Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-29T13:33:15.008Z Has data issue: false hasContentIssue false
  • English
  • Français

Physician Emergency Preparedness: A National Poll of Physicians

Published online by Cambridge University Press:  06 November 2015

Gillian K. SteelFisher ,
Robert J. Blendon ,
Amanda S. Brulé ,
Keri M. Lubell ,
Loretta Jackson Brown ,
Dahna Batts  and
Eran Ben-Porath
Gillian K. SteelFisher*
Affiliation:
Harvard T. H. Chan School of Public Health, Boston, Massachusetts
Robert J. Blendon
Affiliation:
Harvard T. H. Chan School of Public Health, Boston, Massachusetts John F. Kennedy School of Government, Cambridge, Massachusetts
Amanda S. Brulé
Affiliation:
Harvard T. H. Chan School of Public Health, Boston, Massachusetts
Keri M. Lubell
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Loretta Jackson Brown
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Dahna Batts
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Eran Ben-Porath
Affiliation:
SSRS, Media, Pennsylvania
*
Correspondence and reprint requests to Gillian K. SteelFisher, PhD, MSc, Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, 4th Floor, Boston, MA 02115 (e-mail: [email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To provide a more comprehensive view than previously available of US physician preparedness for public health emergencies, this study examined physicians’ assessments of their preparedness, training, participation in institutional activities, information practices, and experiences with patient education. Four kinds of public health emergencies were considered: natural disasters, major airborne infections, major foodborne illness outbreaks, and chemical, biological, radiological, nuclear, or explosives (CBRNE) incidents.

Methods

Between October 19, 2011, and January 11, 2012, researchers conducted a national poll among 1603 practicing physicians in a range of specialties in hospital and nonhospital settings.

Results

More than one-half of physicians felt prepared to handle a natural disaster, a major outbreak of an airborne infection, or a major foodborne illness outbreak, whereas one-third (34%) felt prepared to handle a CBRNE incident. About one-half of physicians (55%) had participated in training or a conference related to emergencies in the past 2 years. Sizable fractions of physicians were unaware of emergency response tools in their care setting. For example, nearly one-half in hospitals (44%) did not know whether their care setting had an emergency response plan, and less than one-quarter had participated in a drill using such a plan in the past 2 years. Less than one-third (31%) of physicians had signed up to receive alerts in the case of future emergencies. One in 10 reported sharing emergency information with patients at least “sometimes.”

Conclusions

Significant gaps remain in physician preparedness for public health emergencies, as well as in related training and participation in institutional activities. New efforts, with a focus on possible collaborations between public health institutions and health system leaders combined with effective use of online resources, are needed to bring more physicians on board and to develop relevant and useful key tools. New approaches, including those that rely on different types of care providers, may be needed to enhance patient education regarding emergency preparedness. (Disaster Med Public Health Preparedness. 2015;9:666–680)

