Sl Elmer

Disaster Preparedness among Health Professionals and Support Staff: What is Effective? An Integrative Literature Review

Introduction It is important that health professionals and support staff are prepared for disasters to safeguard themselves and the community during disasters. There has been a significantly heightened focus on disasters since the terrorist attacks of September 11, 2001 in New York (USA); however, despite this, it is evident that health professionals and support staff may not be adequately prepared for disasters. Report An integrative literature review was performed based on a keyword search of the major health databases for primary research evaluating preparedness of health professionals and support staff. The literature was quality appraised using a mixed-methods appraisal tool (MMAT), and a thematic analysis was completed to identify current knowledge and gaps. Discussion The main themes identified were: health professionals and support staff may not be fully prepared for disasters; the most effective content and methods for disaster preparedness is unknown; and the willingness of health professionals and support staff to attend work and perform during disasters needs further evaluation. Gaps were identified to guide further research and the creation of new knowledge to best prepare for disasters. These included the need for: high-quality research to evaluate the best content and methods of disaster preparedness; inclusion of the multi-disciplinary health care team as participants; preparation for internal disasters; the development of validated competencies for preparedness; validated tools for measurement; and the importance of performance in actual disasters to evaluate preparation. CONCLUSION The literature identified that all types of disaster preparedness activities lead to improvements in knowledge, skills, or attitude preparedness for disasters. Most studies focused on external disasters and the preparedness of medical, nursing, public health, or paramedic professionals. There needs to be a greater focus on the whole health care team, including allied health professionals and support staff, for both internal and external disasters. Evaluation during real disasters and the use of validated competencies and tools to deliver and evaluate disaster preparedness will enhance knowledge of best practice preparedness. However, of the 36 research articles included in this review, only five were rated at 100% using the MMAT. Due to methodological weakness of the research reviewed, the findings cannot be generalized, nor can the most effective method be determined. Gowing JR , Walker KN , Elmer SL , Cummings EA . Disaster preparedness among health professionals and support staff: what is effective? An integrative literature review. Prehosp Disaster Med. 2017;32(3):321-328.

Another Look at the Culture-Quality-Performance Link

Quality improvement is usually driven by quality, safety and risk agendas leading to a focus on measurements of the outputs of care; outputs such as fewer complaints, fewer accidents and adverse events. An oft-neglected theme is the impact of the quality improvement initiative within the organisation itself. This paper presents the findings of the first stage of an evaluation that has examined the changes which have occurred within organisations since participating in a quality improvement initiative. These findings indicate that engaging with a quality improvement program can change the nature of social interactions within the organisation. In this way, quality improvement programs can impact on organisational culture, particularly in relation to organisational learning. Thus, this paper argues that successful engagement with a quality improvement program can enhance organisational learning, and, in turn, build organisational capacity.

Using Project Evaluation to Build Capacity for Integrated Health Care at Local Levels

Capacity‐building evaluation featuring multidisciplinary cross‐agency workshops fostered continuous quality improvement, while focusing on skills required and systemic barriers to health care integration between GPs and a regional hospital.

Associations of health literacy with diabetic foot outcomes: a systematic review and meta‐analysis

People with diabetes have low health literacy, but the role of the latter in diabetic foot disease is unclear.

Perceived barriers to managing medications and solutions to barriers suggested by Bhutanese former refugees and service providers

Introduction: The purpose of this study was to explore perceived barriers to managing medications and potential solutions to such barriers among Bhutanese former refugees and service providers in Tasmania, Australia. Method: Thirty Bhutanese former refugees and service providers recruited through community health programs participated in a community-based participatory research design. Data were elicited through a structured focus group process and analyzed using content analysis. Results: Perceived barriers to managing medications included language barriers, low health literacy, and culturally unresponsive interactions with services. Themes identifying potential solutions to barriers referred to the functional health literacy of individuals (providing reassurance, checking understanding, and involving support networks) and creating supportive health care environments (consistent service providers, culturally responsive care, assistance navigating services, using trained interpreters). Discussion: Creating environments conducive to interactive and critical health literacy about medications is as important for culturally congruent care as supporting the functional health literacy of individuals.

