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– Look at two of my classmate’s posts. I need you to respond to each one separately. Don’t write about how good their posts or how bad. All you need to do is to choose one point of the post and explore it a little bit with one source support for each response. In attachment you will find all the classmates posts.- APA Style.
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Discussion Board Questions:
Comment on one of the key findings described in the Toner et al document.
Identify other funding sources for your hospital emergency management projects.
Reading:
Toner E, Waldhorn R, Franco C, Courtney B, Rambhia K, Norwood A, Inglesby TV,
O’Toole T. (2009). Hospitals rising to the challenge: The first five years of the U.S.
hospital preparedness program and priorities going forward Prepared by the
Center for Biosecurity of UPMC for the U.S. Department of Health and Human
Services under Contract No. HHSO100200700038C.

http://www.upmchealthsecurity.org/our-work/pubs_archive/pubs-pdfs/2009/200904-16-hppreport.pdf
U.S. Department of Health and Human Services Assistant Secretary for
Preparedness and Response: Strategic Plan 2010 – 2015.

http://www.hhs.gov/secretary/about/priorities/strategicplan2010-2015.pdf
Review www.phe.gov/about/pages/default.aspx
Student 1 post:
Hospitals are the backbone of the healthcare response to common medical
disasters. In 2002 the United States Department of Health and Human Services
(HHS) established the Hospital Preparedness Program (HPP) to enhance the
ability of healthcare systems. Hospital emergency operations plans (EOPs) have
become more comprehensive through disaster Preparedness of Individual Hospitals
Has Improved Significantly Throughout the Country Since the Start of The HPP.in
the early stages of catastrophic emergencies, Healthcare planning was assistance
and direction at the national level and, in many locations, are coordinated with
community emergency plans and local hazards. Disaster training has become more
rigorous and standardized; hospitals have stockpiled emergency supplies and
medicines; situational awareness and communications are improving, and exercises
are more frequent and of higher quality.
One of the key findings in the Toner et al. document is Disaster Preparedness of
Individual Hospitals Has Improved Significantly Throughout the Country Since
the Start of the HPP. To ensure low rates of injuries and deaths healthcare facilities
need to preparedness during the disaster, hospital senior leadership is actively
supporting and participating in preparedness activities.
The other funding sources for your hospital emergency management projects, one
of the most significant factors contributing to strengthened healthcare preparedness
is the emergence of Healthcare Coalitions. This helps health departments to train
for the disaster preparedness and reduce the risk of infectious diseases, natural
disasters
Reference:
Toner E, Waldhorn R, Franco C, Courtney B, Rambhia K, Norwood A, Inglesby
TV, O’Toole T. Hospitals Rising to the Challenge: The First Five Years of the U.S.
Hospital Preparedness Program and Priorities Going Forward. Prepared by the
Center for Biosecurity of UPMC for the U.S. Department of Health and Human
Services under Contract No. HHSO100200700038C. 2009
Student 2 post:
The Hospital Preparedness Program (HPP) was established by the United States Department
of Health and Human Services (HHS) in 2002 to enhance the ability of healthcare systems
and hospitals to be prepared for bioterror attacks on people and other public health
emergencies. The primary purpose of the Hospital Preparedness Program (HPP) is improving
the communication systems, personnel management, bed tracking process, fatality
management planning, and hospital evacuation planning.
Comment on one of the key findings described in the Toner et al. document?
1. Disaster Preparedness of Individual Hospitals Has Improved Significantly Throughout the
Country Since the Start of the HPP.
Hospitals and other healthcare facilities need to demonstrate emergency and disaster
preparedness to ensure low rates of injuries and deaths occurring because of emergencies
and disasters. It is essential for every hospital to create a robust and effective emergency
and disaster management system. A disaster and emergency recovery system should consist
of processes and procedures for the mitigation, preparedness, and response and recovery
systems. For an effective emergency recovery system, every hospital or health care facility
should maintain an Emergency Operations Committee (EOC) for the coordination of all the
emergency operations in the hospital or the health care facility
2- Identify other funding sources for your hospital emergency management projects?
