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Concepts in Disaster Medicine

Consensus and Tools Needed to Measure Health Care Emergency Management Capabilities

Melissa L. McCarthy, ScD, Peter Brewster, BS, Edbert B. Hsu, MD, MPH, Anthony G. Macintyre, MD and Gabor D. Kelen, MD

Address correspondence and reprint requests to Dr Melissa McCarthy, 5801 Smith Ave, Davis Bldg, Suite 3220, Baltimore, MD 21209 (e-mail: mmccarth{at}jhmi.edu).

There is no widely accepted, validated framework of health care emergency management capabilities (HEMCs) that can be used by facilities to guide their disaster preparedness and response efforts. We reviewed the HEMCs and the evaluation methods used by the Veterans Health Administration, The Joint Commission, the Institute of Medicine Metropolitan Medical Response System committee, the Department of Homeland Security, and the Department of Health and Human Services to determine whether a core set of HEMCs and evaluative methods could be identified.

Despite differences in the conceptualization of health care emergency management, there is considerable overlap among the agencies regarding major capabilities and capability-specific elements. Of the 5 agencies, 4 identified occupant safety and continuity of operations as major capabilities. An additional 5 capabilities were identified as major by 3 agencies. Most often the differences were related to whether a capability should be a major one versus a capability-specific element (eg, decontamination, management of resources). All of the agencies rely on multiple indicators and data sources to evaluate HEMCs. Few performance-based tools have been developed and none have been fully tested for their reliability and validity. Consensus on a framework and tools to measure HEMCs is needed.




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