Running head: DISASTER RECOVERY PLAN 1

Disaster Recovery Plan

Sarah Borovac

Capella University

NURS-FPX4060 Practicing in the Community to Improve Population Health

Assessment #3

May, 2020
DISASTER RECOVERY PLAN 2

Slide 1

Villa Health Disaster Recovery Plan by Sarah Borovac

Slide 2

Disaster Plan and Recovery (Mobilize collaborative partners)

A disaster is considered anything out of the ordinary that happens and prevents access to

key processes. Planning makes it possible to manage the entire life cycle of a potential disaster.

Strategic and operational planning establishes priorities, identifies expected levels of

performance and capability requirements, provides the standard for assessing capabilities, and

helps stakeholders learn their roles (U.S. Homeland Secruity, 2020). A major component of a

disaster plan is the recovery phase; recovery is defined as the activities that occur before, during

and after a disastrous event. Following a disaster, survival rates depend on health care facilities’

ability to provide care under duress and to handle a sudden influx of large numbers of victims.

Much depends on the staff, supplies, equipment, structure, and systems that are required to treat a

significant increase in patients seeking medical and nursing care (Veenema, 2016). The disaster

recovery process is focused on restoring and revitalizing communities that have been impacted

by the disaster, such as the train derailment disaster that affected the Villa Health community.

Both planning and recovery are essential components for proper management and restoration of

community disasters. After speaking with the Vila Health hospital and community officials, it is

clear their disaster recovery plan needs revised.

Slide 3

MAP-IT Framework

Adopted from the Health People 2020 initiative the MAP-IT framework is used to plan

and evaluate public health interventions such as disaster recovery. The framework outlines a
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path for success; mobilize collaborative partners, assess community needs, plan to lessen health

disparities and improve access to services, implement a plan to reach healthy people 2020

objectives and track community progress (“MAP-IT,” 2020) To achieve the first step in the

framework, goals for recovery need to be established. As mentioned earlier, the Villa Health

community was affected by a train derailment and after speaking with the Vila Health hospital

and community officials, gaps in their current disaster plan were identified. The first goal should

be enhancing collaboration and communication with local emergency services. Collaboration

with hospital personnel should include a new triage and treatment process. In addition,

promotion of community services including rehabilitation to disabled and injured

individuals. Collaborative partners will also include state and government officials and

awareness of government policies, as the implications of the disaster will more than likely

overwhelm the community’s resources.

Slide 4

Barriers that Impact Safety, Health and Recovery Efforts (Assess community needs)

The range of personal, social, economic, and environmental factors that influence health

status are known as determinants of health. Determinants of health fall under several broad

categories: policymaking, social factors, health services, individual behavior, biology and

genetics. It is the interrelationships among these factors that determine individual and population

health (Healthy People 2020, May 2020). Vulnerable populations include social groups with an

increased relative risk or predisposition toward adverse health outcomes. Such as those in the

Villa Health community; 204 residents are elderly with complex health conditions; 147

physically disabled and/or use lip-reading or American Sign Language to communicate.

According to (Reinhardt, 2011) studies show that persons with pre-existing disabilities are more
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likely to die in a natural disaster. Obstacles arise such as impairments that affect one’s ability to

escape a situation, and their ability to recognize and communicate that a is disaster is occurring.

Slide 5

The resources within VCRH’s health system greatly affect the care that can be

delivered, both VCRH’s ambulances are aging and in need of overhaul. Also, much of the

hospital’s basic infrastructure and equipment is old and showing wear, the hospital has run at

persistent deficits and has been unable to upgrade. According to the director of facilities supplies

are also in short supply, as they run out of essential resources during the disaster.

The city is in the midst of a financial crisis, with bankruptcy looming, and has instituted

layoffs at the police and fire departments. Also, may be looking at downsizing nursing staff.

Without funding and a proper budget, the hospital and emergency services cannot function

effectively.

