As Chair of the Walden University Dissertation Committee for Sara Geale, Ph.D..I am pleased to share this very brief SUMMARY prepared by Dr. Geale that describes her timely research. My thanks to her for sharing this Summary. Questions or comments may be directed to her at sara.geale@waldenu.edu or sara.geale@aramco.com
Robert E. Hoye, Ph.D.
Summary
A Case Study of a Modular Logistical Systems Approach to
Community Disaster Response
Background
One of the most basic problems with disaster management is the organization and distribution of supplies (Hogan & Burstein, 2007). The shortage of supplies may lead to a situation in which the emergency response is ineffective, and the result is increased human suffering, morbidity, and mortality. Emergency responders agree that it is important to develop strategies to accelerate supply response to deal with unpredictability of demand (Ergun, Karkus, Keskinoca, Swann, & Villarreal, 2010). Supply needs in a disaster situation change significantly according to the type and the phase of the disaster. The supply and demand structure is both complicated and challenging because of the highly unpredictable nature of the time, location, and magnitude. Logistics planning in emergency medical situations involves dispatching needed commodities to the affected areas in a manner that ensures the right resources get to the right places at the right time.
Problem Statement
The problem addressed was how an emergency medical services (EMS) division of a health care organization can best use a logistical or supply management system to meet the changing response needs of multiple-victim emergencies and disasters.
Methodology
A case study was conducted to describe the development of a modular systems approach to community disaster response. Emergency medical responders who were participants in this study identified and discussed a problem in the supply of and dispatch of disaster medical supplies to the scene of an event in a timely, cost-effective manner. A list of likely supplies was compiled and a trial-and-error process used to determine how many patients could be treated with the supplies in a bag that could be easily pulled by one person and lifted into and out of the back of an emergency vehicle. Descriptive case study methodology was used to evaluate the system and consider its effectiveness in the realm within which it operates. The study also considered generalizability of the system to other emergency medical responders.
Results
The results of this case study illustrated that victims of disaster, as well as the responding medical team, benefit from the significantly increased efficiency of the preparedness of the system. Responses can address nearly every contingency and treat a variety of medical emergencies. The system can meet the needs of trauma caused by a variety of disasters and can be scaled up or down to meet the changing needs of the scenario. The system enables greater efficiency for addressing human needs and is structured to efficiently accommodate ongoing refinements.
Conclusion
With disasters on the increase globally, it is important that communities everywhere prepare for them. EMS has long recognized systems in place to deal with day to day emergencies. Disasters, however, overwhelm those established systems. Disaster from a medical perspective is an imbalance of supply and demand. EMS must have systems and process in place that can deal with this imbalance (Auf Der Heide, 2007; Hogan & Burstein, 2007; Perry & Quarantelli, 2005). The modular color-coded bag system is part of planning and preparation for disasters. It is part of the system approach to the management of disasters. Findings showed that prepacking of medical supplies in modular containers for rapid transfer to multiple victim emergencies could increase the effectiveness of the EMS. The implications for positive social change are that a systems approach to disaster management has the potential to reduce morbidity and mortality through effective disaster response at the community level.
References
Auf Der Heide, E. (2007). Disaster response planning and coordination. In D. E. Hogan & J. L. Burstein (Eds.), Disaster Medicine (pp. 95-126). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.
Ergun, O., Karkus, G., Keskinoca, P., Swann, J., & Villarreal, M. (2010). Operations research to improve disaster supply chain management. Retrieved from http://eu.wiley.com
Hogan, D. E., & Burstein, J. L. (2007). Basic perspectives on disaster. In D. E. Hogan & J. L. Burstein (Eds.), Disaster medicine (pp. 1-11). Philadelphia, PA: Lippincott, Williams & Wilkins.
Perry, R. W., & Quarantelli, E. L. (2005). Foreword. In R. W. Perry & E. L. Quarantelli (Eds.). What is a disaster? New answers to old questions (pp. 13-18). Bloomington, IN: Xlibris.