Brigham and Women’s Emergency Department improvement that was following the
shooting of the Surgeon in 2015, Brigham and Women’s Hospital determined to enhance its
emergency department by providing modernized Observations Units (OU) that would
effectively provide care rather than targeting patients from specific emergency
departments. Effective management of the observation units reduces the amount of time
the patients consume while reducing the costs of the system. (Beaulieu et al., 2015)
References
Beaulieu, D. et al. (2015). Brigham and women’s emergency department. Observation unit
process improvement.
Public Health Emergency. (March 5, 2019). Public Health and Medical Emergency Support
for a Nation prepared. Retrieved from https://www.phe.gov/about/pages/default.aspx
Toner E, Waldhorn R, Franco C, Courtney B, Rambhia K, Norwood A, Inglesby TV, O’Toole T.
(2009). Hospitals rising to the challenge: The first five years of the U.S. hospital
preparedness program and priorities going forward Prepared by the Center for Biosecurity
of UPMC for the U.S. Department of Health and Human Services under Contract No.
HHSO100200700038C.
Hospitals Rising to the Challenge:
The First Five Years of the U.S. Hospital Preparedness Program
and Priorities Going Forward
Evaluation Report | March 2009
Sponsored by the U.S. Department of Health and Human Services under Contract #HHSO100200700038C
The Center for Biosecurity is an independent, nonprofit organization of the University of Pittsburgh Medical Center (UPMC).
The Center’s multidisciplinary professional staff, with experience in government, medicine, public health, bioscience, law, and
the social sciences, works to affect policy and practice in ways that lessen the illness, death, and civil disruption that would
follow large-scale epidemics, whether they occur naturally or result from the use of a biological weapon. Experts at the Center
publish research findings regularly and are consulted by government agencies, businesses, academia, and the media for independent analyses of issues pertaining to national and global epidemic preparedness and response.
Center for Biosecurity of UPMC
The Pier IV Building
621 E. Pratt Street, Suite 210
Baltimore, Maryland 21202
443-573-3304
http://www.upmc-biosecurity.org
Acknowledgments
This work was commissioned by the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response (ASPR), under Contract No. HHSO100200700038C. This report would not
have been possible without the more than 100 dedicated and committed hospital and state preparedness planners and other experts who contributed their time to provide the Center for Biosecurity project team with critical
insight into the state of U.S. hospital preparedness, or without the participants of the June 2008 Issue Analysis
Meeting in Baltimore, Maryland. The project team would also like to give special thanks to the leadership and
staff of the ASPR Office of Preparedness and Emergency Operations components of the Hospital Preparedness
Program and State and Local Evaluation for their guidance and support in the development of this report.
Suggested Citation
Toner E, Waldhorn R, Franco C, Courtney B, Rambhia K, Norwood A, Inglesby TV, O’Toole T. Hospitals Rising
to the Challenge: The First Five Years of the U.S. Hospital Preparedness Program and Priorities Going Forward.
Prepared by the Center for Biosecurity of UPMC for the U.S. Department of Health and Human Services under
Contract No. HHSO100200700038C. 2009.
Hospitals Rising to the Challenge:
The First Five Years of the U.S. Hospital Preparedness Program
and Priorities Going Forward
Evaluation Report | March 2009
Project Team
Center for Biosecurity of UPMC
Eric Toner, MD (Principal Investigator)
Senior Associate
Richard Waldhorn, MD (Co-Principal Investigator)
Distinguished Scholar
Crystal Franco (Project Manager)
Senior Analyst
Brooke Courtney, JD, MPH
Associate
Kunal Rambhia
Analyst
Ann Norwood, MD, COL, USA, MC (Ret.)
