Public Health Preparedness - Research Paper Example

PUBLIC HEALTH PREPAREDNESS Introduction Relevant studies within the public health sector acknowledge that security is one of the prerequisite for quality healthcare services in a nation. Practically, armed conflicts and terrorism effect processes used in delivery of healthcare services to patients, especially during emergency situations. Actually, insecurity compromises on the success rate of treatment while performing medical procedures. Douglas (2004) said that imminent terrorism constitutes threat of violence, which causes psychological harm and a generally impaired well-being in the society. On the other hand, practical acts of violence like terror bombardments results in physical injuries and death. Health and security are related since employees within a healthcare institution cannot deliver their services with utter peace of mind when there is an impending threat of violence. On the other hand, anxiety in the society resulting from terror threats cannot enable individuals to hold their physical and mental components in good health. In this regard, healthcare institutions should ensure preparedness of their systems to handle emergency situations caused by insecurity incidences. Impacts of Violence in Health Care Prior to examining the essential preparedness measures, it is worth acknowledging the actual effects of insecurity to healthcare delivery. Firstly, terrorists and any perpetrators of insecurity do not apply discrimination while selecting their battlegrounds. Suicide bombers can even walk into a hospital’s sickbay full of patients and detonate an explosive device. This means that violence and terrorism renders a healthcare facility insecure. According to Gilliam and Yates (2012), fears prevailing within a healthcare environment with insecurity undermine the level of competence demonstrated by doctors and nurses while treating patients. Apart from insecure healthcare environment, violence and terrorism causes massive casualties, some of which may be in critical conditions. Normally, a healthcare facility with 600-bed capacity does not have an emergency department to host 300 patients in critical condition. This means that incidences of insecurity like terror bombardments may compromise on effectiveness of a healthcare facility in terms of capacity. Therefore, it is advisable for healthcare facility managers to make hay while the sun shines; by ensuring thorough preparedness for imminent emergency situations. Essential Public Health Services versus Emergency In healthcare service delivery, emergency situations require employment of corresponding response procedures. During preparation for imminent emergency situations, managers should evaluate effectiveness of existing procedures in responding to critical calls. Among the four essential services that will be considered include diagnosis, education, mobilization and linkage. Currently, diagnostic procedures in the facility include screening and scanning of patients, laboratory testing plus collection and analysis of epidemiology samples from the field. Current, the hospital provides limited capacity for diagnosis services. According to Gilliam and Yates (2012), acts of violence may lead to surge of patients in need of diagnostic services. In this regard, staffing needs and logistical capacity of departments dealing with diagnosis may not enable effective response to emergency situations. In terms of education, services offered in this sector include distribution of health information resources, provision of first aid training programs and public sensitization through social media. Normally, these procedures are conducted regularly, precisely on weekly basis for social media advertisements and monthly for first aid training programs. Douglas (2004) agreed that during emergency situations like terror attacks, people may be displaced from their homes; hence may not be in a position to access internet and social media platforms. In addition, there may be no secure places to hold training gatherings for first aid education. Therefore, insecurity may impact significantly on the facility’s ability to conduct health education services. Emergency resulting from violence may also impact on procedures used to mobilize the community. Mobilization procedures used include active participation in community based programs. Most of these programs are health improvement in orientation. Normally, the facility is able to address health issues by integrating efforts of stakeholders like donors, patients and medical professionals. With respect to emergency caused by violence, patients in need of help through these community programs will increase. Channels used in integrating efforts of professionals, patients and well wishers may be affected by fear of terror. Lastly, linkage services will also suffer immensely. Currently, linkage procedures include removal of barriers that hinder healthcare access like financial and infrastructural difficulties. According to Jeffrey and Girish (2010), emergency situations may increase the number of people in need of financial assistance and logistical support in accessing health services. Therefore, these current procedures used for mobilization, linkage, education and diagnosis may undermine efficiency of service delivery during emergency situations. Importance of Patient Evaluation during Emergency In 1986, US Congress enacted the Emergency Medical Treatment and Active Labor Act (EMTALA) that obliges hospitals to implement continuous patient evaluation during emergency situations. This act applies to both private and public hospitals. During an emergency, patients in need of Emergency Medical Care (EMC) will increase. During this situation, keeping of patients’ evaluation forms is necessary for billing inquiry purposes. Jeffrey and Girish (2010) claimed that continuing evaluation is important because emergency situations caused by armed violence or terrorism causes a surge in critically injured patients, which may undermine capacity of the hospital’s department to handle increasing patient population. The EMTALA asserts that in case of increase in patient population, a hospital’s emergency department will not discharge individuals because they are not capable of paying for medical fees. In this context, priority of keeping patients in emergency rooms depends on an individual’s medical status rather that his or her financial muscle. Moreover, healthcare facilities have an obligation to treat any patient in need of immediate medical care regardless of the patient’s legal status or economic strength. However, this act stipulates that hospitals can immediately take a patient out of emergency room once he or she is stable, oriented and alert. According to Jeffrey and Girish (2010), continuing evaluation will be able to tell whether a patient’s life is still in danger. Once a healthcare facility ascertains that an individual’s medical status is no longer life-threatening, the patient should get out of emergency and pave way