Andrew C. Rucks

Creating a Regional Pediatric Medical Disaster Preparedness Network: Imperative and Issues

Over the past few decades, the number of disasters, both natural and human initiated has increased. As a result, since the September 11, 2001 attacks on the World Trade Center and Pentagon, there has been a new emphasis on disaster preparedness. However, the preparedness emphasis has been primarily directed toward adults and little attention has been specifically given to the needs of children.One reason for the lack of attention to pediatric needs in disaster planning is that childhood is seldom viewed as a separate and special stage of growth, fundamentally different from adulthood. The expectation during emergencies is that the care provided for adults is appropriate for children.The purpose of this paper is to examine the types of and increase in disasters and discuss the importance of specifically addressing the special needs of children in disaster planning. Further the paper argues for a regional network approach to emergency pediatric care that would increase surge capacity for children during disasters and other emergencies.

Can business learn from wargames

Abstract The value of planning, particularly strategic planning, has long been recognized by both the military and business. Recently, the military has made significant contributions in the area of strategic decision making through the use of war games. Business managers may be able to expand their strategic decision-making judgment by employing the wargaming technology developed by the military. If the wargaming concept is embraced by business, it must serve, as it does in the military, as an aid to decision-making rather than as the decision itself.

Identifying Continuous Quality Improvement Priorities in Maternal, Infant, and Early Childhood Home Visiting.

OBJECTIVE The purpose of this article was to describe a methodology to identify continuous quality improvement (CQI) priorities for one states Maternal, Infant, and Early Childhood Home Visiting program from among the 40 required constructs associated with 6 program benchmarks. The authors discuss how the methodology provided consensus on system CQI quality measure priorities and describe variation among the 3 service delivery models used within the state. DESIGN Q-sort methodology was used by home visiting (HV) service delivery providers (home visitors) to prioritize HV quality measures for the overall state HV system as well as their service delivery model. RESULTS There was general consensus overall and among the service delivery models on CQI quality measure priorities, although some variation was observed. Measures associated with Maternal, Infant, and Early Childhood Home Visiting benchmark 1, Improved Maternal and Newborn Health, and benchmark 3, Improvement in School Readiness and Achievement, were the highest ranked. CONCLUSIONS The Q-sort exercise allowed home visitors an opportunity to examine priorities within their service delivery model as well as for the overall First Teacher HV system. Participants engaged in meaningful discussions regarding how and why they selected specific quality measures and developed a greater awareness and understanding of a systems approach to HV within the state. The Q-sort methodology presented in this article can easily be replicated by other states to identify CQI priorities at the local and state levels and can be used effectively in states that use a single HV service delivery model or those that implement multiple evidence-based models for HV service delivery.

Southeastern Regional Pediatric Disaster Surge Network: a public health partnership.

In the event of a natural or man-made disaster involving large numbers of children, resources in the Southeastern U.S. are extremely limited. This article chronicles the efforts of the Alabama Department of Public Health, the Mississippi State Department of Health, and the South Central Center for Public Health Preparedness in conjunction with more than 40 organizations to develop a voluntary network of health-care providers, public health departments, volunteers, and emergency responders from Alabama, Florida, Louisiana, Mississippi, and Tennessee. The purpose of the Southeastern Regional Pediatric Disaster Surge Network (the Network) is to improve the pediatric preparedness response strategies of public health, emergency response, and pediatric providers in the event of large-scale emergencies or disasters that overwhelm local or state pediatric resources. The planning and development of the Network is proceeding through three general phases—information sharing, mutual goal setting and collective action, and long-term formal linkages. In Phase 1, critical planning tasks to be undertaken in the development of the Network were identified. In Phase 2, the agencies developed a draft operational handbook that served as the basis for a formal memorandum of understanding. In Phase 3, participants will engage in exercises and evaluations that will further identify and work out logistical and operational details.

Planning and executing complex large-scale exercises.

INTRODUCTION Increasingly, public health departments are designing and engaging in complex operations-based full-scale exercises to test multiple public health preparedness response functions. The Department of Homeland Securitys Homeland Security Exercise and Evaluation Program (HSEEP) supplies benchmark guidelines that provide a framework for both the design and the evaluation of drills and exercises; however, the HSEEP framework does not seem to have been designed to manage the development and evaluation of multiple, operations-based, parallel exercises combined into 1 complex large-scale event. METHODS Lessons learned from the planning of the Mississippi State Department of Health Emergency Support Function--8 involvement in National Level Exercise 2011 were used to develop an expanded exercise planning model that is HSEEP compliant but accounts for increased exercise complexity and is more functional for public health. RESULTS The Expanded HSEEP (E-HSEEP) model was developed through changes in the HSEEP exercise planning process in areas of Exercise Plan, Controller/Evaluator Handbook, Evaluation Plan, and After Action Report and Improvement Plan development. The E-HSEEP model was tested and refined during the planning and evaluation of Mississippis State-level Emergency Support Function-8 exercises in 2012 and 2013. DISCUSSION As a result of using the E-HSEEP model, Mississippi State Department of Health was able to capture strengths, lessons learned, and areas for improvement, and identify microlevel issues that may have been missed using the traditional HSEEP framework. NEXT STEPS The South Central Preparedness and Emergency Response Learning Center is working to create an Excel-based E-HSEEP tool that will allow practice partners to build a database to track corrective actions and conduct many different types of analyses and comparisons.

