Community Planning for Pandemic Influenza: Lessons From the VA Health Care System
Community Planning for Pandemic Influenza: Lessons From the VA Health Care System
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DOI：
10.1097/dmp.0b013e31817dd143
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发表时间：
2008-12-01
影响因子：
2.7
通讯作者：
Deyton, Lawrence
中科院分区：
文献类型：
--
作者：
Lurie, Nicole;Dausey, David J.;Deyton, Lawrence
背景：社区合作伙伴--包括卫生部门、应急管理机构和医院--之间的协调和沟通对于有效规划和应对大流行性流感至关重要。作为美国最大的综合卫生保健系统，美国退伍军人事务部(VA)可能是社区规划的关键组成部分。目的：确定与VA社区大流行流感准备相关的问题。方法：作为VA社区规划过程的一部分，我们开发并试点测试了一系列桌面练习，供整个VA系统使用。这些活动包括针对设施、地区(退伍军人综合服务网络)和退伍军人中央办公室的演习。在每一次会议上，退伍军人管理局和社区参与者，包括来自当地卫生保健机构和公共卫生机构的代表，都被介绍了一个关于大流行正在展开的3步情景，并被要求讨论问题并就如何处理情况做出决定。我们报告了从这些试点试验中吸取的教训。结果：退伍军人卫生保健系统代表与当地和地区应急规划者之间针对大流行性流感的现有沟通和协调有限。确定的将受益于更好的协作规划的领域包括应对协调、资源共享、资源分配不均、激增能力、护理标准、劳动力政策和与公众的沟通。结论：美国退伍军人管理局卫生系统和社区对彼此在大流行事件中的计划和需求的了解有限。积极主动的退伍军人管理局社区联合规划和协调--包括演习，然后采取深思熟虑的行动解决出现的问题--可能会改善对大流行流感的防范，并将是互惠互利的。发现的大多数问题并不是退伍军人管理局独有的，但适用于所有综合保健系统。(灾难医学公共卫生准备。2008；2：251-257)
Background: Coordination and communication among community partners-including health departments, emergency management agencies, and hospitals-are essential for effective pandemic influenza planning and response. As the nation's largest integrated health care system, the US Department of Veterans Affairs (VA) could be a key component of community planning.Purpose: To identify issues relevant to VA-community pandemic influenza preparedness.Methods: As part of a VA-community planning process, we developed and pilot-tested a series of tabletop exercises for use throughout the VA system. These included exercises for facilities, regions (Veterans Integrated Service Networks), and the VA Central Office. In each, VA and community participants, including representatives from local health care facilities and public health agencies, were presented with a 3-step scenario about an unfolding pandemic and were required to discuss issues and make decisions about how the situation would be handled. We report the lessons learned from these pilot tests.Results: Existing communication and coordination for pandemic influenza between VA health care system representatives and local and regional emergency planners are limited. Areas identified that would benefit from better collaborative planning include response coordination, resource sharing, uneven resource distribution, surge capacity, standards of care, workforce policies, and communication with the public.Conclusions: The VA health system and communities throughout the United States have limited understanding of one another's plans and needs in the event of a pandemic. Proactive joint VA community planning and coordination-including exercises, followed by deliberate actions to address the issues that arise-will likely improve pandemic influenza preparedness and will be mutually beneficial. Most of the issues identified are not unique to VA, but are applicable to all integrated care systems. (Disaster Med Public Health Preparedness. 2008; 2: 251-257)