Breaking the Code: Considerations for Effectively Disseminating Mass Notifications in Healthcare Settings.

Many healthcare facilities use code-based alert systems to notify staff of ongoing emergencies via public announcement systems. This study sought to assess the ability of clinical and non-clinical employees across the State of Georgia to correctly identify their facility's emergency codes, assess employee's opinions of emergency alert systems, and identify significant predictors of emergency code identification accuracy. Anonymous electronic surveys asked 304 employees at five facilities to identify the codes for 14 different emergencies. Participants correctly identified the emergency codes with 44.37% accuracy on average. The codes for fire, infant abduction, and cardiac arrest were most commonly identified correctly. Code identification accuracy was significantly associated with training at orientation, knowledge of emergency code activation procedures, facility experience, and the total number of facilities in an employee's career. Most survey participants favored a code-based alert system over a plain language-based alert system, citing concerns of causing panic in patients and visitors, and of maintaining confidentiality and discretion. The low code identification accuracy suggests healthcare employees may have limited awareness of ongoing emergencies. Transitioning to plain language overhead emergency alerts will better position employees, as well as patients and visitors, to effectively respond to emergencies and disasters occurring within a healthcare facility.

Using Influenza Vaccination Location Data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) to Expand COVID-19 Vaccination Coverage.

Effective COVID-19 vaccine distribution requires prioritizing locations that are accessible to high-risk target populations. However, little is known about the vaccination location preferences of individuals with underlying chronic conditions. Using data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), we grouped 162,744 respondents into high-risk and low-risk groups for COVID-19 and analyzed the odds of previous influenza vaccination at doctor's offices, health departments, community settings, stores, or hospitals. Individuals at high risk for severe COVID-19 were more likely to be vaccinated in doctor's offices and stores and less likely to be vaccinated in community settings.

Environmental Health Workforce - Essential for Interdisciplinary Solutions to the COVID-19 Pandemic.

Interdisciplinary public health solutions are vital for an effective coronavirus disease 2019 (COVID-19) response and recovery. However, there is often a lack of awareness and understanding of the environmental health workforce connections and capabilities. In the United States, this is a foundational function of health departments and is the second largest public health workforce. The primary role is to protect the public from exposures to environmental hazards, disasters, and disease outbreaks. More specifically, this includes addressing risks relating to sanitation, drinking water, food safety, vector control, and mass gatherings. This profession is also recognized in the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019. Despite this, the profession is often not considered an essential service. Rapid integration into COVID-19 activities can easily occur as most are government employees and experienced working in complex and stressful situations. This role, for example, could include working with leaders, businesses, workplaces, and churches to safely reopen, and inspections to inform, educate, and empower employers, employees, and the public on safe actions. There is now the legislative support, evidence and a window of opportunity to truly enable interdisciplinary public health solutions by mobilizing the environmental health workforce to support COVID-19 response, recovery, and resilience activities.

Lack of Cultural Competency in International Aid Responses: The Ebola Outbreak in Liberia.

A cornerstone of effective disaster management is that response should always begin and end at the local level (1). The response to the Ebola virus disease (EVD) outbreak in Liberia, West Africa, was a combination of independent efforts by many nations and organizations. Many of these independent efforts ignored or were not able to work with the local levels of emergency management in Liberia. This oversight occurred because of the Liberian's mistrust of both their government and foreign aid groups, as well as the lack of cultural competency demonstrated by the aid groups. The health-care and emergency management infrastructure in Liberia appeared to be non-existent at the beginning of the EVD outbreak. However, there were resources available at the community level: the Liberians and their culture. Although these resources were rarely used, there were some instances in which communities were included in response efforts. It was in these instances that possible improvements to international disaster response protocol were found.

A benchmark system to optimize our defense against an attack on the US food supply using the Risk Reduction Effectiveness and Capabilities Assessment Program.

OBJECTIVE: A predictive system was developed and tested in a series of exercises with the objective of evaluating the preparedness and effectiveness of the multiagency response to food terrorism attacks. DESIGN: A computerized simulation model, Risk Reduction Effectiveness and Capabilities Assessment Program (RRECAP), was developed to identify the key factors that influence the outcomes of an attack and quantify the relative reduction of such outcomes caused by each factor. SETTING: The model was evaluated in a set of Tabletop and Full-Scale Exercises that simulate biological and chemical attacks on the food system. PARTICIPANTS: More than 300 participants representing more than 60 federal, state, local, and private sector agencies and organizations. RESULTS: The exercises showed that agencies could use RRECAP to identify and prioritize their advance preparation to mitigate such attacks with minimal expense. RRECAP also demonstrated the relative utility and limitations of the ability of medical resources to treat patients if responders do not recognize and mitigate the attack rapidly, and the exercise results showed that proper advance preparation would reduce these deficiencies. CONCLUSIONS: Using computer simulation prediction of the medical outcomes of food supply attacks to identify optimal remediation activities and quantify the benefits of various measures provides a significant tool to agencies in both the public and private sector as they seek to prepare for such an attack.

Examining roles pharmacists assume in disasters: a content analytic approach.

OBJECTIVE: Numerous practice reports recommend roles pharmacists may adopt during disasters. This study examines the peer-reviewed literature for factors that explain the roles pharmacists assume in disasters and the differences in roles and disasters when stratified by time. METHODS: Quantitative content analysis was used to gather data consisting of words and phrases from peer-reviewed pharmacy literature regarding pharmacists' roles in disasters. Negative binomial regression and Kruskal-Wallis nonparametric models were applied to the data. RESULTS: Pharmacists' roles in disasters have not changed significantly since the 1960s. Pharmaceutical supply remains their preferred role, while patient management and response integration roles decrease in context of common, geographically widespread disasters. Policy coordination roles, however, significantly increase in nuclear terrorism planning. CONCLUSIONS: Pharmacists' adoption of nonpharmaceutical supply roles may represent a problem of accepting a paradigm shift in nontraditional roles. Possible shortages of personnel in future disasters may change the pharmacists' approach to disaster management.