08:04:07 PM Amy Sebring:Welcome to our regular EIIP Round Table Discussion this evening... 08:04:19 PM Amy Sebring:we are very pleased to have you all with us. 08:04:30 PM Amy Sebring:I will introduce Joanne and her topic... 08:04:41 PM Amy Sebring:then Joanne will have a few comments... 08:04:50 PM Amy Sebring:then we will open it up for general participation. 08:05:02 PM Amy Sebring:Joanne McGlown is a healthcare strategist and management consultant to hospitals and health systems. 08:05:10 PM Amy Sebring:Joanne began disaster and emergency work in 1971, obtaining her EMT, EMT-I, and Paramedic certifications by 1974. 08:05:19 PM Amy Sebring:She holds degrees in Nursing, Emergency Medical Services Administration (AS), Fire Science Administration (AS), a B.S. in Sociology/Psychology, a Masters in Hospital and Health Administration ... 08:05:28 PM Amy Sebring:and is currently completing her doctorate in Administration of Health Services at the University of Alabama at Birmingham. 08:05:40 PM Amy Sebring:We are very pleased to have her here with us tonight... 08:05:53 PM Amy Sebring:to lead the discussion of the question... 08:06:03 PM Amy Sebring:"Of all the sectors in your community, how would you rate the "readiness" of the healthcare sector (i.e., prehospitals, hospitals, LT care facilities, home care, etc.) for disaster?" 08:06:14 PM Amy Sebring:Joanne, thank you for being here tonight. 08:06:23 PM Joanne:Hello, everyone! Good to see you here. This process is very new to me, so a sense of humor is in order for tonight!... 08:06:50 PM Joanne:Hello, everyone! Good to see you here. This process is very new to me, so a sense of humor is in order for tonight!... 08:07:08 PM Joanne:While meeting in Denver last July, Avagene graciously volunteered to assist us (health care sector professionals and those interested in health care) by offering an on-line forum for real-time communication. The opportunities for creative discussions, collaboration, and teamwork seem endless. ... 08:07:27 PM Joanne:We are together tonight to informally discuss ways we may wish to use this forum. We will chat about the "key" question, and request topics of interest to the group, or specific issues for future discussion -- most anything your heart desires. ... 08:07:42 PM Joanne:We have an hour, and let's try to leave with a plan in place to continue a professional dialogue. ... 08:08:05 PM Joanne:I have proposed a question to get us started. After we chat a bit, I'd like to open the floor to get your ideas and questions for future discussion or forum use. ... 08:08:29 PM Joanne:Now, here's tonight's opener: "Of the various sectors in your community, how would you rate the "readiness" (or preparedness / integration) of the health care sector (i.e., pre- hospital, hospital, LT care facilities, home care, etc.) for disaster?" 08:09:12 PM Joanne:So, hello to all.. We even had a Japanese friend join in earlier... hope they can come back. Let's chat. Hello to Jakov in Inrael. 3 am!! 08:09:49 PM Amy Sebring:This is not a hypothetical question...Joanne would like some feedback from our audience! 08:10:12 PM Amy Sebring:Let's take some comments. 08:10:16 PM Avagene Moore:Please feel free to ask comment on Joanne's lead question from your community perspective. 08:10:16 PM Isabel McCurdy:No way are they prepared ... 08:10:40 PM Avagene Moore:Isabel should know. She is a nurse. 08:10:48 PM Joanne:Where are the major weaknesses, Isabel? 08:11:18 PM Dave Whitney:From a research perspective, I don't think we have any data on hospital preparedness in the published litaerature! 08:11:19 PM Isabel McCurdy:They have no idea what to do. 08:11:42 PM Isabel McCurdy:Shall I give you an example? 08:12:08 PM Avagene Moore:Yes, Isabel. 08:12:32 PM Loc Nguyen:When you ask about "readiness," do you mean whether we have the plans, the resources, or whether front-line disaster folks are trained/educated in the area of disasters and health? 08:12:38 PM Isabel McCurdy:I am doing a masters degree in policy and practice... 08:12:58 PM Isabel McCurdy:As part of my mark, had to give a presentation... 08:13:38 PM Isabel McCurdy:Focus was on disaster preparedness in a class that consisted of registered nurses... 08:13:51 PM Avagene Moore:(Joanne, please answer Loc's question when Isabel is finished with her example.) 08:14:05 PM Isabel McCurdy:social workers and child and youth care workers... 