Keywords

emergency preparednessdisastersfood safetychemical hazard releasebioterrorism
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 9 , Issue 6 , December 2015 , pp. 666 - 680
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. Bernstein, N, Hartocollis, A. Bellevue hospital evacuates patients after backup power fails. The New York Times. Nov 1, 2012:A26.Google Scholar
2. Hartocollis, A. With some hospitals closed after hurricane, E.R.’s at others overflow. The New York Times. Dec 4, 2012:A24.Google Scholar
3. Ofri, D. The storm and the aftermath. N Engl J Med. 2012;367(24):2265-2267.Google Scholar
4. Redlener, I, Reilly, MJ. Lessons from Sandy--preparing health systems for future disasters. N Engl J Med. 2012;367(24):2269-2277.CrossRefGoogle ScholarPubMed
5. American College of Physicians. The Health Care Response to Pandemic Influenza. Ann Intern Med. 2006;145(2):135-137.Google Scholar
6. Barbera, JA, Yeatts, DJ, Macintyre, AG. Challenge of hospital emergency preparedness: analysis and recommendations. Disaster Med Public Health Prep. 2009;3(2 suppl):S74-S82.Google Scholar
7. Hodge, JG Jr, Anderson, ED, Kirsch, TD, et al. Facilitating hospital emergency preparedness: introduction of a model memorandum of understanding. Disaster Med Public Health Prep. 2011;5(1):54-61.Google Scholar
8. Morton, MJ, Hsu, EB, Shah, SH, et al. Pandemic influenza and major disease outbreak preparedness in US emergency departments: a selected survey of emergency health professionals. Am J Disaster Med. 2011;6(3):187-195.Google Scholar
9. Sexton, KH, Alperin, LM, Stobo, JD. Lessons from Hurricane Rita: the University of Texas Medical Branch Hospital’s evacuation. Acad Med. 2007;82(8):792-796.Google Scholar
10. Alexander, GC, Wynia, MK. Ready and willing? Physicians’ sense of preparedness for bioterrorism. Health Aff (Millwood). 2003;22(5):189-197.CrossRefGoogle ScholarPubMed
11. Chen, FM, Hickner, J, Fink, KS, et al. On the front lines: family physicians’ preparedness for bioterrorism. J Fam Pract. 2002;51(9):745-750.Google Scholar
12. Hsu, CE, Mas, FS, Jacobson, HE, et al. Public health preparedness of health providers: meeting the needs of diverse, rural communities. J Natl Med Assoc. 2006;98(11):1784-1791.Google Scholar
13. Kat, AR, Nekorchuk, DM, Holk, PS, et al. Hawaii Physician and Nurse Bioterrorism Preparedness Study. Prehosp Disaster Med. 2006;21(6):404-413.Google Scholar
14. Sheikh, S, McCormick, LC, Pevear, J, et al. Radiological preparedness-awareness and attitudes: a cross-sectional survey of emergency medicine residents and physicians at three academic institutions in the United States. Clin Toxicol (Phila). 2012;50(1):34-38.Google Scholar
15. Spranger, CB, Kazda, MJ, Harris, AM, et al. Assessment of physician preparedness and response capacity to bioterrorism or other public health emergency events in a major metropolitan area. Disaster Manag Response. 2007;5(3):82-86.Google Scholar
16. Alexander, GC, Larkin, GL, Wynia, MK. Physicians’ preparedness for bioterrorism and other public health priorities. Acad Emerg Med. 2006;13(11):1238-1241.Google Scholar
17. Niska, RW, Burt, CW. National Ambulatory Medical Care Survey: terrorism preparedness among office-based physicians, United States, 2003-2004. Adv Data. 2007;390:1-10.Google Scholar
18. McInerney, JE, Richter, A. Strengthening hospital preparedness for chemical, biological, radiological, nuclear, and explosive events: clinicians’ opinions regarding physician/physician assistant response and training. Am J Disaster Med. 2011;6(2):73-87.Google Scholar
19. The National Library of Medicine website. http://www.PubMed.gov. Accessed June 12, 2013.Google Scholar
20. Academic Search Premier website. http://www.ebscohost.com/academic/academic-search-premier. Accessed June 12, 2013.Google Scholar
21. M’ikanatha, NM, Lautenbach, E, Kunselman, AR, et al. Sources of bioterrorism information among emergency physicians during the 2001 anthrax outbreak. Biosecur Bioterror. 2003;1(4):259-265.Google Scholar
22. Olympia, RP, Rivera, R, Heverley, S, et al. Natural disasters and mass-casualty events affecting children and families: a description of emergency preparedness and the role of the primary care physician. Clin Pediatr (Phila). 2010;49(7):686-698.Google Scholar