Sunday, December 19, 2010
Monday, December 6, 2010
Principles & Practices of Home Health, Edited by John S. Spratt, MD, Robert E. Hoye, Ph.D. & Rhonda Hawley
Home Health Care: Principles and Practices (CRC Press), Hardcover (1996)
by John Spratt, Robert Hoye, Rhonda Hawley
Hardcover, CRC Press
1996
English
ISBN: 188401593X
ISBN-13: 9781884015939
Twenty-nine practitioners combine their expertise to bring clarity to an issue that is at the forefront of discussion-home health care.The field is emerging and is growing faster than most professionals and their patients can keep up with. Here is a text in which the authors make every effort to provide readers with the latest thinking and technology that can better the home health care field. Spiraling costs have forced all aspects of illnesses to be closely scrutinized for possible home care applications and financial savings.The industry is growing rapidly, fueled by increasing service and constant technological breakthroughs, but the overriding philosophy must be focused on cost containment with maintenance of high quality care. This book is directed at providing highly practical, up-to-date information that health care professionals can use in their daily practices.
by John Spratt, Robert Hoye, Rhonda Hawley
Hardcover, CRC Press
1996
English
ISBN: 188401593X
ISBN-13: 9781884015939
Twenty-nine practitioners combine their expertise to bring clarity to an issue that is at the forefront of discussion-home health care.The field is emerging and is growing faster than most professionals and their patients can keep up with. Here is a text in which the authors make every effort to provide readers with the latest thinking and technology that can better the home health care field. Spiraling costs have forced all aspects of illnesses to be closely scrutinized for possible home care applications and financial savings.The industry is growing rapidly, fueled by increasing service and constant technological breakthroughs, but the overriding philosophy must be focused on cost containment with maintenance of high quality care. This book is directed at providing highly practical, up-to-date information that health care professionals can use in their daily practices.
Sunday, December 5, 2010
Number of U.S. residents without health insurance at new high
FOR YOUR RESEARCH... From the Kaiser Health News: September 16, 2010
Number of U.S. residents without health insurance at new high
A reflection of the weak economy, experts say
By Phil Galewitz, Andrew Villegas
Thursday, September 16, 2010
WASHINGTON, D.C. — In a reflection of the battered economy, the number of people without health insurance rose sharply last year to 50.7 million — an all time high — according to data released Thursday by the Census Bureau.
That pushed the rate of uninsured Americans to 16.7 percent last year from 15.4 percent in 2008, when there were 46.3 million uninsured. It was one of the largest single year increases since the Census starting tracking the figure in 1987.
Nearly every demographic and geographic group posted a rise in the uninsured rate — with the exception of children, who remained stable at about 10 percent. The sharpest jumps were in the Midwest and South, although all areas of the country saw increases.
Jim McLean’s KPR report on the increase in uninsured Kansans
"In a word this is devastating," said Jonathan Oberlander, professor of social medicine and health policy at the University of North Carolina-Chapel Hill.
Both Democrats and Republicans hoped to gain public support from the new figures. The surge in the uninsured could help Democrats gain more support for the new health overhaul law because it underscores the need for dramatically changing the health system. But at the same time, Republicans calling for repeal of that law can use the report to blame Democrats for failing to fix the economy.
"Though not surprising, the uninsured numbers do indicate the role of the dismal economy," said Joseph Antos, a health policy expert from the conservative American Enterprise Institute. "Health insurance is really secondary to the economy."
Although in the short term the report could hurt Democrats, the higher number of uninsured should make it harder for Republicans to talk about repealing the health law, said Oberlander.
"From a political standpoint," he said, "the report makes the administration's and Democrats' point that the status quo is not sustainable and underscores why you needed to do something to stabilize insurance."
The health law approved in March mandates that nearly all Americans have health insurance. It would provide coverage to 32 million more Americans starting in 2014 as the state-federal Medicaid program is expanded and lower-income people get government subsidies to buy coverage through new insurance exchanges or marketplaces.
The jump in uninsured last year reflects the worsening recession, which started in 2008 but ravaged the economy in 2009. The unemployment rate rose to 9.3 percent in 2009 from 5.8 percent in 2008.