08:14:32 PM Isabel McCurdy:A scenario of a disaster was laid out... 08:14:44 PM Isabel McCurdy:Reaction... 08:15:33 PM Isabel McCurdy:They had no idea what to do first. They just stood there confused. 08:15:40 PM Joanne:Dave, you're right. Researching the role of hospitals is like looking for a needle in a haystack! And CEO's just don't seem very concerned! And Loc, readiness (in context of this question) means "how do we rate compared to readiness of all the other sectors: law enforcement, fire, communication, etc.? I'd like some comparative analysis here. My feeling is that the HC sector is dropping the ball . Am I wrong? 08:16:26 PM Joanne:Isabel - I, too have experienced this. Is the Southeast US the only area where administrators feel a disaster will not affect the hospital? 08:17:26 PM Joanne:Howdy, Kim. Good to see the LA area represented. Are you awake yet, Dr. Adler (Israel?) 08:17:51 PM Isabel McCurdy:I don't think the health care sector have picked up the ball. 08:18:17 PM Jakov Adler:Hi Joanne, sorry for logging in late. there has been some confusion with the time difference. Regarding preparedness of health facilities in Israel - I would say they are pretty well prepared-specially hospitals in response to a disaster, which happens in our country quite often. Terrorist acts. they are however, not well prepared for a disaster situation within the facility. Very seldom are fire exercises performed in facilities and in some instances in the past there was a lot of confusion. 08:18:43 PM Isabel McCurdy:There is no legislation in place for them to do so. 08:19:32 PM Joanne:From the States with legislation, does it make a difference in the integration of overall services? 08:19:42 PM Joanne:Florida, California? 08:20:46 PM Joanne:Can we hear from some of you who have been quiet tonight? 08:21:11 PM KimShoaf:Hi Joanne and all. Sorry to log in late. I think it is difficult for us to compare the health sector's readiness to other sectors. If we are going to compare the health sector to fire services for example we are talking about entirely different creatures. Disasters (or emergencies) are what they do on a daily basis. In the health sector, that is a contingency that needs to be planned for. 08:21:53 PM Amy Sebring:Joanne, can you tell us a little about the disaster planning requirements included in the accreditation process? 08:22:02 PM Amy Sebring:That is almost all we have to rely on here. 08:22:11 PM Amy Sebring:(in Texas) 08:22:21 PM Avagene Moore: I may be wrong but my experience as an emergency manager led me to believe that Joint Commission was the driving force for planning and preparedness in the US? To be an accredited hospital, certain measure have to be in place, plans and exercises are a big part of that effort. 08:22:49 PM Loc Nguyen:All of this begs the question: Should more resources go to research into this area (in order to show policy makers the "proof"). Or do we put more resources/funding into training/educating more health professionals to learn to integrate with other services, address disasters, etc. 08:23:02 PM Joanne:Useless, in my humble opinion (!) I'll get in trouble for that, I'm sure. They make the hospitals develop a plan -- but it has not heart unless the CEO "owns" it -- or the hospital is in an area very prone to disasters... 08:23:08 PM KimShoaf:I think in a lot of ways, accreditation is the best process to looking at preparedness for hospitals. However, hospitals are only one small part of the health system. 08:23:32 PM Avagene Moore:Good point, Kim. 08:23:34 PM Joanne:The "useless" was the JCAHO part! 08:23:35 PM Amy Sebring:Joanne, your response does not surprise me...this is similar situation in most organizations it appears. 08:24:42 PM KimShoaf:I agree that administrators need to own the process, but not just administrators. It is generally the nursing staff that needs to implement most of the procedures. They are an important target population 08:24:42 PM Joanne:I am glad that we at least have JCAHO mandates for planning. Without them, I fear no healthcare facilities (how right you are... not just hospitals) would plan! 08:25:15 PM Isabel McCurdy:What is JCAHO? 08:25:41 PM Joanne:Joint Commission on the Accreditation of Healthcare Organizations 08:26:01 PM Avagene Moore:I have a question Joanne. From your experience and others online as well, how much interaction and collaboration is there with the health care system and the emergency managers in the community? 