Hospitals may not be ready for major disaster

Part of problem is funding to train staff

Even though national initiatives to improve bioterrorism, epidemic, and natural disaster preparedness have strengthened communities' overall public health readiness, hospitals' ability to handle sudden surges of patients during a mass emergency remains a concern, particularly due to shortage of funds to train staff, according to a study by the Center for Studying Health System Change (HSC).

The researchers present their findings in the July/August edition of the journal Health Affairs (www.healthaffairs.org).

"Hospitals, and to a lesser extent other health care providers, have improved their ability to respond to public health threats, but observers are not confident of their ability to handle large-scale emergencies," the author write. Some hospitals report "funding wasn't sufficient to make adequate investments, particularly for improving information systems and training staff.

"Several hospitals reported that finding time and money to train staff was an ongoing concern, particularly given staff turnover."

Another unfunded mandate?

Studies identifying critical and vulnerable institutions in the event of a major catastrophic event never fail to mention hospitals. The recently released National Strategy for Pandemic Influenza strategy report, prepared by the Department of Homeland Security, states that hospitals and health care personnel are at high risk due to exposure in the event of an influenza epidemic. The plan and calls on all employers, both public and private, to take steps now to protect continuity of operations and employees in the event of a pandemic — a tall order when your place of business is where all the sick people go, and not easily done without substantial training and preparation.

"The implementation of transmission interventions to protect personnel with such responsibilities is crucial," the federal plan report states, "And organizations can additionally reduce risk by dedicating specific space and personnel for the care of patients with influenza and reducing or eliminating the connectivity of such areas and providers with the rest of the organization."

Training and drilling staff on transmission interventions takes money and space, both of which are in short supply in some places, the Health Affairs authors report.

"The recent federal funding has helped communities enhance public health capacity, but communities are worried that they won't be able to sustain public health improvements made since 2001 if funding continues to decline," says Andrea B. Staiti, an HSC health research analyst and co-author of the study. "Hospital officials also face a daunting array of possible threats, from chemical to nuclear to biological, which are challenging even to the best of planners. The predicament was voiced by one emergency department director, who wondered, 'How much do you really prepare for the unknown? How many victims do you plan for?' No one can really tell us."