Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-25T20:12:04.044Z Has data issue: false hasContentIssue false

Using Functional Needs and Personal Care Assistance Rather Than Disability Status During Chronic Care Triage in Community Mass Care

Published online by Cambridge University Press:  25 March 2015

Athena Fannin*
Affiliation:
Boonshoft School of Medicine, Wright State University, Dayton, Ohio
Donald E. Brannen
Affiliation:
Greene County Combined Health District, Xenia, Ohio
Melissa Howell
Affiliation:
Greene County Combined Health District, Xenia, Ohio
Shari Martin
Affiliation:
Greene County Combined Health District, Xenia, Ohio
*
Correspondence and reprint requests to Athena Fannin, MPH, PO Box 224, Yellow Springs, OH 45387 (e-mail: [email protected]).

Abstract

Objective

To evaluate Medical Reserve Corps volunteers and public health workers in conducting chronic care triage by use of a rubric prior to sheltering to connect survivors with services.

Methods

Participants were randomly assigned to 1 of 3 algorithms or a control group during a simulated disaster scenario and were asked to rate 20 survivors arriving at a chronic care triage station with situation-appropriate transport services. Survivors were simulated on the basis of the expected disability distributions of mobility, sensory-visual, cognition, medical devices, capacity to perform activities of daily living (ADLs), age (18 to 90 years), weight, and gender expected in the general population but expanded to 90% of those presenting. Mean percentage correct scores were assessed by using one-way analysis of variance.

Results

Accounting for personal care assistance and service methodology during chronic care triage increased efficiency by up to 8% in meeting chronic care health service needs during disaster community mass care management.

Conclusions

A chronic care triage process as part of community mass care management that considers the availability of personal care assistance and service methodology will enhance the allocation of functional needs support services and increase compliance with Americans with Disabilities Act requirements regarding not segregating persons because of disability. (Disaster Med Public Health Preparedness. 2015;9:265-274)