08:26:02 PM Isabel McCurdy:Thank you. 08:26:10 PM Joanne:Surveys health facilities for compliance in all areas... 08:26:10 PM Jakov Adler:Why is FEMA not involved in disaster preparedness in the States? I would assume that the Federal government would be responsible for the preparedness and coordination . 08:26:53 PM Amy Sebring:It has to do with our history of states rights in part Jakov. 08:27:13 PM Amy Sebring:FEMA supports preparedness, through the states, down to the local communities. 08:27:38 PM KimShoaf:I think the collaboration is minimal. In part, I think it is because the health care community only discovers disasters when they occur. This is one of the reasons that here at UCLA we have this new program in public health and disaster relief 08:27:50 PM Avagene Moore:FEMA provides guidance and training, but local governments set the standard of care. Hospitals and health system are primarily privately ownedl 08:28:23 PM Joanne:Avagene: My experience has been very little interaction and collaboration. I hope others have experienced better integration. Great needs here. And, Jakov - FEMA isn't involved directly with the states... facility and community planning is basically left to each entity. 08:28:33 PM Isabel McCurdy:Kim, can you elaborate on this new program? 08:28:39 PM KimShoaf:We hope that if we can get health care professionals to talk the language of emergency managers and understand that disasters exist, we can better prepare the health care system for the inevitable disasters. 08:29:58 PM Avagene Moore:Kim, this is exactly what is needed in the health care profession, business, industry, you name it. 08:30:07 PM Joanne:FEMA is making a huge effort to fill the education void by Dr. Blanchard's development of the various programs for University level education. Are any of you involved with the use of these tools?? 08:30:17 PM KimShoaf:The program is within the school of public health. We are offering 4 courses at the masters level that both currently enrolled MPH students and health professionals can take. The courses are 1) an overview of disasters and public health 2) program planning for community disaster preparedness 3)interagency management in disasters and post disaster community health 08:31:31 PM Amy Sebring:We have recently had a presentation by Dr. Blanchard on EIIP Joanne. 08:31:56 PM Joanne:Hi, David... glad you could join us. Please join in! 08:32:33 PM Joanne:Kim - What's that 4th course? and, how is the program going? Is there participation from the entire emergency mgmt. community? 08:32:41 PM Jakov Adler:In the medical literature, doctors seem to be interested in reporting on disaster situations. They should be an integral part of the preparedness activities in planning and exercising and not "leave" it totally to administrators and other health proffessionals. I believe that this issue should be a part of the curriculum in medical schools as well (electives). 08:33:46 PM Amy Sebring:I absolutely agree with Jakov ... they need to include disaster planning for patients as part of overall health care schema ... 08:33:59 PM Joanne:Hear! Hear! The attitudes of medical staff are so different in Israel. I agree that coursework offered to the Medical Schools (even one) would be so helpful to all emergency managers. 08:34:01 PM Amy Sebring:especially for highly vulnerable areas, and highly vulnerable patients. 08:34:19 PM KimShoaf:the fourth class is post disaster community health...sorry. The program is going well. We have good support from the County (our dept of health funded the start-up) We have a core of about 4-5 students who have gone through the courses. And Steve Rottman has actually taught the first class once in the medical school as an elective. 08:34:43 PM Isabel McCurdy:Disaster planning should be included in all curriculum. 08:34:51 PM Joanne:Kim, does your program address medical students? 08:35:30 PM Joanne:Oops, poorly worded in light of your response. Sorry! 08:35:59 PM Amy Sebring:(I will be distributing hurricane preparedness materials next week during hurricane preparedness week from our County Health Dept., as well as other outlets.) 08:36:25 PM Avagene Moore:Joanne, we have quite a diverse audience here tonight. I would very much like to get reaction from them as to how we might pursue various issues of interest related to the health care sector and broad emergency management community. I am very glad to see such a global audience here tonight. Any thoughts on issues and best way of building an audience for further discussion? 