The U.S. government has released its plan to deal with the health consequences associated with major national emergencies such as disease outbreaks, natural disasters, and terrorist attacks.
The National Health Security Strategy (www.hhs.gov/disasters
The plan outlines several objectives including fostering integrated, scalable health care delivery systems; incorporating postincident health recovery into planning and response; maintaining a workforce necessary to respond to health emergencies; and preventing or minimizing emerging threats to health. DHHS will update the plan every 2 years to reflect advances in medicine and public health.
Although the National Health Security Strategy was prepared by the federal government, DHHS Secretary Kathleen Sebelius said that for the plan to be effective, it requires participation from everyone in the nation.
“As we've learned in the response to the 2009 H1N1 pandemic, responsibility for improving our nation's ability to address existing and emergency health threats must be broadly shared by everyone—governments, communities, families, and individuals,” Ms. Sebelius said in a statement. “The National Health Security Strategy is a call to action for each of us so that every community becomes fully prepared and ready to recover quickly after an emergency.”
The new national plan provides a framework for physicians, in particular, to begin planning for their response to an emergency, Dr. Georges C. Benjamin, executive director of the American Public Health Association, said in an interview. Looking back at the challenges that physicians faced during the aftermath of Hurricane Katrina, Dr. Benjamin said that many of those obstacles could have been addressed in a systematic way if a strategy like this one had existed at the time.
This year, DHHS officials, with the help of government and external partners, plan to analyze health care workforce levels, seeking to identify any areas where there is a shortage when it come to health security readiness. For example, shortages have already been identified in the number of public health nurses, epidemiologists, and laboratory personnel, according to DHHS.
Dr. Benjamin said that workforce is a major issue. Although part of the solution will likely involve recruiting more people to the health care field, it will also involve asking clinicians to expand their traditional scope of practice.
For example, practicing internists are trained in a range of emergency skills, but don't use in them in daily practice. As part of emergency planning, they may need to refresh those skills, he said.
Emergency skills also must be taught so that health care providers are ready for the long term, Dr. Benjamin said. That means reexamining graduate medical education to ensure that the full range of practitioners—physicians, nurses, physician assistants, and nurse practitioners—are able, he said. “We've never done that in a comprehensive way in our country. We've been very specialized and silo-based in most of what we do.”
In addition to staying current on emergency skills, physicians also need to consider how a major crisis would affect their practice, Dr. Benjamin advised, adding they should identify the most likely emergency scenarios in their area and think through their role in an emergency. That should include examining employment policies and ensuring safe storage of medical records.
Physicians should also plan for the recovery from an emergency, he said. Have a plan for how to get rapidly recredentialed in another hospital or state, if necessary.
“Good planning for those kinds of emergencies, for your own needs as well as your family's and your patients' needs, is probably a good thing to do,” Dr. Benjamin said.