23. Steelfisher, GK, Blendon, RJ, Sussman, T, et al. Physicians’ views of the Massachusetts Health Care Reform Law--a poll. N Engl J Med. 2009;361(19):e39.Google Scholar
24. Response Rate Calculator V3.1. American Association of Public Opinion Research (AAPOR) website. http://www.aapor.org/Standard_Definitions2.htm. Accessed May 20, 2013.Google Scholar
25. Blendon, RJ, Benson, JM, DesRoches, CM, Weldon, KJ. Using opinion surveys to track the public’s response to a bioterrorist attack. J Health Commun. 2003;8(suppl 1):83-92.Google Scholar
26. Keeter, S, Miller, C, Kohut, A, et al. Consequences of reducing non-response in a national telephone survey. Public Opin Q. 2000;64:125-148.Google Scholar
27. Keeter, S, Kennedy, C, Dimock, M, et al. Gauging the impact of growing nonresponse on estimates from a national RDD telephone survey. Public Opin Q. 2006;70(5):759-779.Google Scholar
28. Kohut, A, Keeter, S, Doherty, C, et al. Assessing the representativeness of public opinion surveys. The Pew Research Center for The People & The Press website. http://www.people-press.org/files/legacy-pdf/Assessing%20the%20Representativeness%20of%20Public%20Opinion%20Surveys.pdf. Published May 15, 2012. Accessed May 20, 2013.Google Scholar
29. Blendon, RJ, Kohut, A, Benson, JM, et al. Health system reform physicians’ views on the critical choices. JAMA. 1994;272(19):1546-1550.Google Scholar
30. Intergovernmental Panel on Climate Change. Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation. IPCC website. http://www.ipcc.ch/pdf/special-reports/srex/SREX_Full_Report.pdf. Published 2012. Accessed May 20, 2013.Google Scholar
31. Paturas, JL, Smith, D, Smith, S, Albanese, J. Collective response to public health emergencies and large-scale disasters: putting hospitals at the core of community resilience. J Bus Continuity Emerg Plann. 2010;4(3):286-295.Google Scholar
32. Hospital Preparedness Program (HPP), Office of the Assistant Secretary for Preparedness and Response, US Department of Health and Human Services. Healthcare Preparedness Capabilities: National Guidance for Healthcare System Preparedness. http://www.phe.gov/preparedness/planning/hpp/reports/documents/capabilities.pdf. Published January 2012. Accessed September 7, 2015.Google Scholar
33. Sugerman, D, Nadeau, KH, Lafond, K, et al. A survey of emergency department 2009 pandemic influenza A (H1N1) surge preparedness. Clin Infect Dis. 2011;52(suppl 1):S177-S182.Google Scholar
34. Bartley, BH, Stella, JB, Walsh, LD. What a disaster?! Assessing utility of simulated disaster exercise and associated educational process. Prehosp Disaster Med. 2006;21(4):249-255.CrossRefGoogle Scholar
35. Gebbie, KM, Valas, J, Merrill, J, Morse, S. Role of exercises and drills in the evaluation of public health in emergency response. Prehosp Disaster Med. 2006;21(3):173-182.Google Scholar
36. Facts about hospital accreditation. The Joint Commission website. http://www.jointcommission.org/assets/1/18/Hospital_Accreditation_9_17_12.pdf. September 19, 2012. Accessed May 20, 2013.Google Scholar
37. Healthcare executives’ role in emergency preparedness. American College of Healthcare Executives (ACHE) website. http://www.ache.org/policy/emergency_preparedness.cfm. Revised November 2009. Accessed May 20, 2013.Google Scholar
38. Tierney, KJ. Emergency medical preparedness and response in disasters: the need for interorganizational coordination. Public Admin Rev. 1985(special issue):77-84.CrossRefGoogle Scholar
39. Waeckerle, JF. Disaster Planning and Response. N Engl J Med. 1991;324:815-821.Google Scholar
40. Cicero, MX, Blake, E, Gallant, N, et al. Impact of an educational intervention on residents’ knowledge of pediatric disaster medicine. Pediatr Emerg Care. 2009;25(7):447-451.Google Scholar
41. Franc, JM, Nichols, D, Dong, SL. Increasing emergency medicine residents’ confidence in disaster management: use of an emergency department simulator and an expedited curriculum. Prehosp Disaster Med. 2012;27(1):31-35.Google Scholar
42. Blendon, RJ, Connolly, JM, Benson, JM, et al. Challenges faced by the chronically ill and disabled in high-risk hurricane areas. J Emerg Manag. 2009;7(6):19-28.Google Scholar
43. Walsh, L, Craddock, H, Gulley, K, et al. Building health care system capacity: training health care professionals in disaster preparedness health care coalitions. Prehosp Disaster Med. 2015;30(2):123-130.Google Scholar