"A lot of it is due to changes in people's employment status as people moved from full time to part time and from working to not working," said David Johnson, chief of the housing and household economic statistics division at the Census Bureau.
Analysts said they were not surprised by the big increase in uninsured.
"We've reached yet another milestone in the number of uninsured," said Peter Cunningham, senior fellow at the Center for Studying Health System Change, an independent, nonpartisan think tank. "It's not surprising because it's being driven almost entirely by a big drop in people with private coverage and employer-sponsored coverage."
The percentage of people covered by employer-sponsored coverage dropped to 55.8 percent last year from 58.5 percent in 2008.
The Census report showed there were 43.6 million people in poverty in 2009, up from 39.8 million in 2008 — the third consecutive annual increase.
"The numbers are heartbreaking," said Sara Rosenbaum, a professor of health law and policy at George Washington University. "If we needed any more evidence of the absolute imperative of health reform, this is it."
Indeed, the reliance in America on an employer-based delivery system for health coverage means that the population is susceptible to such explosions of the number of uninsured when unemployment increases, Rosenbaum added. Often, Medicaid — meant to provide coverage for the nation's poor — can't cover many of these newly uninsured, she explained, because strict qualifications exclude many middle class families who lose their jobs and take unemployment benefits.
And it may not get better anytime soon. Rosenbaum said that there will probably be at least one more year with "terrible" health insurance numbers as the economy lags and employers continue to lay workers off.
The report also found that nearly a third of Americans — about 93 million — are now covered by government insurance, mainly Medicare and Medicaid. While the numbers of people on Medicare remains stable, the percentage of people covered by Medicaid, the federal-state program for people with low incomes, rose from to 15.7 percent of Americans from 14.1 percent. Nearly 48 million Americans are in Medicaid programs.
Given the sharp divide in public opinion of the new health law, many Democrats have been reluctant to talk about the health law on the campaign trail. That probably won't change, even with these new figures, said Ross Baker, a professor of political science at Rutgers University.
"They're not going to go back to it. If they've run [from the new law in their campaigns] they're not going to pull a U-turn and embrace it." And voters, Baker said, are unlikely to be more receptive to health reform now because they still simply don't understand what it means for them.
Indeed, the other danger for Democrats going into November's midterm elections is that "any bad stat is going to reflect poorly on the incumbent," Baker said.
Amber Hergen, 34, of Los Angeles, is one of those Americans who lost coverage last year. She left her publicity job at a marketing company, where she had insurance, to pursue her dream of becoming an actress. She's been unable to find affordable individual coverage.
She learned the risk of being uninsured last month when she went to the emergency room after accidentally ingesting a household cleaner. Though she was at the hospital less than an hour, her bill was $2,500.
"Being without insurance is kind of like walking on a tightrope without a net," she said. "It's scary."
Kaiser Health News (KHN) is a nonprofit news organization committed to in-depth coverage of health care policy and politics. The Washington, D.C.-based news service is a partner of KHI News Service.
Number of U.S. residents without health insurance at new high
A reflection of the weak economy, experts say
By Phil Galewitz, Andrew Villegas
Thursday, September 16, 2010
WASHINGTON, D.C. — In a reflection of the battered economy, the number of people without health insurance rose sharply last year to 50.7 million — an all time high — according to data released Thursday by the Census Bureau.
That pushed the rate of uninsured Americans to 16.7 percent last year from 15.4 percent in 2008, when there were 46.3 million uninsured. It was one of the largest single year increases since the Census starting tracking the figure in 1987.
Nearly every demographic and geographic group posted a rise in the uninsured rate — with the exception of children, who remained stable at about 10 percent. The sharpest jumps were in the Midwest and South, although all areas of the country saw increases.
Jim McLean’s KPR report on the increase in uninsured Kansans
"In a word this is devastating," said Jonathan Oberlander, professor of social medicine and health policy at the University of North Carolina-Chapel Hill.