Type
Original Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Caring for Special Needs During Disasters: What’s Being Done for Vulnerable Populations? Hearing Before the Subcommittee on Emergency Communications, Preparedness, and Response of the Committee on Homeland Security House of Representatives. 2010; 111th Cong. Second Session. Serial No. 111-69. http://www.gpo.gov/fdsys/pkg/CHRG-111hhrg63092/pdf/CHRG-111hhrg63092.pdf. Accessed July 2013.Google Scholar
2. Federal Emergency Management Agency. Guidance on Planning for Integration of Functional Needs Support Services in General Population Shelters. http://www.fema.gov/pdf/about/odic/fnss_guidance.pdf. Published November 2010. Accessed July 2013.Google Scholar
3. Sherry, N, Harkins, A. Leveling the emergency preparedness playing field. J Emerg Manage. 2011;9(6):11-16. http://www.mdchhs.com/wp-content/uploads/JEM-9-6-01-CHHS.pdf. Accessed July 2013.Google Scholar
4. American with Disabilities Act of 1990, as Amended. 42 USC §12101-12213 (2008). http://www.ada.gov/pubs/adastatute08.htm. Accessed July 2013.Google Scholar
5. Department of Homeland Security. Emergency Support Function #6. National Response Framework. http://www.fema.gov/media-library-data/20130726-1913-25045-4194/final_esf_6_mass_care_20130501.pdf. Published May 2013. Accessed June 2, 2014.Google Scholar
6. Communities Actively Living Independently and Free, et al. v. City of Los Angeles and County of Los Angeles. Case No. CV 09-0287 CMB (RZx). 2010. http://www.ada.gov/briefs/calif_interest_br.pdf. Accessed July 2013.Google Scholar
7. DeMarsh, S. Emergency shelters, ADA, and FNSS compliance. Presentation by County Attorney of Sarasota County, Florida. 2012. http://www.fl-counties.com/docs/faca/emergency-shelters-ada-and-fnss-compliancepp.pdf?sfvrsn=2. Presented August 29, 2012. Accessed July 2013.Google Scholar
8. Hultman, NE, Bozmoski, AS. The changing face of normal disaster: risk, resilience, and natural security in a changing climate. J Int Aff. 2006;59:25-41.Google Scholar
9. Saliba, D, Buchanan, J, Kington, RS. Function and response of nursing facilities during community disaster. Am J Public Health. 2004;94(8):1436-1441.Google Scholar
10. US Department of Homeland Security. Nationwide Plan Review: Phase 2 Report. http://www.in.gov/ipsc/files/Prep_NationwidePlanReview.pdf. Published June 16, 2006. Accessed July 2013.Google Scholar
11. Mont, D. Measuring disability prevalence. Social Protection Discussion. Paper no. 0706. The World Bank. http://siteresources.worldbank.org/SOCIALPROTECTION/Resources/SP-Discussion-papers/Disability-DP/0706.pdf. Published March 2007. Accessed July 2013.Google Scholar
12. World Health Organization. Measuring health and disability: Manual for WHO disability assessment schedule, WHODAS 2.0. 2012. http://books.google.com/books?id=h9fhLNiaRTgC&printsec=frontcover#v=onepage&q&f=false. Accessed July 2013.Google Scholar
13. Saez, A. The Implications of FEMA’s Functional Needs Support Services Guidelines on the City of Orlando’s Office of Emergency Management. http://www.usfa.fema.gov/pdf/efop/efo46193.pdf. Published December 1, 2011. Accessed July 2104.Google Scholar
14. Bisin, A, Verdier, T. Cultural Transmission. In: Durlauf SN, Blume LE, eds. The New Palgrave Dictionary of Economics, 2nd ed. Palgrave Macmillan; 2005. http://www.nyu.edu/econ/user/bisina/Palgrave_culturaltransmission2.pdf. Accessed July 2013.Google Scholar
15. Osterman, K, Kottkamp, R. Reflective Practice for Educators. Newbury Park, CA: Corwin Press; 1993. http://www.fgse.nova.edu/edl/secure/mats/rdgelach2.pdf. Accessed July 2013.Google Scholar
16. Fannin, AK. Knowledge, Training and Experience of Emergency Responders in the Context of Functional Needs in General Shelters. Master of Public Health Program Student Publications. Core Scholar. http://corescholar.libraries.wright.edu/mph/115. Published Fall 2013. Accessed June 2, 2014.Google Scholar
17. Nelson, A, Baptiste, AS. Evidence-based practices for safe patient handling and movement. Online J Issues Nurs. 2004;9(3):4.CrossRefGoogle ScholarPubMed
18. Hirschfeld, S, Moore, T. Triage, evaluation, and care of special needs-vulnerable populations: Putting it all together. Presented at: Integrated Medical, Public Health, Preparedness, and Response Training Summit; 2012; Nashville, Tennessee. http://www.integratedtrainingsummit.org/presentations/2012/main_training_summit/34-triage_evaluation_and_care_of_special_needs-vulnerable_populations-putting_it_all_together.pdf. Accessed July, 2013.Google Scholar
19. IBM SPSS [computer program]. IBM SPSS Statistics 20. Release 20.0.0.0 64-bit edition. Somers, NY: IBM Corporation, Software Group.Google Scholar
20. Stemler, S, Tsai, J. Best Practices in Interrater Reliability. In: Osborne J, ed. Best Practices in Quantitative Methods. California: Sage Publications; 2008:38-42.Google Scholar
21. Mills, MA, Edmondson, D, Park, CL. Trauma and stress response among Hurricane Katrina evacuees. Am J Public Health. 2007;97(suppl 1):S116-S123. Epub 2007 Apr 5. http://www.ncbi.nlm.nih.gov/pubmed/17413068. Accessed June 2, 2014.CrossRefGoogle ScholarPubMed
22. Jonkman, S, Maaskant, B, Boyd, E, Levitan, ML. Loss of life caused by the flooding of New Orleans after Hurricane Katrina: Analysis of the relationship between flood characteristics and mortality. Risk Analysis. 2009;29(5):676-698. [first published online January 31, 2009] doi: 10.1111/j.1539-6924.2008.01190.x. http://onlinelibrary.wiley.com/doi/10.1111/j.1539-6924.2008.01190.x/full. Accessed June 2, 2014.CrossRefGoogle ScholarPubMed
23. Greenough, PG, Lappi, MD, Hsu, EB, et al. Burden of disease and health status among Hurricane Katrina–displaced persons in shelters: a population-based cluster sample. Ann Emerg Med. 2008;51(4):426-432 http://www.sciencedirect.com/science/article/pii/S0196064407004490. Accessed June 2, 2014.Google Scholar
24. Brannen, DE, Barcus, R, McDonnell, MA, et al. Mental health triage tools for medically cleared disaster survivors: an evaluation by MRC volunteers and public health workers. Disaster Med Public Health Prep. 2013;7(1):20-28.Google Scholar
25. Federal Emergency Management Agency. No Discrimination in FEMA Disaster Assistance. News Release. No. 066. FEMA Press Office. http://www.fema.gov/news-release/2013/01/18/no-discrimination-fema-disaster-assistance. Published January 18, 2013. Accessed June 2, 2014.Google Scholar
26. Tavakol, M, Dennick, R. Making sense of Cronbach’s alpha. Int J Med Educ. 2011;2:53-55. doi: 10.5116/ijme.4dfb.8dfd53. http://www.ijme.net/archive/2/cronbachs-alpha.pdf. Accessed June 2, 2014.Google Scholar
27. Barrett, P. Assessing the reliability of rating data. Revised March 2001. http://www.pbarrett.net/presentations/rater.pdf. Accessed June 2, 2014.Google Scholar
28. Bland, JM, Altman, DG. Statistics notes: Cronbach’s alpha. BMJ. 1997;314:572 doi: http://dx.doi.org/10.1136/bmj.314.7080.572 [published online February 22, 1997). http://www.bmj.com/content/314/7080/572. Accessed June 2, 2014.Google Scholar
29. Rhode Island Medical Reserve Corps. Assessment and Identification of Medical/Functional Dependencies of Shelter Residents. [Powerpoint training with videos]. NIH MRC listserv. July 2014.Google Scholar
30. Springer, JD. A Cot-to-cot model for meeting client needs. University of Minnesota, School of Nursing Doctor of Nursing Practice, Leadership Project, August 2012.Google Scholar