for others in need of immediate attention. Therefore, continuing patient evaluation is important because it will enable optimization of the hospital’s emergency department during emergency situations. Measures to Maintain Electronic Medical Records Today, the US healthcare industry has undergone full transformation from paper work to electronic systems in patient records management. Electronic Medical Records (EMR) is cost effective, efficient and easily accessible than traditional paper records. During emergency situations, increase in patient number may compromise on the hospital’s ability to maintain its electronic records. One objective of EMR involves keeping accurate and complete information about patients. However, fluctuation of persons in need of services causes lack of coordination during patient admission. A patient may be unconscious, thus not in a position to provide accurate information for the electronic records. In this case, one measure of ensuring maintenance of these records is patient empowerment during his or her recovery. Shepherd (1994) mentioned that healthcare professionals with access to patient records should involve their patients in validation of information while staying in hospital rooms. Through patient empowerment, nurses and doctors will be able to correct any mistakes made during data entry; hence ensuring maintenance of accurate and complete records in emergencies. Another measure for maintenance of EMR includes enabling of multi-user access. Multi-user access technique allows medical staff to view a patient’s records from multiple computer screens at the same time. During emergency situations, many personnel including surgeons, psychiatrists and physicians may be involved in treatment of a single patient. Therefore, allowing all these persons access to records simultaneously reduces chances of medical errors. Finally, another measure for maintaining EMR involves improving system security. During emergency situations, doctors accessing electronic records may forgot to log out from the information interface, thus paving way for those in prey of patient health data. In this case, appropriate measures should be put in place to prevent unauthorized access to patient information. In case of any emergency, adopting all the three measures will ensure sustained maintenance of electronic medical records. Health Insurance during Emergency Conventionally, there are high chances of delay in emergency treatment as a result of financial concerns. Most managers in healthcare institutions are reluctant when it comes to according immediate treatment to patients with uncertain financial ability. Recent research indicates that approximately, 60% of all emergency care services in the US remain uncompensated. Jeffrey and Girish (2010) agreed that most insurance companies today are increasingly applying cost control initiatives in responding to health related claims. Active application of these control initiative programs makes almost impossible for healthcare facilities to get compensation from health insurance policies. At the end, hospitals end up depending on the general good will of patients to pay for emergency treatment fee or they will eventually have to write off those costs from their financial statements. Despite increase in default risks associated with insurance policies during emergency care provision, healthcare facilities still have to treat patients. In case of an emergency situation, I will accept insurance policies as a possible source of payment based on two decision factors. First, I will consider any relevant enactment concerning patients in need of immediate medical attention. The emergency medical act asserts that the law prohibits any healthcare institution from denying patients emergency medical access. The law clearly states that doctors should not delay treatment because of unresolved payment issues. According to Douglas (2004), every healthcare institution should respond to a patient’s immediate medical needs irrespective of the underlying cost factors. In most cases, failure to obey the law results in consequences. In case of a patient’s death due to delayed treatment, the hospital may be forced to compensate the family. Secondly, my decision will be based on the overall mission and vision of the healthcare institution. Medical ethics prohibits hospitals from denying treatment to patients, even to criminals or terrorists injured during violence. Therefore, I will not hesitate to accept payment in form of insurance policies during emergency situations. Quality Care during Emergency It is undeniable that emergency situations like terrorist attacks and increase of armed violence may undermine the quality of services offered by healthcare institutions. First of all, the purpose of immediate response units like ambulance services and other emergency medical services revolves around preventing death and reducing chances of patient disability. In case of ineffective preparation, the emergency situation in subject will severely undermine the quality of emergency medical care. Many fatally injured patients may succumb to their injuries outside emergency rooms as a result of overcrowding or even lack of enough equipment. In addition, panic and fear caused by imminent terror and violence will infiltrate into the workforce, thus affecting employees’ competency. According to Gilliam and Yates (2012), undermined employee competency coupled with problems related to under staffing will not only lead to many deaths but also severe patient disability. In order to maintain quality of care in emergency situations, I would recommend for effective staffing within the facility. In case of emergency, surge in patient population will be offset by presence of adequate medical personnel. On the other hand, the facility should purchase tents and equipment that will enable establishment of mobile emergency centers during tragic situations. Conclusion In conclusion, one can appreciate the fact that emergency medical situations calls for appropriate response measures. Such measures include structuring of procedures in essential health services to meet upsurge in patient population, application of appropriate techniques in managing patient records and consideration to relevant laws related to emergency cases. Lack of timely preparedness will compromise on quality of care during emergency situations. However, effective preparation will ensure that emergency incidents can be handled will minimal difficulty. Reference List Douglas, D. L. (2004). Quality Management in Health Care: Principles and Methods. Harrisburg: Jones & Bartlett Learning. Gilliam, S. & Yates, J. (2012). Essential Public Health Services: Theory and Practice. Cambridge: Cambridge University Press. Jeffrey, S. & Girish, K. (2010). Emergency Public Health: Preparedness and Response. Harrisburg: Jones & Bartlett Learning. Shepherd, J. (1994). Violence in Health Care: A practical guide to copying with violence and caring for victims. London: Oxford University Press. Read More