today for many hospitals, an unfunded mandate, hospitals and their communities are struggling to know how to get started. Assignment: healthcare emergency management standards There is a fundamental need for templates or scalable models of community-wide preparedness to guide planning before, and actions taken during and after, an emergency. Several nascent templates are emerging; however, there are In addition to the disputes and confusion over meeting what remains today for many hospitals, an unfunded mandate, hospitals and their communities are struggling to know how to get started. 7 Health Care at the Crossroads: Strategies for Creating and Sustaining Co m m unity-wide E m ergency Preparedness Syste ms Based on those discussions, the following recommendations are proposed: II. Focus on the key aspects of the preparedness system that will preserve the ability of community health care resources to care for patients, protect staff and serve the public. • Prospectively define point-in-time and longitudinal surge capacity at the community level. • Establish mutual aid agreements among community hospitals and other health care organizations. • Ensure a 48-72 hour stand-alone capability through the appropriate stockpiling of necessary medications and supplies. • Fund and facilitate the creation of a credentialing database to support a national emergency volunteer system for health care professionals. • Make direct caregivers the highest priority for training and for receipt of protective equipment, vaccinations, prophylactic antibiotics, chemical antidotes, and other protective measures. • Support the provision of decontamination capabilities in each hospital. • Maintain the ability to provide routine care. • Make provision for the graceful degradation of care. • Provide for waiver of regulatory requirements under conditions of extreme emergency. I. Enlist the community in preparing the local response • Initiate and facilitate the development of community-based emergency preparedness programs across the country. • Constitute community organizations that comprise all of the key participants – as appropriate to the community – to develop the community-wide emergency preparedness program. • Encourage the transition of community health care resources from an organization-focused approach to emergency preparedness to one that encompasses the community. • Provide the community organization with necessary funding and other resources and hold it accountable for overseeing the planning, assessment and maintenance of the preparedness program. • Encourage the pursuit of substantive collaborative activities that will also serve to bridge the gap between the medical care and public health systems. • Develop and distribute emergency planning and preparedness templates for potential adaptation by various types of communities. 8 Health Care at the Crossroads: Strategies for Creating and Sustaining Co m m unity-wide E m ergency Preparedness Syste ms • Adopt incident management approaches that provide for simultaneous management involvement by multiple authorities and fluidity of authority. • Make provisions for accommodating and managing the substantial acute mental health needs of the community. • Directly address the fear created by terrorist acts through targeted education, application of risk reduction strategies and the teaching of coping skills. • Provide public education about emergency preparedness. • Actively engage the publ … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10