HealthLit4Kids study protocol; crossing boundaries for positive health literacy outcomes

BackgroundHealth attitudes and behaviours formed during childhood greatly influence adult health patterns. This paper describes the research and development protocol for a school-based health literacy program. The program, entitled HealthLit4Kids, provides teachers with the resources and supports them to explore the concept of health literacy within their school community, through classroom activities and family and community engagement.MethodsHealthLit4Kids is a sequential mixed methods design involving convenience sampling and pre and post intervention measures from multiple sources. Data sources include individual teacher health literacy knowledge, skills and experience; health literacy responsiveness of the school environment (HeLLO Tas); focus groups (parents and teachers); teacher reflections; workshop data and evaluations; and children’s health literacy artefacts and descriptions. The HealthLit4Kids protocol draws explicitly on the eight Ophelia principles: outcomes focused, equity driven, co-designed, needs-diagnostic, driven by local wisdom, sustainable, responsive, systematically applied. By influencing on two levels: (1) whole school community; and (2) individual classroom, the HealthLit4Kids program ensures a holistic approach to health literacy, raised awareness of its importance and provides a deeper exploration of health literacy in the school environment. The school-wide health literacy assessment and resultant action plan generates the annual health literacy targets for each participating school.DiscussionHealth promotion cannot be meaningfully achieved in isolation from health literacy. Whilst health promotion activities are common in the school environment, health literacy is not a familiar concept. HealthLit4Kids recognizes that a one-size fits all approach seldom works to address health literacy. Long-term health outcomes are reliant on embedded, locally owned and co-designed programs which respond to local health and health literacy needs.

What are the Most Effective Methods of Disaster Preparation for Health Professionals and Support Staff? Perspectives from Staff at St Vincent’s Private Hospital, Sydney - Phase 1 of a Multi-site Study

and crises. Ongoing operation is dependent on the availability of manpower, infrastructure, medical equipment, information technology, and computerized systems. Advanced planning is required to ensure sustainability of services, even during significant disasters. Methods: An operational continuity plan was established, basing the sustainability efforts on international standards. Through adaptation of a process of Business Impact Analysis on the health care system, core vulnerabilities within the HMO were identified, priorities, and criticality of each service were defined as follows: HIGH: Recovery Time Objective (RTO) immediately or up to 24 hours; MEDIUM: RTO within a week; LOW: RTO within four weeks. The plan encompasses all critical elements and services, including computerized system, manpower, infrastructure, and vital equipment. Results: The operational continuity plan was evaluated and approved by the senior Executive Board of the HMO and has been adopted as a perennial work plan. A designated organizational structure was developed as responsible for the implementation and management of the recovery plan during a crisis. Once a year, training and exercise of the recovery plan is conducted, cross-cutting all critical services including: primary care, nursing, pharmacy, laboratory, radiology, home care for vulnerable populations, mental, and emergency dental health services. The aim is to achieve participation of at least 25% of the pre-defined population in the annual training program. Conclusion: Implementing preparedness for various disasters ensures recovery within the designated objectives, which were defined in the operational continuity plan. A significant budget needs to be allocated in order to facilitate an effective preparedness.

Risk, morality and emotion: social media responses to pregnant women who smoke

In this article, we use qualitative data to examine the shape and nature of the online ‘moral outrage’ that was directed at a research trial that used financial incentives to encourage pregnant mothers to quit smoking. Mai Frandsen developed the research trial in Tasmania, a small island state in Australia characterised by high rates of smoking in pregnancy. In this article, we draw on data from 121 online text comments posted in relation to three Australia-wide media stories relating to the research trial in 2015. Two of the online stories came from popular Australian independent ‘mummy’ website ‘Mamamia’. We found that the intense negative moral judgement directed at the programme and the women it benefited was driven by an individualised risk discourse drawing on ideologies of the ‘good’ and ‘intensive’ mother. We argue in this article that the over-emphasis on risk in relation to pregnancy produces a conservative morality that demonise women, fails to account for the social determinants of health and diminishes care for the Other. We argue that the research programme with its incentive component was a useful alternative to more punitive risk approaches as it promoted reward rather than blame and shame and acknowledged the importance of including emotions and morality in analysing the relationship between risk, health and society.