Emergency preparedness: Interviews with senior leadership in Nebraska hospitals

Authors

  • Shreya Roy, PhD
  • Sarbinaz Bekmuratova, PhD
  • Sharon Medcalf, PhD
  • Harlan Sayles, MS
  • Wael ElRayes, MD, PhD, FACHE
  • Jeanne S. Ringel, PhD
  • Ronald J. Shope, PhD

DOI:

https://doi.org/10.5055/jem.2020.0488

Keywords:

hospital, emergency, preparedness, rural, Nebraska, qualitative, grounded theory

Abstract

Objective: The objective of this study was to explore perceptions of senior leadership in hospitals on the motivations, cost, benefits, barriers, and facilitators of investment in emergency preparedness.

Study design: This is a qualitative study which used a grounded theory approach to develop a theory of hospital emergency preparedness.

Setting and study participants: A purposive sample of hospital leaders (n = 11) in the US state of Nebraska were interviewed.

Results: Results showed that the environmental risk associated with the hospital location, the hospital’s position in the community, and the preparedness requirements of the Centers for Medicare and Medicaid Services contribute to investment decisions. Rural hospitals face unique challenges in preparing for disasters, for example, lack of trained personnel. Facilitators of disaster preparedness include the availability of federal funds, the commitment of leadership, and an organizational mission aligned toward emergency preparedness. Hospitals invest in hazard vulnerability assessments; partnerships with other organizations in the community; staff trainings and infrastructure.

Conclusions: The authors concluded that hospitals in Nebraska are committed toward investing in preparedness activities. The theory of hospital emergency preparedness developed will be used in a subsequent study to develop a decision-support framework for hospital investment in preparedness.

Author Biographies

Shreya Roy, PhD

Research Associate, Oregon Center for Children and Youth with Special Health Needs (OCCYSHN); Student, Department of Health Services Research and Administration, College of Public Health, UNMC, Omaha, Nebraska

Sarbinaz Bekmuratova, PhD

Assistant Professor, Department of Occupational Therapy, School of Pharmacy and Health Professions, Creighton University, Omaha, Nebraska

Sharon Medcalf, PhD

Assistant Professor, Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska; Director, Center for Biosecurity, Biopreparedness, and Emerging Infectious Diseases, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska

Harlan Sayles, MS

Statistician III, Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska

Wael ElRayes, MD, PhD, FACHE

Instructor, Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska; Program Manager, Training, Simulation & Quarantine Center (TSQC), University of Nebraska Medical Center, Omaha, Nebraska

Jeanne S. Ringel, PhD

Director, Access and Delivery Program, Health Care Division, RAND Corporation, Santa Monica, California; Senior Economist, RAND Corporation, Santa Monica, California

Ronald J. Shope, PhD

Education Researcher, Interprofessional Academy of Educators, University of Nebraska Medical Center, Omaha, Nebraska; Associate Professor, Department of Health Promotion, Social & Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska

References

US Department of Health and Human Services: Hospital Preparedness Program overview. 2014. Available at https://www.phe.gov/Preparedness/planning/hpp/Pages/default.aspx. Accessed February 26, 2019.

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 August 16, 2019.

Centers for Disease Control and Prevention: Hospital Preparedness Program (HPP) and Public Health Emergency Preparedness (PHEP) Cooperative Agreements Budget Period 3 Continuation Guidance Supplemental Information, 2014. Available at https://www.cdc.gov/cpr/documents/HPP-PHEP-BP3-Continuation-Guidance_Supplemental-Information.pdf. Accessed August 16, 2019.

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

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 16, 2019.

Corbin J, Strauss A: Basics of Qualitative Research. Thousand Oaks, CA: SAGE, 2015. https://www.ruralhealthinfo.org/topics/criticalaccess-hospitals. Accessed August 16, 2019.

Creswell JW, Poth CN: Qualitative Inquiry and Research Design: Choosing Among Five Approaches. Thousand Oaks, CA: SAGE, 2017.

National Quality Forum: Safe Practices for Better Healthcare—2010 Update: A Consensus Report. Washington, DC: NQF, 2010.

Rural Health Information Hub: Critical Access Hospitals (CAHs). 2018. Available at https://www.ruralhealthinfo.org/topics/criticalaccess-hospitals.

Strauss A, Corbin JM: Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Thousand Oaks, CA: SAGE, 1998.

United States Census 2010: 2010 Census—Census tract reference maps. 2010. Available at https://www.census.gov/geo/mapsdata/maps/2010tract.html. Accessed December 26, 2017.

NEJM Catalyst: What is risk management in healthcare? 2018. Available at https://catalyst.nejm.org/what-is-risk-management-inhealthcare/. Accessed January 30, 2019.

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

Morse S: When disaster strikes: CFOs help hospitals recover after Joplin tornado, Hurricane Sandy. Healthcare Finance, 2015. Available at http://www.healthcarefinancenews.com/news/whendisaster-strikes-cfos-help-hospitals-recover-after-joplin-tornado-hurricane-sandy. Accessed August 16, 2019.

Internal Revenue Service: New requirements for 501(c)(3) hospitals under the Affordable Care Act. 2017. Available at https://www.irs.gov/charities-non-profits/charitable-organizations/requirements-for-501c3-hospitals-under-the-affordable-care-act-section-501r. Accessed August 16, 2019.

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

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. Baltimore, MD: US Department of Health and Human Services, 2009.

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

Priest C, Stryckman B: Identifying indirect benefits of Federal Health Care emergency preparedness grant funding to coalitions: A content analysis. Disaster Med Public Health Prep. 2015; 9(6): 704-711.

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.

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

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 16, 2019.

Published

09/01/2020

How to Cite

Roy, PhD, S., S. Bekmuratova, PhD, S. Medcalf, PhD, H. Sayles, MS, W. ElRayes, MD, PhD, FACHE, J. S. Ringel, PhD, and R. J. Shope, PhD. “Emergency Preparedness: Interviews With Senior Leadership in Nebraska Hospitals”. Journal of Emergency Management, vol. 18, no. 5, Sept. 2020, pp. 399-0, doi:10.5055/jem.2020.0488.