Community preparedness and response is essential for successful recovery from major disasters, and encompasses a multitude of factors, situations, and contexts. VEMEC’s experience improving the preparedness of local communities across the nation, affords it a wealth of experience and knowledge that reflects this diversity. Whether the subject is providing primary care to homebound patients, empowering nurses to become leaders in disaster preparedness and response, assessing the resiliency of all veterans in the U.S., examining the participation of volunteer veterans as first responders, or establishing effective means of communication with patients in times of major crisis, VEMEC has played a critical role in strengthening community preparedness and response in local communities across the U.S.
Call to Action: Nurses as Leaders in Disaster Preparedness & Response
On December 9, 2014, VEMEC led a workshop in conjunction with the 5th Annual Advancing & Redefining Communities (ARC) conference in Los Angeles, CA to discuss Nurses as Leaders in Disaster Preparedness & Response. The devastation caused by recent disasters has led to a heightened awareness of the importance of preparedness in healthcare. The 2011 IOM/RWJF report, The Future of Nursing, Leading Change, Advancing Health brought a greater understanding of the nursing profession’s breadth and untapped potential at a time when major disasters are occurring with increasing frequency. Nurses represent the largest segment of the US healthcare workforce, are employed in diverse settings, collaborate with a broad range of healthcare professionals, and are consistently ranked by the public as trusted sources of health information. Further, nurses are the healthcare professionals in highest demand following a disaster when care is needed. In addition to providing care on the frontlines to disaster victims, their families, and the community, nurses also assume significant leadership roles during disasters. Building on the 2011 IOM/RWJF report and the coalitions developed as part of the RWJ/AARP Future of Nursing: Campaign to Action, this event brought together nursing leaders and practitioners to develop an agenda to expand the role of nurses in emergency preparedness and response in the community and health system settings. Presentations and discussions explored:
- The pivotal role nurses can play as patient educators, responders, and decision-makers in disaster preparedness through improved efforts in education/training, practice, research and policy;
- Prior efforts to develop nursing education and competencies for emergency preparedness and response;
- Short- and long-term strategies to expand the role of nurses in emergency preparedness and response;
- Collaboration and partnerships necessary to achieve this goal.
VA Healthcare Provider Assessments of the Preparedness of Homebound Veterans
The Home Based Primary Care (HBPC) project bolsters community preparedness by examining the barriers and facilitators of disaster readiness among Veterans Health Administration (VHA) HBPC programs. Home-bound Veterans are among the most vulnerable populations in a disaster because of their health conditions and functional limitations, which may prevent them from being adequately prepared. This project involved 30 semi-structured interviews with leaders and practitioners from 5 VHA HBPC programs, with 3 sites being in urban areas and 2 in rural ones. Results include: 1) individual HBPC programs are generally tasked with developing their own preparedness policies; 2) assessment tools are rudimentary; 3) comprehension of criteria for assigning risk categories varies among practitioners; 4) practitioners receive limited training on how to prepare their patients for a disaster; 5) practitioners recommend training focused on effective strategies to encourage patient engagement, formalization of the initial assessment, and having emergency preparedness be formally addressed on a more consistent basis; and 6) cognitive impairment and limited resources are the primary challenges to patient preparedness. Standardized strategies regarding disaster preparedness assessment for home-bound patients, which leave room for flexibility in consideration of local factors such as common hazards, could assist in creating more comprehensive planning agendas and ultimately improve the preparedness of this vulnerable population.
Modeling Vaccine Resource Allocation and Coverage Among Veterans
VEMEC is partnering with Sandia National Laboratories to investigate the impact of different vaccine resource allocation and service partnership strategies on vaccination levels of Veterans. This project uses system dynamics modeling to explore hypotheses related to delivery of vaccine services through community partnerships and coordination. Preliminary analysis of data has identified that community partnership and coordination are strategic policy actions the VHA could take to improve vaccination uptake among Veterans. Ultimately, we hope to foster community partnerships in VHA disaster preparedness efforts and examine the effect of coordination on best practice adoption of vaccinations and other preventive efforts, including disaster preparedness kits.
VA Preparedness Communications Survey
The Veterans Affairs Preparedness Communications Survey will inform VA how to best communicate medical facility closures to Veteran patients during and after a natural disaster. Medical facility closures and displacement following a disaster are particularly stressful events for special populations, such as Veterans, who have complex medical conditions and who may not have the resources to seek health care elsewhere. This survey supports VHA Office of Emergency Management operations by providing VA stakeholders with high-quality information to inform the development of a disaster preparedness communication plan to reach Veterans with diverse communication needs. We will survey a sample of 1,500 Veterans living in the Northeastern region of the United States who recently received care from a VA facility. This work is a critical step to reduce barriers to accessing care post-disaster.
Resiliency to Disasters: National Survey of All Veterans
The Veteran Community Resilience Survey is a national survey assessing the relationship of community resiliency to emergency and disaster preparedness among individual Veterans, Veteran households, and their respective communities. Recent studies show that household preparedness is necessary, but not sufficient, to promote successful recovery from disasters. Critical to the recovery process is robust community resilience, which can be defined as a process linking a set of adaptive individual and community-level capacities to a positive trajectory of functioning after a major disaster. This project will survey a population-based national sample of 6,500 Veterans. This study is a critical step in promoting enhanced preparedness among Veterans, and strengthening the resiliency of the communities in which they live.
Disaster Preparedness of Non-Profit Organizations Serving Homeless Veterans
The Disaster Preparedness in Non-Profit Organizations Serving Homeless Veterans project seeks to understand what community-based organizations in a major metropolitan area need to become better prepared for a disaster and what barriers they currently face. Non-profit homeless service organizations constitute a “safety net” for homeless populations, both daily and in times of crisis. Homeless individuals may be particularly vulnerable to the adverse effects of a disaster due to extreme poverty, lack of access to housing and other resources, and chronic health conditions, particularly if disaster shelters are not prepared to address their needs. We conducted semi-structured interviews with 12 key staff members from 6 community-based non-profit providers of housing and shelter services to individuals experiencing homelessness. Topics discussed included: 1) expected disaster impacts; 2) current plans; and 3) needs and barriers for disaster preparedness. Interviews were audio-recorded, transcribed, and analyzed using qualitative analysis software. Preliminary findings suggest that providing technical assistance and training, and improving non-profit organizations’ collaboration with government emergency management agencies would strengthen the disaster readiness of this vital safety net for homeless Veterans. These findings have been translated into policy recommendations through the 2013 Workshop on Integrating Homeless Populations into Disaster Preparedness, Planning, and Response, and a Toolkit is currently in development to identify best practices, policies, and further research to improve organizational preparedness.
Veterans Responding to Disasters: Interviews with Team Rubicon Members
Disaster response work provides Veterans with opportunities to apply emergency management skills to disasters. Military personnel have numerous skills that could be applied to assist communities after a disaster and are often trained to provide trauma care. We conducted semi-structured interviews with 9 Team Rubicon members to describe how Veterans perceive the benefits of disaster response work. Team Rubicon is a non-governmental organization founded by retired U.S. Marines William McNulty and Jacob Wood. Its mission is to unite the skills and experiences of military Veterans with first responders to rapidly deploy emergency response teams.