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Disaster Preparedness in Home-based Primary Care: Policy and Training

Published online by Cambridge University Press:  19 June 2015

Maria L. Claver ,
Tamar Wyte-Lake  and
Aram Dobalian
Maria L. Claver*
Affiliation:
Department of Veterans Affairs, Veterans Emergency Management Evaluation Center (VEMEC), North Hills, CaliforniaUSA
Tamar Wyte-Lake
Affiliation:
Department of Veterans Affairs, Veterans Emergency Management Evaluation Center (VEMEC), North Hills, CaliforniaUSA
Aram Dobalian
Affiliation:
Department of Veterans Affairs, Veterans Emergency Management Evaluation Center (VEMEC), North Hills, CaliforniaUSA
*
Correspondence: Maria L. Claver, PhD Veterans Emergency Management Evaluation Center (VEMEC) Department of Veterans Affairs 16111 Plummer St. (152) North Hills, California 91343 USA E-mail: Maria.claver@csulb.edu
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Abstract

Introduction

Veterans served by Veterans Health Administration (VHA) home-based primary care (HBPC) are an especially vulnerable population due to high rates of physical, functional, and psychological limitations. Home-bound patients tend to be an older population dealing with normal changes that accompany old age, but may not adequately be prepared for the increased risk that often occurs during disasters. Home health programs are in an advantageous position to address patient preparedness as they may be one of the few outside resources that reach community-dwelling adults.

Problem

This study further explores issues previously identified from an exploratory study of a single VHA HBPC program regarding disaster preparedness for HBPC patients, including ways in which policy and procedures support the routine assessment of disaster preparedness for patients, including patient education activities.

Methods

This project involved semi-structured interviews with 31 practitioners and leadership at five VHA HBPC programs; three urban and two rural. Transcripts of the interviews were analyzed using content analysis techniques.

Results

Practitioners reported a need for further training regarding how to assess properly patient disaster preparedness and patient willingness to prepare. Four themes emerged, validating themes identified in a prior exploratory project and identifying additional issues regarding patient disaster preparedness: (1) individual HBPC programs generally are tasked with developing their disaster preparedness policies; (2) practitioners receive limited training about HBPC program preparedness; (3) practitioners receive limited training about how to prepare their patients for a disaster; and (4) the role of HBPC programs is focused on fostering patient self-sufficiency rather than presenting practitioners as first responders. There was significant variability across the five sites in terms of which staff have responsibility for preparedness policies and training.

Conclusion

Variability across and within sites regarding how patient needs are addressed by preparedness policies, and in terms of preparedness training for HBPC providers, could place patients at heightened risk of morbidity or mortality following a disaster. Despite the diversity and uniqueness of HBPC programs and the communities they serve, there are basic aspects of preparedness that should be addressed by these programs. The incorporation of resources in assessment and preparedness activities, accompanied by increased communication among directors of HBPC programs across the country, may improve HBPC programs’ abilities to assist their patients and their caregivers in preparing for a disaster.

ClaverML, Wyte-LakeT, DobalianA. Disaster Preparedness in Home-based Primary Care: Policy and Training. Prehosp Disaster Med. 2015;30(4):17.

Keywords

disastershome-bound personshome-care servicesveterans’ healthvulnerable populations
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 30 , Supplement 4 , August 2015 , pp. 337 - 343
Copyright
© World Association for Disaster and Emergency Medicine 2015 

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