Slide 6

Disaster Recovery Plan (Plan to lessen health disparities and improve access to services)

Medical Care Improvement

The disaster recovery process focuses on restoring, redeveloping, and revitalizing

communities impacted by a disaster. This would include increasing the hospital and clinical care

standards at which they function during a disaster. Medical care must promote the use of limited

resources to benefit the population as a whole. As well as training medical professionals to shift

their work pattern from general daily care to a model (emergency response system) that

accommodates the sudden unanticipated surge in the demand for health care. This model may

force them to make very difficult legal, ethical, and moral decisions; examples include triaging
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who gets care first and who does not get care at all, allocating limited numbers of ventilators, and

deciding who has access to lifesaving medications. (Veenema, 2016). Ideally, these will include a

centralized structure for control (incident command system), a framework for the allocation of

scarce resources, and effective adaptation of standards for crisis care. Despite the ethical strain

that is imposed on medical staff, the emergency response system implies a decrease in health

disparities and is supported by the Department of Homeland Security; EOC = emergency

operations center; NRP = National Response Plan. Source: (U.S. Department of Homeland

Security)

Slide 7

Rehabilitation (implement a plan to reach healthy people 2020)

Lack of access, or limited access, to health services greatly impacts an individual’s health

status and recovery from disasters. Health-related rehabilitation potentially results in decreased

morbidity due to disabling injuries sustained during a natural disaster and is, therefore, an

essential component of the medical response plan within communities. Significant systematic

challenges to effective delivery of rehabilitation interventions during disaster include a lack of

trained responders as well as a lack of medical recordkeeping, data collection, and established

outcome measures (Reinhardt, 2011). Since a person's functional needs require attention in the

immediate living environment as well as in the greater community, a range of activities including

provision of accessible and appropriate home care; housing; transportation; and educational,

vocational, and social opportunities is necessary. Based on the person's unique medical needs,

health-related rehabilitation is best delivered by a multi-disciplinary team. The Vila health

community would benefit from officials working with federal funding agencies to identify a

disaster relief plan with the aim of strengthening the rehabilitation perspective in the response to
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natural disaster. These funding’s would support the employment of interdisciplinary health teams

and rehabilitation services. The rehabilitation services would also support the goals addressed by

Healthy People 2020, including, attain high-quality, longer lives free of preventable disease,

disability, injury, and premature death; achieve health equity, eliminate disparities, and improve

the health of all groups; create social and physical environments that promote good health for all;

and promote quality of life, healthy development (Healthy People, 2020).

Slide 8

Health and Governmental Policy Impact Disaster Recovery Efforts

The Centers for Medicare and Medicaid Services (CMS) offers funding designed to help

health care organizations manage operations during and after a disastrous event. All health care

facilities must comply with all applicable federal and state emergency preparedness requirements

in order to participate in CMS programs and to receive CMS funding. These regulations require

health care facilities to develop specific emergency plans, communications, policies, and training

that complies with both federal and state law, also ensures coordination of patient care across the

continuum (Veenema, 2016). These funding’s may be beneficial to addressing the lack of

supplies and resources the city is suffering from.

Health and Governmental Policy Impact Disaster Recovery Efforts cont.

Slide 9

The Stafford Act, Disaster Relief and Emergency Assistance Act, is the main source of

authorities for the Federal Emergency Management Agency's (FEMA's) disaster assistance

programs. Under this act, the President is authorized to issue major disaster or emergency

declarations, resulting in the distribution of wide-ranging federal aid to individuals and families,

certain nonprofit organizations, and public agencies (Committee on Post-Disaster Recovery,

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2015). If the governor of an affected state is slow in executing the state’s emergency response

plan, the president may provide accelerated federal assistance where it is necessary to save lives

or prevent severe damage. The Stafford Act covers major disasters and emergencies defined as

any natural catastrophe or fire, flood, or explosion, regardless of cause, which is of sufficient

severity to warrant assistance under the act to alleviate the damage, loss, or hardship caused by

the event. Three types of assistance are authorized; individual assistance—provides immediate

direct and financial assistance to individuals for housing and other disaster related needs, hazard

mitigation—provides grants to affected governments to implement long-term hazard mitigation

measures after a major disaster declaration, public assistance—provides aid to eligible applicants

seeking assistance with eligible costs for eligible work performed at eligible facilities

(Committee on Post-Disaster Recovery, 2015).

