Open Access Open Access  Restricted Access Subscription or Fee Access

From silos to coalitions: The evolution of the US Hospital Preparedness Program

Sharon Medcalf, PhD, Shreya Roy, MS, PhD Student, Sarbinaz Bekmuratova, PhD, Wael ElRayes, MBBCh, PhD, FACHE, Harlan Sayles, MS, Jonathon Gruba, MS, Ronald Shope, PhD

Abstract


Objective: The objective of this article is to trace the hospital emergency preparedness movement in the United States, strengthen the case for hospital investments in emergency preparedness, and make recommendations to ensure sustainability of the program.  

Design/Approach: This article is a narrative review. Main themes from the literature about the US Hospital Preparedness Program (HPP) are discussed, beginning with the trends in funding levels of the HPP, the rise of regional healthcare coalitions, preparedness performance measures, and the challenges faced over the past 15 years of HPP activities. Finally, recommendations are made about ways to sustain the program.

Findings: The HPP was established in 2002 and funding for the program has seen a 56 percent decrease over the last 16 years. Beyond the initial investment in supplies and equipment, hospitals have received very little of the healthcare preparedness funding.

Disaster drills and exercises to test emergency plans in hospitals are perceived as a costly distraction from daily work. The biggest challenge is the lack of engagement and support from hospital leadership.

Conclusions: To ensure the sustainability of the HPP, the positive impact of preparedness activities on the hospital’s day-to-day operations must be demonstrated.


Keywords


hospital emergency preparedness, United States, federal funding, hospital preparedness program, hospital leadership, business case

Full Text:

PDF

References


World Health Organization: World Health Organization hospital emergency response checklist. 2011. Available at http://www.euro.who.int/__data/assets/pdf_file/0020/148214/e95978.pdf?ua=1. Accessed August 8, 2018.

US Department of Health and Human Services: United States Department of Health and Human Services Hospital preparedness program overview. 2014. Available at https://www.phe.gov/preparedness/planning/hpp/pages/default.aspx. Accessed August 8, 2018.

Hanfling D: Health care preparedness funding: Are we inviting disaster? 2013. Available at http://healthaffairs.org/blog/2013/12/31/health-care-preparedness-funding-are-we-inviting-disaster/. Accessed February 4, 2019.

Centers for Disease Control and Prevention: Centers for Disease Control and Prevention HPP budget period 4 (Fiscal year 2015) funding. 2015. Available at https://www.phe.gov/Preparedness/planning/hpp/Documents/hpp-phep-2015fundingtable.pdf. Accessed August 8, 2018.

Kellerman AL: What Should We Learn from Boston? Arlington, VA: RAND Office of External Affairs, 2013.

Toner E: Healthcare preparedness: Saving lives. Health Secur. 2017; 15(1): 8-11.

Department of Health and Human Services, Centers for Disease Control and Prevention: Justification of Estimates for Appropriations Committee. Atlanta, GA: Department of Health and Human Services, 2015.

Greene J: Post 9/11 federal disaster funds: Where did the $7 billion trickle down? Ann Emerg Med. 2008; 52(3): 263-265.

Boddie C, Sell TK, Watson M: Federal funding for health security in FY2015. Biosecur Bioterror. 2014; 12(4): 163-177.

US Department of Health and Human Services: Assistant Secretary for Preparedness and Response HPP funding table, 2007-2016. Available at https://www.phe.gov/preparedness/planning/hpp/pages/funding.aspx. Accessed August 8, 2018.

De Lorenzo RA: Financing hospital disaster preparedness. Prehosp Disaster Med. 2007; 22(5): 436-439.

Niska RW, Shimizu IM: Hospital preparedness for emergency response: United States, 2008. Natl Health Stat Rep. 2011; 37: 1-14.

Toner E, Waldhorn R, Franco C, et al.: Hospitals Rising to the Challenge: The First Five Years of the US Hospital Preparedness Program and Priorities Going Forward. Washington, DC: Center for Biosecurity of UPMC, 2009.

Cagliuso N: Stakeholders’ experiences with US hospital emergency preparedness: Part 1. J Bus Contin Emerg Plan. 2014; 8(2): 156-168.

Centers for Medicare & Medicaid Services (CMS), HHS: Centers for Medicare and Medicaid Services Medicare and Medicaid Programs; Emergency preparedness requirements for medicare and medicaid participating providers and suppliers. 2016. Available at https://www.federalregister.gov/documents/2016/09/16/2016-21404/medicare-and-medicaid-programs-emergency-preparedness-requirements-for-medicare-and-medicaid. Accessed August 8, 2018.

Courtney B, Toner E, Waldhorn R, et al.: Healthcare coalitions: The new foundation for national healthcare preparedness and response for catastrophic health emergencies. Biosecur Bioterror. 2009; 7(2): 153-163.

Dornauer ME: In preparation or response: Examining health care coalitions amid a changing economic and political landscape. Disaster Med Public Health Prep. 2015; 9(6): 698-703.

Office of the Assistant Secretary for Preparedness and Response: 2017-2022 Health care preparedness and response capabilities. 2016. Available at https://www.phe.gov/Preparedness/planning/hpp/reports/Documents/2017-2022-healthcare-pr-capablities.pdf. Accessed August 8, 2018.

US Government Accountability Office: Improvements needed for measuring awardee performance in meeting medical and public health preparedness goals. 2013. Available at https://www.gao.gov/products/GAO-13-278. Accessed August 8, 2018.

Center for Biosecurity of UPMC: Healthcare facilities partnership program and emergency care partnership program evaluation report. 2010. Available at http://www.centerforhealthsecurity.org/our-work/pubs_archive/pubs-pdfs/2010/2010-01-29-hfpp_eval_rpt.pdf. Accessed August 8, 2018.

Trust for America’s Health: Ready or not? 2016. Available at https://www.tfah.org/releases/readyornot2016/. Accessed December 10, 2018.

Lazar EJ, Cagliuso NVSr, Gebbie KM: Are we ready and how do we know? The urgent need for performance metrics in hospital emergency management. Disaster Med Public Health Prep. 2009; 3(1): 57-60.

Hanfling D, Altevogt BM, Viswanathan K, et al.: Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response. Washington, DC: National Academies Press, 2012.

Barbera JA, Yeatts DJ, Macintyre AG: Challenge of hospital emergency preparedness: Analysis and recommendations. Disaster Med Public Health Prep. 2009; 3: S74-S82.

Pole T, Marcozzi D, Hunt RC: Interrupting my shift: Disaster preparedness and response. Ann Emerg Med. 2014; 63(5): 584-588.

Sands P, Mundaca-Shah C, Dzau VJ: The neglected dimension of global security--A framework for countering infectious-disease crises. N Engl J Med. 2016; 374(13): 1281-1287.

Lane SJ, McGrady E: Measures of emergency preparedness contributing to nursing home resilience. J Gerontol Soc Work. 2018; 61(7): 751-774.




DOI: https://doi.org/10.5055/jem.2020.0459

Refbacks

  • There are currently no refbacks.


Copyright (c) 2020 Journal of Emergency Management