08:37:44 PM KimShoaf:I've actually been asking a similar question. We really haven't had much of an opportunity as a segment of either the health care community or the disaster community to get to know one another. Any suggestions... 08:38:11 PM Avagene Moore:With the right venue for discussion, we can create and draw attention to the need for the types of issues and problems we have heard here. 08:38:12 PM David Whitney:Kim - the courses sound like a great opportunity, but I wonder whether medical students will really see disaster preparedness as much of a priority. Is this the sense you get? What carrot could be used? 08:38:43 PM Joanne:In what ways would it benefit each of us to come together and discuss health related issues in emergency preparedness? How can we help each other - and affect change? 08:39:14 PM KimShoaf:Actually the course that Dr. Rottman offered was well accepted. We don't talk just about preparedness, but also about response and planning. That certainly affects the medical community. 08:39:22 PM Loc Nguyen:There are very few programs in the country that offer curriculum in the health and disaster context. Harvard's school of public health has a course on disaster managment. Emory's school of public health has an intro course on public health and disasters. Johns Hopkins school of public health has a one unit course on sanitation, a two unit course on public health and disasters, and a three unit course on refugee health care. There are a few other disaster medicine courses floating here and t 08:39:30 PM Jakov Adler:The elective course given annually at the Hebrew University and all the other medical schools in Israel is a 2 weeks course with disaster simulations, table top exercises, and real simulations in the field, where the 6th years students play the role of both the patients and the medical staff. It is extremely popular.n 08:39:46 PM Amy Sebring:The difficulty is probably time more than anything. Both are extremely busy and demanding fields. 08:40:16 PM Loc Nguyen:Kim forgot to mention a fifth course being proposed for next year: disaster epidemiology. 08:41:12 PM Joanne:Is there a need for closer coordination, communication and infrastructure (emergency management, fire service, law enforcement, etc.)? How can this be accomplished? 08:41:24 PM Amy Sebring:We could easily employ someone fulltime in our local emergency management office, just on health care facility related issues alone. 08:41:45 PM KimShoaf:I think first Joanne that we need to coordinate amongst ourselves... How can we do this? 08:41:46 PM Amy Sebring:In terms of the time requirements, unfortunately not in terms of budget. 08:42:50 PM Amy Sebring:Issues include 1) review of disaster planning assumptions by nursing homes and retirement facilities (rapidly growing) 08:42:54 PM Joanne:The great thing about this forum is that it will allow us to do whatever would benefit the group! The floor is yours! Let's create something wonderful... Let's make some change happen!! 08:43:07 PM Jakov Adler:I think public awareness of the need to educate emergency services in coordination can help. Are the media interested in this issue? 08:43:19 PM Amy Sebring:2) ER readiness for HazMat, terrorist incidents 08:43:33 PM Amy Sebring:3) special needs populations 08:43:35 PM Loc Nguyen:For those who are interested, we have funding to hold a conference at UCLA on public health and natural disasters. We hope to bring together 300 researchers and front-line people. I hope some of these issues are touched upon at this conference (even on an informal level would be important). One area we hope to look at is also the media and health and disasters. 08:44:13 PM Avagene Moore:When is the conference scheduled? 08:44:20 PM Joanne:Don't know about the rest of the world... but here the media want to be "in your face" with everything. Japan even sent a satellite feed truck to our F5 tornado disaster - here within 24 hours of everything being blown away! 08:44:46 PM Loc Nguyen:April 11-14, 1999. The last year of IDNDR and dovetails on national public health week. 08:45:03 PM Avagene Moore:good timing! 08:45:09 PM David Whitney:Is there a way of finding out additional information about the UCLA conference? 08:45:30 PM Joanne:Loc, the conference sounds very interesting. Can we help stir up questions for you? 08:46:14 PM Loc Nguyen:We are in the inital planning stages, so questions would be nice. Maybe we can find a place for some topics. Who knows? 