Preparedness and response activities of the US Department of Veterans Affairs (VA) home-based primary care program around the fall 2017 hurricane season

Abstract

Background Large-scale natural disasters disproportionally affect both the medically complex and the older old, groups that are responsible for most medical surge after a disaster. To understand how to ameliorate this surge, we examined the activities of the nine US Department of Veterans Affairs (VA) Home Based Primary Care (HBPC) programs impacted during the 2017 Fall Hurricane Season. Methods Convergent mixed methods design, incorporating independently conducted qualitative and quantitative analyses. Phase One: 34 clinical staff were interviewed from the nine VA HBPC programs impacted by Hurricanes Harvey, Irma, and Maria to examine the experiences of their HBPC programs in response to the Hurricanes. Phase Two: Secondary quantitative data analysis used the VA’s Corporate Data Warehouse (CDW) to examine the electronic health records of patients for these same nine sites. Results The emergency management activities of the HBPC programs emerged as two distinct phases: preparedness, and response and recovery. The early implementation of preparedness procedures, and coordinated post-Hurricane patient tracking, limited disruption in care and prevented significant hospitalizations among this population. Conclusions Individuals aged 75 or older, who often present with multiple comorbidities and decreased functional status, typically prefer to age in their homes. Additionally, as in-home medical equipment evolves, more medically vulnerable individuals are able to receive care at home. HBPC programs, and similar programs under Medicare, connect the homebound, medically complex, older old to the greater healthcare community. Engaging with these programs both pre- and post-disasters is central to bolstering community resilience for these at-risk populations.

What attributes influence rural household’s willingness to get vaccinated for COVID-19? Perspectives from six Chinese townships

“…categorizing patients into a risk category group, hurricane evacuation planning etc.) limited disruptions in patient care and prevented significant hospitalizations of medically vulnerable populations [88] . However, the immediacy of taking actions varied according to the types of emergency preparedness measures.…”

Evidence of Disaster Planning by Home Care Providers: An Integrative Literature Review

“…One follow-up study was documented in three different articles [28][29][30]. Another empirical study was published in two articles [31,32]. As a result, nine different original research studies were included in this analysis.…”

“…Wyte-Lake et al (2019) [38] Wyte-Lake et al (2020) [31]; Wyte-Lake et al (2020) [32] arrangements, (2) information and networking activities, and (3) measures for safeguarding patient care. These three areas are presented here in condensed form.…”

“…Some providers used secure text messaging systems, software, or mobile apps, while others relied on manual telephone chains or call trees. Sometimes, backup strategies for employee accessibility during communication outages were mentioned, such as an 800-Hz-radio battery-operated walkie-talkie system, web-based scheduling, two-way digital radio communication devices, or a contract with local ham radio operators [28][29][30][31][32][33]35,36].…”

“…Zane & Biddinger (2011) [39] Organisational disaster plan Disaster plans were mentioned relatively often as an organisational measure that home care providers use to prepare for disasters [28][29][30][31][32][33][34][35][36][37]39]. These plans covered, for example, an incident command system as well as other communication plans, a hazard vulnerability analysis, employee protection, an integrated business continuity plan, processes for safeguarding client records, material resources, agreements with partners, and other procedures for patient tracking.…”