17 October 2012EDITS 2012

Coordinating National Healthin Disasters…

Through Knowledge and Learning

Kenneth Schor, DO, MPHCaptain, Medical Corps, US Navy (Retired)

Acting Director, NCDMPHAssistant Professor, USUHS

Disclaimer

The following presentation is the opinion of Dr. Schor and DOES NOT represent the official position or opinion of the Uniformed Services University of the Health Sciences, the US Department of Defense, or the US Government. It is provided for educational purposes only.

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Learning Outcomes for Disaster Health? Its about performance!

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Auguste Rodin “Thinking Man”

Richard Macdonald Bronze Sculptures

Learning Objectives

Learners will be able to:1. Discuss why a disaster is not just an event2. Draw a disaster “cycle”3. Interpret the acronym and describe what the NCDMPH

does4. Discuss the Educational Thesis5. Apply the 3 research questions6. Self-determine their position on the competency triangle

and consider establishing a new goal7. List at least 50% of the core disaster health competencies

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Yucatan Meteor

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Disaster Cycle and Humans

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“If a tree falls in a forest and no one is around to  hear it, does it make a sound?”

1910, Physics

by Mann and Twiss

So was the Yucatan meteor a disaster?

Maybe notDisasters and their cycles are societal

phenomena 

and constructs

Conceptual Framework*

7“Health Disaster Management Guidelines for Evaluation and Research in the Utstein Style”, WADEM, 2003

1‐Hazard

2‐Event

3‐Damage

4‐Changes in Societal Function

5‐Needs

6‐Local Responses (Emergency)

7‐Outside Responses

* Source: World Assoc. of Disaster & Emergency Medicine 

(WADEM)

Disaster Cycle U.S. Federal Emergency Management Agency

Mitigation – Minimizing disaster effects. Ex: building codes and zoning; vulnerability analyses; public education.

Preparedness - Planning how to respond. Ex: preparedness plans; emergency exercises/training; warning systems.

Response – Minimize disaster effects. Ex: search and rescue; emergency relief.

Recovery - Return community to new “normal”. Ex: temporary housing; grants; medical care, rebuilding.

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Another Disaster Cycle Visual

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A More Accurate Diagram?

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(Linear Strand Variant)

Greetings and Best Wishes from the Staff of the

National Center for Disaster Medicine and Public Health (NCDMPH)

The NCDMPH ( http://ncdmph.usuhs.edu )•Serves as the Nation’s center of excellence for education, training, and educational research in disaster medicine and public health preparedness

•Is a Center of the Uniformed Services University of the Health Sciences (USU) – the Nation’s only federal health sciences university ( www.usuhs.mil )

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Who We Are

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“…the Secretaries of Health and Human Services and Defense, in coordination with the Secretaries of Veteran Affairs and Homeland Security, shall establish an academic Joint Program for Disaster Medicine and Public Health housed at a National Center for Disaster Medicine and Public Health at the Uniformed Services University of the Health Sciences. The Program shall lead Federal efforts to develop and propagate core curricula, training, and research related to medicine and public health in disasters. The Center will be an academic center of excellence…” HSPD-21, Paragraph 38

Strategy1. Workforce = Who: Characterize the disaster health workforce

2. Competencies = What: Lead the creation and promotion of national core competencies in disaster health

3. Curriculum = How: Contribute to the research, development, testing, and evaluation of core curricula for disaster health education and training

4. Continuous Learning Improvement = Why: Focus on continuous improvement through the application of adult learning best practices to enhance disaster health lifelong learning

5. National Resource = Goal: Become a trusted national resource for disaster health education and training

Transparent – Neutral -- Unbiased 14

Projects

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Adult Education Tools

Pediatric DisasterLearning Objects

Operation Continuing Promise Support National and Local Exercises

Online Resourcesfor Disaster Health

Sign-Up for our updates:

NCDMPH@gmail.com

Social Media:

Facebook.com/NCDMPH

@NCDMPH

Website: http://ncdmph.usuhs.edu

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Competency

Core Competency• The foundation• Standardizes learning• Supports consistent

application• Translates knowledge

to practice

Competency• Combines/Synthesizes

– Knowledge– Skills– Attitudes

• Beyond the classroom• Measure performance

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In U.S., all health profession education is competency based.

Competency Examples

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• Nurses: Patient assessment• Physicians: History and physical• Public Health: Surveillance

What are core competencies for disaster medicine and public health?

Core Competencies for Disaster Medicine and Public Health

Span:• All health professions• Health effects on all disaster

impacted populations• All hazards

This is a broader scope than profession- specific competencies

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A Visual Segue…

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“Shape”

Educational ThesisWhat you need to know in disaster health…

shapes Competencies…which shape Curricula…which shape Learning…

which saves lives and reduces suffering• WHO needs to know (workforce learners)• WHAT learners need to know (competencies)• HOW learners gain knowledge (curriculum)• APPLY competencies and knowledge to disasters• CONTINUOUSLY IMPROVE (lifelong learning of

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Research Questions You Can Use!