08:46:21 PM KimShoaf:I'm hoping that Loc is formulating a response. We will have info on the conference on our webpage. Loc will give you the address. 08:46:30 PM Avagene Moore:I am wondering how many online tonight plan to attend the Haz Research Applications Wkshop in Boulder in July? 08:46:42 PM KimShoaf:I'll be there.. 08:47:14 PM Loc Nguyen:The info is not on the webpage just quite yet. But it will be, soon. I'll be there in Boulder. 08:47:15 PM David Whitney:Unfortunately I can't attend the Boulder workshop this year. 08:47:18 PM KimShoaf:By the way, is this David Whitney at Long Beach?? 08:47:24 PM Joanne:I'll be there for the entire week! At Harvest House -- look me up! 08:47:42 PM Amy Sebring:Am planning to be there also. 08:47:52 PM Avagene Moore:I hope to be there. 08:48:12 PM Loc Nguyen:Hey, maybe we can all get together again like we did last year. 08:48:19 PM Avagene Moore:There will be others I am sure. Might be a good time to do some brainstorming. 08:48:20 PM KimShoaf:I hope that we can have another health care forum this year. Last year was a good opportunity to get to know each other. 08:48:22 PM Amy Sebring:What are the specific problems from the health care side of the house? 08:48:50 PM KimShoaf:I think one of the biggest problems is that health care people don't know what everybody else is doing 08:49:31 PM Loc Nguyen:Gotta run off to another meeting. See you all. 08:49:40 PM Avagene Moore:Thanks, Loc. 08:49:45 PM KimShoaf:A couple of years ago, there were a number of sessions at American Public Health Association on disasters. Everybody who presented seemed to think that nobody else was doing anything in disasters. 08:49:56 PM Joanne:Bye, Loc. Thanks! 08:50:20 PM Avagene Moore:In other words, there is no means of networking about such things? 08:50:28 PM Loc Nguyen:P.S. I have the mailing list that Joanne sent so I can reach some of you regarding the conference. For others, reach me by email. 08:50:39 PM Isabel McCurdy:I think health care professionals don't know themselves what to do, never mind what everybody else is doing.g 08:50:43 PM Avagene Moore:Will do, Loc. 08:51:33 PM Avagene Moore:Would the i 08:51:51 PM Avagene Moore:Sorry. Hit the wrong key. 08:51:59 PM Joanne:I would like to see us continue to meet, informally, in Boulder. Especially to keep our Asian counterparts in the loop -- it was so helpful to meet each of you face to face... 08:52:14 PM KimShoaf:By the way, Loc said to reach him by email but didnt give his address. It is locn@ucla.edu 08:52:52 PM KimShoaf:Isabel, I think you are right but, what happens is we reinvent the wheel and then want a Nobel for it. 08:52:58 PM Avagene Moore:Would the Internet work as a means of networking, i.e., through a Discussion Group or Mail List which goes directly to email (in your face)? 08:53:27 PM KimShoaf:I think a discussion group would be nice. We need to identify who is out there first... 08:54:40 PM KimShoaf:Is anybody else interested in a discussion group or mail list? 08:54:41 PM Avagene Moore:How would you do that? 08:55:10 PM Joanne:I successfully participate in another mail group that is very helpful. We ask questions of each other, and receive information: source documents, suggestions for different approaches to problems,... it is wonderful. 08:55:26 PM Avagene Moore:Which one is that? 08:55:42 PM KimShoaf:I don't know. We had a student list once...established at Boulder. But it was hard to get people going. I've been on other established lists that work a little too well. 08:56:14 PM Joanne:This is for the American Assn. of Legal Nurse Consultants! 08:57:30 PM David Whitney:As with Kim, I too am a bit leary off e- lists. On the other hand, it sounds like a good way to establish some sort of continuing discussion. 08:57:47 PM Joanne:I get about 50 emails a day from this list. The subject line is the indicator, and if you don't want to read, you just delete it! No attachments. Short and sweet notes... very helpful. 08:58:10 PM KimShoaf:We would need to market the list. We don't want to just talk to the 5-10 of us that already know each other. We could email each other with that. Whoaa 50 is alot. My email would explode..:) 08:58:44 PM Isabel McCurdy:Kim, the old wheel does not seem to be working. Maybe a Nobel prize would be a great incentive for change. 