Senior Associate
Thomas V. Inglesby, MD
Deputy Director and Chief Operating Officer
Tara O’Toole, MD, MPH
Director and Chief Executive Officer
Project Contacts: Eric Toner, MD, and Richard Waldhorn, MD
Hospitals Rising to the Challenge | March 2009
Contents
List of Tables and Figures …………………………………………………………………………………………………………..iii
Executive Summary …………………………………………………………………………………………………………………… v
I. Project Overview
Summary………………………………………………………………………………………………………………………………. 1
Methodology ………………………………………………………………………………………………………………………… 2
II. State of U.S. Hospital Preparedness Prior to the Hospital Preparedness Program
Historical Context ………………………………………………………………………………………………………………….. 7
Pre-HPP Hospital Preparedness Research ………………………………………………………………………………… 11
III. History of the Hospital Preparedness Program
Legislative and Funding History ……………………………………………………………………………………………… 17
Program Guidance (FY2002–FY2008)………………………………………………………………………………………. 19
Impact of Guidance Evolution on Data Collection and Reporting ……………………………………………….. 20
Hospital Preparedness Research Conducted after HPP Implementation ………………………………………. 21
IV. Key Findings
1. Disaster preparedness of individual hospitals has improved significantly
throughout the country since the start of the HPP. ………………………………………………………………… 23
2. The emergence of Healthcare Coalitions is creating a foundation for
U.S. healthcare preparedness. …………………………………………………………………………………………… 36
3. Healthcare planning for catastrophic emergencies is in early stages; progress
will require additional assistance and direction at the national level………………………………………… 46
4. Surge capacity and capability goals, assessment of training, and analysis of
performance during actual events and realistic exercises are the most useful
indicators for measuring preparedness. ………………………………………………………………………………. 55
V. Conclusions
1. The HPP has improved the resilience of U.S. hospitals and communities and
increased their capacity to respond to “common medical disasters.” ……………………………………… 57
2. The HPP should focus on building, strengthening, and linking Healthcare
Coalitions to lay the foundation for a national disaster health and medical
response system. ……………………………………………………………………………………………………………… 58
3. Administrative adjustments to the HPP could improve the program’s
effectiveness and efficiency. ………………………………………………………………………………………………. 59
4. To prepare the nation to respond to catastrophic emergencies, HHS should
provide continued leadership to assist states in their efforts to address the many
procedural, ethical, legal, and practical problems posed by a shift to disaster
standards and ACFs that is required when demand for care overwhelms available resources. ……. 60
5. Catastrophic emergency preparedness is a national security issue and requires
the continued funding of the HPP. ………………………………………………………………………………………. 61
Center for Biosecurity of UPMC
i
Hospitals Rising to the Challenge | March 2009
Appendix A. List of Acronyms …………………………………………………………………………………………………… 63
Appendix B. Center for Biosecurity Descriptive Framework for Healthcare
Preparedness for Mass Casualty Events: The Framework and Crosswalk of
Elements of Preparedness ……………………………………………………………………………………… 65
Appendix C. Map of Working Group Participants Contacted for Participation ………………………………… 79
Appendix D. HPP Guidance Terminology by Year………………………………………………………………………… 81
Appendix E. Summary of HPP Program Guidance: FY2002–FY2008………………………………………………. 83
Appendix F.
Summary of Studies on Hospital Preparedness Since the Establishment
of the HPP by Year………………………………………………………………………………………………… 87
Center for Biosecurity of UPMC
ii
Hospitals Rising to the Challenge | March 2009
List of Tables and Figures
Table 1. Number of Virtual Working Group Participants by Sector …………………………………………………. 4
Table 2. Studies on Pre-HPP Hospital Preparedness by Year …………………………………………………………. 12
Table 3. Hospital Preparedness Program Funding: FY2002–FY2009 ………………………………………………. 18
Figure 1. Timeline of Significant Events for Healthcare Preparedness: 1989–2007 …………………………….. 9
Figure 2. Percent HPP Hospital Participation by Reporting States, Municipalities,
and Territories: 2006 (n = 58) ……………………………………………………………………………………….. 19
Figure 3. Percentage of Hospitals with Redundant Communications Capabilities by
Number of HPP-Participating States, Municipalities, and Territories: 2006
(n = 58) ……………………………………………………………………………………………………………………… 30
Figure 4. Percent Hospital Use of Corrective Actions/Improvement Plans Following a
Drill or Exercise by Number of HPP-Participating States, Municipalities, and
Territories: 2006 (n = 58)………………………………………………………………………………………………. 36
Figure 5. HHS Medical Surge Capacity and Capability (MSCC) Framework ……………………………………… 39
Figure 6. Multi-Agency Coordination (MAC) Model for Regional Healthcare
Emergencies ……………………………………………………………………………………………………………… 42
Figure 7. Percentage of HPP-Participating States, Municipalities, and Territories with
a Functional ESAR-VHP System that Allows Volunteer Health Professionals
to Register for Work in Hospitals or Other Facilities during Emergencies: 2006
(n = 62) ……………………………………………………………………………………………………………………… 45
Figure 8. Administrative and Clinical Adaptations to Resource-Poor Situations ………………………………… 48
Center for Biosecurity of UPMC
iii
Hospitals Rising to the Challenge | March 2009
Executive Summary
Executive Summary
Hospitals are the backbone of the healthcare response to common medical disasters (i.e., mass casualty events
that occur with relative frequency, overwhelm a single hospital, and require a communitywide health response)
and, in particular, to catastrophic emergencies, such as an influenza pandemic or large-scale aerosolized anthrax
attack. The need for hospitals to be prepared to respond to disasters has increasingly become a priority for hospital leaders. They have been influenced by events such as the 2001 terrorist attacks and Hurricane Katrina and
the increased emphasis placed by accreditation organizations and regulatory agencies on the importance of such
disasters.
