Category Archives: Emergency Services

Nursing Homes in Public Health Emergencies: Special Needs and Potential Roles

Source: Elisabeth D. Root, Jacqueline B. Amoozegar, Shulamit Bernard, Agency for Healthcare Research and Quality, AHRQ Publication No. 07-0029-1, May 2007

From the overview:
To date, most health care preparedness planning efforts have been focused on hospital and first responder preparedness. Nevertheless, the elderly are particularly vulnerable to bioterrorism and other public health emergencies due to their complex physical, medical, and psychological needs. The potential role and question of preparedness on the part of nursing homes has emerged in local and national preparedness discussions. However, little is known about the extent to which nursing homes have planned for and/or been incorporated into regional planning efforts
To address this issue, a series of focus groups was conducted to collect information about disaster- and bioterrorism-related planning activities among nursing homes in five States—North Carolina, Oregon, Pennsylvania, Washington, and Utah—and southern California. The aims of the focus groups were to:
• Determine if nursing home administrators have prepared and trained staff on disaster plans, including bioterrorism response.
• Assess the special needs of the elderly population in nursing home settings during a public health emergency.
• Determine if nursing homes are able to accommodate patient flows from acute care hospitals or provide other resources.
• Assess the impact of State regulations on the ability of nursing homes to offer support and/or surge capacity.
Findings from this report can provide important insight into current nursing home preparedness activities as well as the potential role of nursing homes in larger local or regional preparedness efforts and the special needs of the nursing home population.

See also: Emergency Preparedness Atlas — U.S. Nursing Home and Hospital Facilities
The Agency for Healthcare Research and Quality (AHRQ) sponsored preparation of this atlas to support local/regional planning and response efforts in the event of a bioterrorism or other public health emergency. In the atlas, case studies in six areas illustrate the location of nursing homes relative to population and various emergency preparedness regions. There are also maps of the location of hospitals and nursing homes in all 50 States and the District of Columbia.
Download in sections (PDFs)

Public Safety Concept in the Post-9/11 World

Source: Leonard Matarese, Kenneth Chelst, Gayle Fisher-Stewart, and Albert Pearsall, Public Management, Vol. 89 no. 4, May 2007
(subscription required)

More than 15 years ago, authors Kenneth Chelst and Leonard Matarese described in an ICMA report the efficiencies and successes gained by the consolidation of police and fire departments. They defined the issues surrounding a police-fire merger, identified the key decisions that had to be made, developed a process to assess and overcome environmental barriers to a merger and presented a mathematical model for predicting the impact on costs and performance of a proposed police-fire merger. Specifically, they were addressing mergers where police officers and firefighters routinely worked together, rather than just administrative consolidations. Yet, in a post-9/11 environment, does consolidation continue to make sense? Is it an efficient use of human and financial resources? As this “age of terrorism” forces local governments to assess issues of interoperability and emergency management, while still competing for scarce resources, should emergency response organizations become combined under one public safety umbrella?

Letters From the Field: Case Studies of Exemplary Collaborative Managers

Public Administration Review, December 2006, Vol. 66 supplement

These mini-case studies explore the practice of collaborative management within a variety of public sector settings, focusing on the meritorious roles played by public managers – how they performed well and why their actions mattered.

Articles include:
– Amy K. Donahue, “The Space Shuttle Columbia Recovery Operation: How Collaboration Enabled Disaster Response.”
– Mary Belefski, “Collaboration at the U.S. Environmental Protection Agency: An Interview with Two Senior Managers.”
– Kurt Thurmaier, “High-Intensity Interlocal Collaboration in Three Iowa Cities
– Heather Getha-Taylor, “Preparing Leaders for High-Stakes Collaborative Action: Darrell Darnell and the Department of Homeland Security.”
– Kim Eagle and Philip Cowherd, “Collaborative Capital Planning in Charlotte-Mecklenburg County, North Carolina.”
– Tracy Yandle, “The Challenger Scallop Enhancement Company: Collaborative Management of a Natural Resource Based in the Private Sector.”
– Sharon Friedrichsen, “Collaborative Public Management in San Francisco.”
– Gerald Andrews Emison, “The EPA Bureaucrat Who Could.”
– David W. Sears and W. Robert Lovan. “Encouraging Collaboration in Rural America.”
– Brenda Bushouse, “West Virginia Collaboration for Creating Universal Prekindergarten.”
– Rob Alexander, “Kirk Emerson and the U.S. Institute for Environmental Conflict Resolution.”

Collaboration and Leadership for Effective Emergency Management

Source: William L. Waugh Jr. and Gregory Streib, Public Administration Review, December 2006, Vol. 66 supplement

Collaboration is a necessary foundation for dealing with both natural and technological hazards and disasters and the consequences of terrorism. This analysis describes the structure of the American emergency management system, the charts development of the Federal Emergency Management Agency, and identifies conflicts arising from the creation of the Department of Homeland Security and the attempt to impose a command and control system on a very collaborative organizational culture in a very collaborative sociopolitical and legal context. The importance of collaboration is stressed, and recommendations are offered on how to improve the amount and value of collaborative activities. New leadership strategies are recommended that derive their power from effective strategies and the transformational power of a compelling vision, rather than from hierarchy, rank, or standard operating procedures.

Incrementalism before the Storm: Network Performance for the Evacuation of New Orleans

Source: John J. Kiefer and Robert S. Montjoy, Public Administration Review, December 2006, Vol. 66 supplement

In this timely look at evacuation before, during and after Hurricane Katrina’s landfall in New Orleans, the authors trace the actions and interactions of the key players and highlight the strengths and weaknesses of their performance during the crisis. Though it was apparent that informal collaborative networks were necessary to deal with the disaster, this article suggests that they are never sufficient alone because networks, by definition, lack legal authority and diffuse public responsibility.

Hurricane Katrina revealed a lack of preparedness in disaster management networks covering the New Orleans area. This paper focuses on the operation of networks in preparing to evacuate residents in advance of a major disaster. There are two cases: the relatively successful evacuation of residents who left by private conveyance and the widely publicized failure to provide for those who could not or would not leave on their own. We trace the actions and inactions of various players to reach conclusions about the strengths and weaknesses of networks in the special circumstances of disaster preparation.

More Mandates, Less Dollars: Emergency Management Agencies Focused on Standards

Source: PA Times, December 2006, Volume 29, no. 12

Lexington, KY–The just-released 2006 Biennial Report from the National Emergency Management Association (NEMA) reveals ever-increasing responsibilities for state emergency management agencies; an on-going struggle for adequate federal funding and states leading the way in continuous improvement for their emergency management programs.

While all states have homeland security functions, most are tasking significant homeland security responsibilities to their state emergency management agencies.