08:58:50 PM Joanne:This list (AALNC) is a subsciber-only list. I pay about $49/year to participate -- and it is well worth it. Also assures no "spam" or weirdo's arrive unannounced. Very moderated list. 08:59:23 PM Jakov Adler:I would be interested in joining such a mail group. But, please conduct the discussios 2hours later at 10PM so I can get some sleep first! 08:59:29 PM Avagene Moore:I may be a bit too simple, but I still see this in terms of bringing different audiences together. This has been an eye opener for me since we started the Virtual Forum ---- repeatedly we find all the people with vested interests in emergency preparedness not talking to each other! We all have so much to learn from each other. 08:59:36 PM Joanne:What are the rational options, Avagene? 09:00:37 PM KimShoaf:I agree with Avagene. I think that is exactly the problem with health people. We thin we are the only ones. Boulder has really helped me with seeing other options. 09:00:58 PM Avagene Moore:Well, we won't have time tonigh to make any decisions. And of course, you guys have to give input. May I suggest we think about this and perhaps share some email about possible options. 09:01:03 PM Amy Sebring:It is not unique to health field by any means... 09:01:12 PM Joanne:I'd love to be able to fire questions directly at a Human Services specialist, a Fire Chief, and EOC manager, etc... an researcher -- if it wasn't their cup of tea, they could delete me -- but others would give great responses. And they could do this at their leisure -- no set time required. 09:01:16 PM Avagene Moore:Exactly, Amy. 09:01:23 PM Amy Sebring:we find that repeatedly in many areas...due to specialization. 09:01:26 PM KimShoaf:I agree.. 09:01:34 PM Amy Sebring:Each field has its own conferences... 09:01:48 PM Amy Sebring:professional publications, etc and there are few opportunities for connections. 09:02:24 PM Amy Sebring:...connections across fields. 09:02:43 PM Avagene Moore:Frankly, I would like to try to get some interest generated based on some of our discussion here tonight. Can we all agree that we will meet again? Perhaps have others join us? 09:02:48 PM Amy Sebring:That was the prime motivation behind the Virtual Forum, was to try to provide some opportunities. 09:03:07 PM KimShoaf:Thats why things like this forum and Boulder are great. Thanks to those who are trying to get us to talk with each other 09:03:08 PM Joanne:Sooo, group... What would you like to do? 09:03:28 PM Amy Sebring:Probably need to plan on brainstorming in Boulder again... 09:03:34 PM Amy Sebring:and see what we can come up with. 09:03:44 PM Avagene Moore:Yes, I think that is a given, Amy. 09:03:47 PM KimShoaf:I first hope we can continue talking and yes do some brainstorming in Boulder 09:03:55 PM Amy Sebring:The least we can do is a Wed. feature on this topic. 09:04:09 PM KimShoaf:I need to run. See most of you in Boulder... 09:04:09 PM Joanne:Avagene or Amy could inform us on the technology and what is available to us... 09:04:33 PM Joanne:Bye, Kim. Thanks for being here. See you in Boulder. 09:05:07 PM Joanne:What would the Wednesday feature be, again? 09:05:10 PM Avagene Moore:Yes, we can do that. I would like to consider the health care sector/emergency management issues discussed in a Discussion Group or Mail List also. 09:05:26 PM David Whitney:Good luck with the Boulder conference. Please keep me on your lists! Thanks 09:05:55 PM Avagene Moore:Wenesday is a formal discussion, perhaps a panel. 09:06:39 PM Joanne:I would be glad to volunteer to work with Amy or Avagene on preparing something for Boulder. Perhaps continue to investigate the Discussion Group or Mail List option. Also, if you know of others that should be on this list, please let any of us know! 09:06:55 PM Jakov Adler:By, everybody, enjoyed to participate in this discussion. Good luck with your conferences. 09:07:07 PM Avagene Moore:Joanne, and all, it is time to wrap it up tonight. 09:07:23 PM Avagene Moore:this has been very interesting and challenging. 09:07:37 PM Joanne:Thanks so much for your participation. 09:07:49 PM Amy Sebring:Somebody tell Jakov, thanks for being here at 3:00 am!! I didn't get the chance. 09:07:49 PM Avagene Moore:thanks to all for being here -- we have much more to talk about in my opinion. 09:08:01 PM Amy Sebring:Thank you Joanne for leading our discussion... 09:08:16 PM Amy Sebring:you are a natural at this! 09:08:20 PM Joanne:My pleasure. This is very exciting!