ACEP proposes plan to increase ED capacity
David C. Seaberg, MD, a board member of the American College of Emergency Physicians (ACEP), has proposed a 10-point plan to increase capacity, alleviate overcrowding, and improve surge capacity in the nation’s emergency departments (ED).
Among other proposals, the plan suggests changing the way hospitals are funded to allow for inpatient and intensive care unit surge capacity; requiring hospitals severely affected by a natural or other disaster to postpone elective admissions until the crisis abates, while compensating them for lost revenue; and providing federal and state funding to compensate hospitals and EDs for the unreimbursed costs of meeting their critical public health and safety net roles. His plan was part of Feb. 8 testimony before a House Committee on Homeland Security hearing on pandemic flu preparedness.
"Without sufficient warning, emergency physicians and nurses would be unprepared to place arriving avian flu patients in isolation until it was too late," Seaberg told the hearing, titled "Protecting the Homeland: Fighting Pandemic Flu From the Front Lines." "Since most hospitals only have one isolation unit, there would be no way to isolate the next avian flu patient seeking emergency care," he said.
(Editor’s note: To access the entire 10-point plan, go to www.acep.org. Under "Breaking News, click: "ACEP Presents 10-Point Plan for Avoiding Mass Casualties in Pandemic Flu, Other Disasters.")
CDC recommends free flu vaccines for staff
The Centers for Disease Control and Prevention (CDC) has released new guidance aimed at increasing flu vaccination among health care workers.
Developed by two CDC advisory committees, the guidance recommends facilities offer flu vaccine annually in the workplace to all eligible personnel at no cost; use reminders, education and other proven strategies to improve vaccination coverage; and obtain a signed form from staff who decline vaccination for nonmedical reasons to help in monitoring and addressing barriers to vaccination. The guidance also recommends using flu vaccination coverage rates as one measure of a patient safety quality program. The CDC has recommended that all health care workers be vaccinated annually against the flu since 1984, but only about 40% do.
Certification offered in disaster medicine
The American Board of Physician Specialties (ABPS) in Atlanta has established the American Board of Disaster Medicine, making available for the first time a board certification in disaster medicine. The board will be accepting applications from physicians of various specialties, including emergency medicine, starting May 1, 2006, and plans to administer the first examination this fall.
The need for such a certification was underscored by the recent hurricane disasters, notes Maurice Ramirez, MD, chairman of the new board. "There is a hesitance on the part of staff physicians to volunteer when a disaster is headed their way because they are afraid they will be pressed into duties they are not familiar with," he explains. "One cardiovascular surgeon was pressed into urgent care and fast-track services in the wake of Rita and had to totally rely on a physician’s assistant," he says. "He said he would never be back."
David McCann, MD, a member of the board, says over the past two years, the board has amassed a core body of knowledge and skill sets the applicants will have to demonstrate. "How they get that training will be up to them, but they must be board-certified already in one of the specialties of medicine: emergency medicine, family medicine, surgery, pediatrics, pathology, and so forth," he says. "Disasters require a multispecialty approach."
The required skill sets will include basic and advanced disaster life support or Disaster Medical Assistance Team (DMAT)-equivalent training, says Ramirez. Also, CME requirements in disaster should include communication, planning, interaction with other agencies, psychology of refugees, refugee status and care, public health, all weapons of mass destruction, and natural disasters, he notes. "These will be prerequisites for the certification test," he says. "Without this knowledge base, you won’t be able to pass our exam."
[Editor’s note: For more information on the American Board of Disaster Medicine, contact: The American Board of Physician Specialties, 2296 Henderson Mill Road, Suite 206, Atlanta, GA 30345. Phone: (770) 939-8555. Fax: (770) 939-8559.]