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Preparedness and Response: Best Practices of Healthcare Providers and SCI/D Veterans in the Face of Natural Disasters

Hogan TP, Weaver FM, Holmes SA, Evans CT, Rapacki LM, Lindblom L, Hoenig HM, Hahm B, Goldstein B. Preparedness and Response: Best Practices of Healthcare Providers and SCI/D Veterans in the Face of Natural Disasters. Poster session presented at: VA QUERI National Meeting; 2008 Dec 12; Phoenix, AZ.


Objectives: Recent national events highlight the challenges that natural disasters present for healthcare organizations. However, little research exists regarding the ways that providers and SCI/D patients prepare for and respond to disasters. The objectives of this study were to collect the experiences of providers and veterans with SCI/D who had recently experienced a natural disaster and to identify best practices for disaster preparedness and response. Methods: Providers and veterans were recruited from four VA SCI centers and three SCI clinics located in areas prone to natural disasters. Forty (N) semi-structured telephone interviews were conducted. Providers (n = 21) consisted of physicians, social workers, nurses, and care coordinators who worked in VHA for less than five to over 20 years. The 19 veterans interviewed had been living with SCI/D for five to over 40 years. Data were coded by two investigators using constant comparative analysis. Results: The disasters experienced by participants were weather-related. Veterans were typically evacuated to unaffected areas or admitted to nearby SCI centers but some chose to stay in their communities. Social support from family and local agencies was critical for these individuals to attain a sense of preparedness. All facilities had formal disaster plans in place and engaged in disaster training activities; however, participants explained that many aspects of a response take shape “in the moment” and that pre-established plans often serve only as useful starting points. Implementing a sustainable response meant addressing provider as well as veteran needs, and facilities had different strategies for doing so. A range of barriers made it difficult for providers to offer well-coordinated care over the course of such events, but capitalizing on teamwork, advanced warnings, locally developed tools like critical patient call lists, and VA’s EMR system helped to overcome such challenges. Implications: Responding to natural disasters in high-risk populations requires appropriate organizational and community resources, but also tailoring responses to address the unique needs of individuals with SCI/D. Impacts: These findings have the potential to improve disaster preparedness and response practices across VA and to ensure safety and minimize negative outcomes for veterans with SCI/D.

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