@article{ref1,
title="Emergency management program operational responses to weapons of mass destruction: Veterans Health Administration, 2001-2004",
journal="American journal of industrial medicine",
year="2004",
author="Hodgson, Michael J. and Bierenbaum, Arnold and Mather, Susan and Brown, Mark A. and Beatty, John and Scott, Margie and Brewster, Peter",
volume="46",
number="5",
pages="446-452",
abstract="BACKGROUND: Despite the recognition of chemical emergencies, terrorist events, and ongoing threats, little practical guidance exists for healthcare facilities. METHODS: An approach and materials developed by the Veterans Health Administration in a five-element program over the last 2 years to enhance the existing emergency management program is outlined. Nine steps to the development of a comprehensive all-hazards, emergency plan and program, with auditing and improvement tools are offered. RESULTS: Cognitive aids for clinical use are available on-line and in hard copy. A hazard assessment modeled patients as emission sources documenting the operations strategies under which level C personal protective equipment will protect healthcare workers. The development of this response program appears to support a broader, long-standing VHA approach to problem solving. This involves bringing together individual talented field staff, representing specific skills, geographic regions, and work styles; investing in face-to-face consensus development; and developing programs with extensive internal peer-review (&quot;field-based,&quot; &quot;bottom-up and top-down,&quot; and external reviews). CONCLUSIONS: Comprehensive and effective programs can be constructed at low cost with reasonable speed within large systems with a public mandate, leading to responsible use of public funds internally, and as models for private sector programs. It is the long-term operational cost implications, under budget constraints in health care, which often present the true challenge.<p /><p>Language: en</p>",
language="en",
issn="0271-3586",
doi="10.1002/ajim.20090",
url="http://dx.doi.org/10.1002/ajim.20090"
}