Ayanna V. Buckner, MD, MPH

Disclosures

October 07, 2009

In This Article

Recommendations for Clinicians

Incorporate Disaster Preparedness Into Routine Clinical Care

Disaster preparedness can become a part of regular health maintenance visits. Clinicians can provide information to assist individuals or families to create an emergency plan, discuss the plan with family members, and practice the plan. A basic emergency plan should include the contact information for an out of town contact, as well as the name, birth date, social security number, and important medical information of family members. It should also include the address, phone number, and evacuation locations for the places that family members frequent (ie, work, schools, etc.). Information about compiling an emergency plan may be found at Ready.gov. Clinicians can also encourage patients to include children and pets in their emergency preparedness plans and drills. The clinician-patient interaction can be used to highlight the importance of complying with government evacuation orders and maintaining an emergency contact outside of the state or region to facilitate communication with family members who may be separated during evacuation.

Clinicians should also stay abreast of specialty specific disaster preparedness recommendations. The American Academy of Pediatrics' policy statement for disaster preparedness[10] is one example. The organization asserts that both general pediatricians and specialists play a central role in managing family concerns regarding disaster preparedness by educating families in anticipation of events and responding to questions during and after actual events. Clinicians in other specialties can play a similar role with their patients.

The American Academy of Pediatrics states that pediatricians should provide guidance to families of children with special healthcare needs. Their recommendations are also relevant for clinicians who provide care for adults, particularly those with chronic illnesses and other special healthcare needs. These recommendations include:

  • Notification of utility companies to provide emergency support during a disaster;

  • Maintenance of medications and equipment should their supply be disrupted during a disaster;

  • Knowledge of how to obtain additional medications and equipment during times of disaster;

  • Training for family members to assume the role of in-home healthcare providers, who may not be available during a disaster; and

  • Keeping up-to-date emergency information to provide healthcare workers with the patient's medical information should the regular care provider be unavailable.

Patients with chronic diseases or patients with acute medical needs, such as chemotherapy regimens, may require more frequent disaster preparedness follow-up. These topics could also be discussed and updated during seasons of natural disasters or during periods of national heightened terror alerts. Clinicians could consider discussing the plans for how a patient would continue treatment (chemotherapy, dialysis, etc.) if the clinician or patient is geographically displaced, how to establish communication with the clinician and office staff, and how to maintain a personal health record and plan for medical records' transfer.

Consider an Interdisciplinary Approach to Prepare Patients for Disasters

Clinicians may also involve other key healthcare providers in preparing patients for disasters. A clinician might appoint a nurse, nursing care manager, or nurse educator to review recommendations with patients. The nurse-based care coordination program model provides an example of this approach. Nurses work in the office setting to provide patient education and monitoring for chronic medical conditions to improve patients' adherence with recommendations and their ability to communicate with physicians. This model has worked successfully for chronic disease management[11,12] and may be helpful in the preparation of patients for disasters.

Refer Patients to a Home Health Agency

Inquire about the patient emergency preparedness policies and practices at local home health agencies. The National Association for Home Care & Hospice has developed an all-hazards emergency preparedness plan to be used by home health and hospice providers. The association has designed templates to assist home health and hospice agencies in preparing patients and their families for emergencies. Home health agency nurses are uniquely positioned to do home emergency preparedness assessments and to reinforce emergency preparedness counseling in greater detail.[13] These assessments may include examination of supplies and emergency preparedness kits, as well as the development of an emergency preparedness plan. The National Association for Home Care & Hospice's Emergency Preparedness Packet includes sample plans that home care agencies can distribute and review with patients and families. The plans may be used as presented or tailored to each patient family's needs. The plan includes general instructions for emergency preparedness for all patients and families and a section designed for individuals with special needs or chronic conditions.

Some states have adopted legislation that requires licensed home health agencies to have minimum standards that include the procedures for: the evacuation of agency clients who require community assistance, as well as for those with available caregivers; the delivery of essential care and services to agency clients whether they are in a shelter or other locations; provisions for the management of staff, including distribution and assignment of responsibilities and functions; a plan for coordinating transportation services required to evacuate agency clients to another location; and assurance that the agency will notify the client's family or caregiver if the client is evacuated to another location.[14]

Engage in Regular Training for You and Your Staff to Keep Up-to-Date

Clinicians may seek information from professional organizations, the Centers for Disease Control and Prevention (CDC) and US DHHS Websites, and their local health departments. These resources also provide disaster preparedness checklists (Figure) and other supporting materials that clinicians and their staff may share with patients during visits and make available in waiting rooms.

Figure.

Sample of the Emergency Preparedness Checklist. From the Federal Emergency Management Agency and American Red Cross Emergency Preparedness Checklist. Available at: http://www.fema.gov/pdf/library/epc.pdf 15 Accessed September 23, 2009.

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