The U.S. government has released its plan to deal with the health consequences associated with major national emergencies such as disease outbreaks, natural disasters, and terrorist attacks.
The National Health Security Strategy, available at www.hhs.gov/disasters
The plan outlines several objectives including fostering integrated, scalable health care delivery systems; incorporating postincident health recovery into planning and response; maintaining a workforce necessary to respond to health emergencies; and preventing or minimizing emerging threats to health. HHS will update the plan every 2 years to reflect advances in medicine and public health.
Although the National Health Security Strategy was prepared by the federal government, HHS Secretary Kathleen Sebelius said that for the plan to be effective, it requires participation from everyone in the nation.
“Responsibility for improving our nation's ability to address existing and emergency health threats must be broadly shared by everyone–governments, communities, families, and individuals,” she said in a statement. “The [strategy] is a call to action for each of us so that every community becomes fully prepared and ready to recover quickly after an emergency.”
The new national plan provides a framework for physicians, in particular, to begin planning for their response to an emergency, Dr. Georges C. Benjamin, executive director of the American Public Health Association, said in an interview. Many of the obstacles faced in the aftermath of Hurricane Katrina could have been addressed in a systemic way if a strategy like this one had existed at the time, he said.
This year, HHS officials, with the help of government and external partners, plan to analyze health care workforce levels, seeking to identify any areas where there is a shortage when it comes to health security readiness. For example, shortages have already been identified in the number of public health nurses, epidemiologists, and laboratory personnel, according to HHS.
Dr. Benjamin said that workforce is a major issue. Whereas part of the solution will likely involve recruiting more people to the health care field, it will also involve asking clinicians to expand their traditional scope of practice. For example, there are a range of emergency skills that practicing internists are trained in, but don't use in daily practice. As part of emergency planning, they may need to refresh those skills, he said.
Emergency skills also must be taught so that health care providers are ready for the long term, Dr. Benjamin said. That means reexamining graduate medical education to ensure that the full range of practitioners–physicians, nurses, physician assistants, and nurse practitioners–are able, he said.
In addition to staying current on emergency skills, physicians also need to consider how a major crisis would affect their practice, Dr. Benjamin advised, adding they should identify the most likely emergency scenarios in their area and think through their role in an emergency. That should include examining employment policies and ensuring safe storage of medical records. Physicians should also plan for the recovery from an emergenc, such as having a plan for how to get rapidly re-credentialed in another hospital or state if necessary, he said.