Citation

Meredith LS, Eisenman DP, Tanielian T, Taylor SL, Basurto-Davila R, Zazzali J, Diamond D, Cienfuegos B, Shields S. Disaster Med. Public Health Prep. 2011; 5(1): 73-80.

Affiliation

Dr Meredith is with the RAND Corporation, Santa Monica, California; Dr Eisenman is with the RAND Corporation, Santa Monica, California, and the Department of Medicine, David Geffen School of Medicine, UCLA; Ms Tanielian is with the RAND Corporation, Arlington, Virginia; Dr Taylor is with the Center of Excellence for the Study of Healthcare Provider Behavior, VA Greater Los Angeles at Sepulveda; Mr Basurto-Dávila is with the Centers for Disease Control, Atlanta, Georgia; Dr Zazzali is with Genentech, Inc, San Francisco, California; Dr Diamond is with the Los Angeles County Department of Public Health, Los Angeles, California; Ms Cienfuegos is with the Los Angeles County Department of Mental Health, Los Angeles, California; Ms Shields is with the Los Angeles County Department of Health Services, Emergency Medical Services Agency, Sante Fe Springs, California.

Copyright

(Copyright © 2011, Society for Disaster Medicine and Public Health, Publisher Cambridge University Press)

DOI

10.1001/dmp.2010.47

PMID

21402830

Abstract

While information for the medical aspects of disaster surge is increasingly available, there is little guidance for health care facilities on how to manage the psychological aspects of large-scale disasters that might involve a surge of psychological casualties. In addition, no models are available to guide the development of training curricula to address these needs. This article describes 2 conceptual frameworks to guide hospitals and clinics in managing such consequences. One framework was developed to understand the antecedents of psychological effects or "psychological triggers" (restricted movement, limited resources, limited information, trauma exposure, and perceived personal or family risk) that cause the emotional, behavioral, and cognitive reactions following large-scale disasters. Another framework, adapted from the Donabedian quality of care model, was developed to guide appropriate disaster response by health care facilities in addressing the consequences of reactions to psychological triggers. This framework specifies structural components (internal organizational structure and chain of command, resources and infrastructure, and knowledge and skills) that should be in place before an event to minimize consequences. The framework also specifies process components (coordination with external organizations, risk assessment and monitoring, psychological support, and communication and information sharing) to support evidence-informed interventions.

Language: en