Both Democrats and Republicans hoped to gain public support from the new figures. The surge in the uninsured could help Democrats gain more support for the new health overhaul law because it underscores the need for dramatically changing the health system. But at the same time, Republicans calling for repeal of that law can use the report to blame Democrats for failing to fix the economy.
"Though not surprising, the uninsured numbers do indicate the role of the dismal economy," said Joseph Antos, a health policy expert from the conservative American Enterprise Institute. "Health insurance is really secondary to the economy."
Although in the short term the report could hurt Democrats, the higher number of uninsured should make it harder for Republicans to talk about repealing the health law, said Oberlander.
"From a political standpoint," he said, "the report makes the administration's and Democrats' point that the status quo is not sustainable and underscores why you needed to do something to stabilize insurance."
The health law approved in March mandates that nearly all Americans have health insurance. It would provide coverage to 32 million more Americans starting in 2014 as the state-federal Medicaid program is expanded and lower-income people get government subsidies to buy coverage through new insurance exchanges or marketplaces.
The jump in uninsured last year reflects the worsening recession, which started in 2008 but ravaged the economy in 2009. The unemployment rate rose to 9.3 percent in 2009 from 5.8 percent in 2008.
"A lot of it is due to changes in people's employment status as people moved from full time to part time and from working to not working," said David Johnson, chief of the housing and household economic statistics division at the Census Bureau.
Analysts said they were not surprised by the big increase in uninsured.
"We've reached yet another milestone in the number of uninsured," said Peter Cunningham, senior fellow at the Center for Studying Health System Change, an independent, nonpartisan think tank. "It's not surprising because it's being driven almost entirely by a big drop in people with private coverage and employer-sponsored coverage."
The percentage of people covered by employer-sponsored coverage dropped to 55.8 percent last year from 58.5 percent in 2008.
The Census report showed there were 43.6 million people in poverty in 2009, up from 39.8 million in 2008 — the third consecutive annual increase.
"The numbers are heartbreaking," said Sara Rosenbaum, a professor of health law and policy at George Washington University. "If we needed any more evidence of the absolute imperative of health reform, this is it."
Indeed, the reliance in America on an employer-based delivery system for health coverage means that the population is susceptible to such explosions of the number of uninsured when unemployment increases, Rosenbaum added. Often, Medicaid — meant to provide coverage for the nation's poor — can't cover many of these newly uninsured, she explained, because strict qualifications exclude many middle class families who lose their jobs and take unemployment benefits.
And it may not get better anytime soon. Rosenbaum said that there will probably be at least one more year with "terrible" health insurance numbers as the economy lags and employers continue to lay workers off.
The report also found that nearly a third of Americans — about 93 million — are now covered by government insurance, mainly Medicare and Medicaid. While the numbers of people on Medicare remains stable, the percentage of people covered by Medicaid, the federal-state program for people with low incomes, rose from to 15.7 percent of Americans from 14.1 percent. Nearly 48 million Americans are in Medicaid programs.
Given the sharp divide in public opinion of the new health law, many Democrats have been reluctant to talk about the health law on the campaign trail. That probably won't change, even with these new figures, said Ross Baker, a professor of political science at Rutgers University.
"They're not going to go back to it. If they've run [from the new law in their campaigns] they're not going to pull a U-turn and embrace it." And voters, Baker said, are unlikely to be more receptive to health reform now because they still simply don't understand what it means for them.
Indeed, the other danger for Democrats going into November's midterm elections is that "any bad stat is going to reflect poorly on the incumbent," Baker said.
Amber Hergen, 34, of Los Angeles, is one of those Americans who lost coverage last year. She left her publicity job at a marketing company, where she had insurance, to pursue her dream of becoming an actress. She's been unable to find affordable individual coverage.
She learned the risk of being uninsured last month when she went to the emergency room after accidentally ingesting a household cleaner. Though she was at the hospital less than an hour, her bill was $2,500.
"Being without insurance is kind of like walking on a tightrope without a net," she said. "It's scary."
Kaiser Health News (KHN) is a nonprofit news organization committed to in-depth coverage of health care policy and politics. The Washington, D.C.-based news service is a partner of KHI News Service.
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