Established by the U.S. Department of Health and Human Services (HHS) in 2002, the goal of the Hospital
Preparedness Program (HPP)1 is to enhance the ability of hospitals and healthcare systems to prepare for and
respond to bioterror attacks on civilians and other public health emergencies, including pandemic influenza and
natural disasters. Current HPP priorities include strengthening hospital capabilities in the areas of interoperable communication systems, bed tracking, personnel management, fatality management planning, and hospital
evacuation planning. Past priorities include improving bed and personnel surge capacity, decontamination capabilities, isolation capacity, pharmaceutical supplies, training, education, drills, and exercises.
The HPP was initially administered by the Health Resources and Services Administration (HRSA). Congress directed the transfer of the HPP to the Office of the Assistant Secretary for Preparedness and Response (ASPR) under
the 2006 Pandemic and All-Hazards Preparedness Act (PAHPA).2 All 50 states, as well as the District of Columbia,
the nation’s three largest municipalities (Chicago, Los Angeles, and New York City), the Commonwealths of Puerto
Rico and the Northern Mariana Islands, three territories (American Samoa, Guam, and the U.S. Virgin Islands),
Micronesia, the Marshall Islands, and Palau, have received over $2 billion in HPP funding through grants, partnerships, and cooperative agreements since 2002.
In 2007, ASPR contracted with the Center for Biosecurity of the University of Pittsburgh Medical Center (UPMC)
(Center) to conduct an assessment of U.S. hospital preparedness and to develop recommendations for evaluating
and improving future hospital preparedness efforts. The first deliverable was the Center’s Descriptive Framework
for Healthcare Preparedness for Mass Casualty Events,3 which is a description of the most important components
of preparedness for mass casualty response at the local and regional hospital and healthcare system levels (Appendix B). Hospitals Rising to the Challenge: The First Five Years of the U.S. Hospital Preparedness Program and
Priorities Going Forward is the second deliverable under the contract. It is the Center’s assessment of the impact
of the HPP on hospital preparedness from the time of the program’s establishment in 2002 through mid-2007, as
well as our preliminary recommendations for improving the state of U.S. hospital preparedness going forward.
This evaluation report is based on extensive analyses of the published literature, government reports, and HPP
program assessments, as well as on detailed conversations with 133 health officials and hospital professionals
representing every state, the largest cities, and major territories of the U.S.
1
2
3
The original name of the program was the National Bioterrorism Hospital Preparedness Program (NBHPP).
Public Law No. 109-417.
Toner E, Waldhorn R, Franco C, et al. Descriptive Framework for Healthcare Preparedness for Mass Casualty Events. Prepared by
the Center for Biosecurity of UPMC for the U.S. Department of Health and Human Services under Contract No.
HHSO100200700038C. 2008.
Center for Biosecurity of UPMC
v
Hospitals Rising to the Challenge | March 2009
Executive Summary
Key Findings
Disaster preparedness of individual hospitals has improved signif …
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