Ask disaster health workers:

1. What did you know that you needed or used?

2. What did you not know that you needed?3. How and when should this knowledge be

learned?

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SO, TO COORDINATE THE

NATION’S HEALTH IN A

DISASTER, YOU NEED…

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A KNOWLEDGE STRUCTURE FOR

LIFELONG LEARNING AND IMPROVEMENT

IN DISASTER MEDICINE AND

PUBLIC HEALTH

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Core Competencies for Disaster Medicine and Public HealthWalsh L, Subbarao I, Gebbie K, Schor K, Lyznicki J, Strauss-Riggs K, Cooper A, Hsu E, King R, Mitas II J, Hick J, Zukowski R, Altman B, Steinbrecher R, James J. Disaster Medicine and Public Health Preparedness. 2012;6(1):44-52.

Free, full-text available at: http://www.dmphp.org/cgi/reprint/6/1/44 Free, full-text available at: http://www.dmphp.org/cgi/reprint/6/1/44

Hierarchical Learning Framework of Competency Sets  in Disaster Medicine and Public Health (DMPH)

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Core Competencies in DMPH

Role/Function/Category 

Specific DMPH Competencies

Discipline/Profession 

Specific DMPH 

Competencies

Highly Specialized

Who?  Examples could be:

Disaster Response Teams

Surgeons, Advanced Nurse 

Practitioners, Pediatricians 

Hospital Workers, 

Response Team 

Volunteers

Whole Health Sector

Core Competencies

1. Personal and family preparedness1.1 Prepare personal/family disaster plan1.2 Gather supplies/equipment for plan1.3 Practice annually1.4 Know methods for enhancing resilience

2. Know organization/institution roles2.1 Incident management role2.2 Know role in community/company plan2.3 Know how to report health threats to authorities2.4 Practice in community/company drills and exercises

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Core Competencies

3. Demonstrate Situational Awareness of Health Hazards3.1 Identify indicators of epidemiological clues3.2 Describe measures to maintain situational awareness

4. Communicate effectively4.1 Identify authoritative information sources4.2 Explain risk communication4.3 Strategies for information sharing4.4 Address cultural issues

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Core Competencies5. Personal safety (or protective) measures

5.1 Health, safety, security risks5.2 Risk reduction measures

6. Surge capacity assets and capability6.1 Describe impact of mass casualties on health system6.2 Identify surge capacity assets

7. Clinical Management all populations7.1 Common physical and mental health consequences7.2 Role of Triage7.3 Basic lifesaving and support

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Core Competencies

8. Public Health principles and practices8.1 Public Health consequences8.2 Identify needs of vulnerable populations8.3 Address needs of vulnerable populations8.4 Common public health interventions

9. Ethical principles9.1 Discuss issues9.2 Issues and challenges of crisis standards of care9.3 Issues and challenges of allocation scarce resources

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Core Competencies

10. Legal principles10.1 Legal and regulatory issues10.2 Legal and regulator issues crisis standards of care10.3 Legal and regulatory issues allocation of scarce resources10.4 Special legal statutes available for use

11. Recovery considerations11.1 Recovery clinical considerations11.2 Recovery public health considerations11.3 Strategies for increasing resilience11.4 Monitor physical and mental health impacts

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More Competency Issues to Highlight

• Teams of Teams

• Inter-professionalism

• Adaptation to Austere Resources

• Importance of community consultation

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Learning Objectives

Learners will be able to:1. Discuss why a disaster is not just an event2. Draw a disaster “cycle”3. Interpret the acronym and describe what the NCDMPH

does4. Discuss the Educational Thesis5. Apply the 3 research questions6. Self-determine their position on the competency triangle

and consider establishing a new goal7. List at least 50% of the core disaster health competencies

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Registration and Poster Submissions Now Open!

Georgetown UniversityHotel & Conference CenterWashington, DC

Contact:Kelly HarrisonKelly.harrison.ctr@usuhs.edu240-833-4431

BACK-UP SLIDES

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FROM THE NATIONAL LIBRARY OF MEDICINE

Disaster Information Management Research Centerhttp://sis.nlm.nih.gov/dimrc.html

orhttp://disasterinfo.nlm.nih.gov

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Workforce

Project

National Health Security Strategy Objective #2—”Develop and maintain the workforce needed for national health security”

Report describes domestic natural disaster health professions workforce:

Five key federal departmentsSelected occupational groupsLA County Case StudyNational Conference

Workforce Report

Public release Feb. 1

Landscape analysis of the domestic disaster health workforce

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Available at ncdmph.usuhs.edu

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Pediatric CurriculumLetter to the Editor: Toward a Pediatric Disaster Health Core CurriculumStrauss-Riggs, K. Schor, K. Altman, B. Letter to the Editor: Toward a Pediatric Disaster Health Core Curriculum. Disaster Medicine and Public Health Preparedness. 2012;6(2):88.

Pocket Cards & Tip Sheets

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