A Regional Public Health Field Placement Program: making an IMPACT.

Beginning in 2010, the U.S. Department of Health and Human Services, Health Resources and Services Administration, made provisions in its Public Health Training Center cooperative agreements for field placements. This article describes best practices and lessons learned establishing and managing the South Central Public Health Partnership’s Interns and Mentors Program for ACTion (IMPACT) Field Placement Program, which was initially funded through the Centers for Disease Control and Prevention’s Centers for Public Health Preparedness Cooperative agreement in 2002. The IMPACT program is based on a six-step process that has been developed and refined over its 10-year history: (a) identifying field placement opportunities, (b) marketing field experience opportunities to students, (c) selecting students seeking field experience opportunities, (d) placing students with practice partners, students with practice partners, (e) evaluating student progress toward field experience objectives, and (f) evaluating the program. This article describes the program’s structure and processes, delineates the roles of its academic and practice partners, discusses evidence of its effectiveness, and describes lessons learned from its decade-long history. Hopefully, this information will facilitate the establishment, management and evaluation of internship and field placement programs in other Public Health Training Centers and academic public health programs.

Pandemic influenza preparedness: bridging public health academia and practice.

In 2006, the Alabama Department of Public Health, through the University of Alabama at Birmingham’s South Central Center for Public Health Preparedness, sponsored a series of infectious disease outbreak exercises in Alabama’s six hospital planning regions. The six exercises were conducted in rural and metropolitan areas and were designed to be full-scale assessments of multiagency and multijurisdictional responses to an infectious disease outbreak. This article details the lessons learned from the exercises and collaborations of academia with the public health practice and emergency response communities. We provide the results for our qualitative assessment with the hope that this information can identify trends and potential issues applicable to regions and future disasters outside of Alabama. Thus, while these exercises took place in one state, the trends we observed may be generalizable to other locales as well.

The FORTRAN synthetic program a tool for simulating a computer workload

The FORTRAN Synthetic Program (FSP) facilitates simu lation of a computer workload by providing control of processing time, memory usage, and instruction mix. The FSP features modular design, parameterized control, and internal defaults that enhance flexib ility. The FSP offers the advantages of system independence, ease of use, high flexibility, and the ability to produce verifiable, predictable, and repeatable experiments.

National Environmental Policy: Coordination or Confusion?.

North Texas State University Denton, Texas 76203 In recent months there has been considerable controversy involving the role and effectiveness of the Council on Environmental Quality (CEQ). This controversy emanates from the divergent opinions of the role that CEQ has assumed to ensure adequate protection of the environment and the concomitant costs to operate CEQ programs,’ and the role its critics see mandated for the CEQ under PL 91-190. To gain a proper perspective of the functioning of the CEQ, it is useful to compare and contrast the intended coordinative role of the CEQ as a governing board with its actual activities since its formation.

Man Versus Machine: Comparing Double Data Entry and Optical Mark Recognition for Processing CAHPS Survey Data

Objective:Historically, double data entry (DDE) has been considered the criterion standard for minimizing data entry errors. However, previous studies considered data entry alternatives through the limited lens of data accuracy. This study supplies information regarding data accuracy, operational efficiency, and cost for DDE and Optical Mark Recognition (OMR) for processing the Consumer Assessment of Healthcare Providers and Systems 5.0 survey. Methods:To assess data accuracy, we compared error rates for DDE and OMR by dividing the number of surveys that were arbitrated by the total number of surveys processed for each method. To assess operational efficiency, we tallied the cost of data entry for DDE and OMR after survey receipt. Costs were calculated on the basis of personnel, depreciation for capital equipment, and costs of noncapital equipment. Results:The cost savings attributed to this method were negated by the operational efficiency of OMR. There was a statistical significance between rates of arbitration between DDE and OMR; however, this statistical significance did not create a practical significance. Conclusions:The potential benefits of DDE in terms of data accuracy did not outweigh the operational efficiency and thereby financial savings of OMR.