Slide 10

Enhance Communication

The actions of first responders, including local fire, police, and emergency medical

services (EMS), are driven by the procedures and protocols developed by those responding

agencies. The Vila Health hospital workers identified an issue when communicating with local

emergency services, lack of communication lead to ineffective triage and waste of resources. It is

imperative that all voluntary healthcare professionals learn the chain of command within their

disaster response system. The chain of command is critical to making sure services and resources

are utilized in a timely manner without duplication. The World Health Organization Regional

Office has developed the hospital emergency response checklist to assist hospital administrators

and emergency managers in responding effectively to the most likely disaster scenarios. The

checklist includes clear and accurate internal and external communication guidelines and
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protocols for a safe environment for healthcare workers (WHO, 2020). Some examples of the

guidelines include; brief hospital staff on their roles and responsibilities within the incident

action plan, ensure that all communications to the public, media, ensure that all decisions related

to patient prioritization, and more. The principles and recommendations included in this tool may

be used to in the Vila Health hospital at any level for emergency preparedness

Slide 11

Timeline (Track community progress)

To ensure the goals have been met, measurable actions should be taken. Communication

should occur between with federal funders and community officials, like the Hospital CFO and

Facility director. These communications should provide an outline of coverage and limitations

for possible occurrence of future disasters. This would help to avoid confusion about resources

available and protect the community. The director of hospital operations would need to work

with the CFO and director in organizing rehabilitation and interprofessional teams that would

treat injured community members. This will also need involvement of funders to ensure the

community budget can support these efforts. Training and mock drills for health care workers

should be designed and implemented ASAP. These drills would provide the staff with the

knowledge and skill to properly communicate, triage, and utilize resources during a future

disaster. The new skills would ultimately ensure the community is getting the help they need in

an organized well-functioning system. The hospital and leaders would implement the changes

and a new disaster plan within 3 months. After the plan is implemented, they will hold annual

meetings to address any new concerns and changes, keeping the leadership team up to date and

prepared.

Slide 11
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Conclusion

Slide 12

Creating a revamped disaster plan will ensure the protection of the Villa Health

community. A healthy relationship between the Villa Health community workers and leaders can

be facilitated in an effort to improve recovery goals. An effective recovery plan utilizes

government resources while addressing health disparities, the needs of the community, and

communication barriers. Organized planning and implementation will result in a positive

outcome for the community.

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References

Committee on Post-Disaster Recovery of a Community's Public Health, Medical, and Social

Services; Board on Health Sciences Policy; Institute of Medicine. Healthy, Resilient, and

Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for

Recovery. Washington (DC): National Academies Press (US); 2015 Sep 10. A, The

Federal Policy Environment Influencing Disaster Recovery. Available from:

https://www.ncbi.nlm.nih.gov/books/NBK316538/

“Healthy People 2020|About DHDSP|DHDSP|CDC.” Centers for Disease Control and

Prevention, Centers for Disease Control and Prevention, 13 Mar. 2014,

www.cdc.gov/dhdsp/hp2020.htm.

“Hospital Emergency Response Checklist.” World Health Organization, World Health

Organization, www.who.int/publications-detail/hospital-emergency-response-checklist.

MAP-IT: a guide to using Healthy People 2020 in your community. (2020). Retrieved from

https://www.healthypeople.gov/2020/tools-and-resources/Program-Planning

“Natural Disaster Response and Recovery.” U.S. Department of the Interior, 4 Sept. 2018,

www.doi.gov/recovery.

“Program Planning.” Program Planning | Healthy People 2020,

www.healthypeople.gov/2020/tools-and-resources/Program-Planning.

Reinhardt, J. D., Li, J., Gosney, J., Rathore, F. A., Haig, A. J., Marx, M., DeLisa, J. A., &

International Society of Physical and Rehabilitation Medicine's Sub-Committee on

Rehabilitation Disaster Relief (2011). Disability and health-related rehabilitation in

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international disaster relief. Global health action, 4, 7191.

https://doi.org/10.3402/gha.v4i0.7191

Veenema, T. G. , Losinski, S. L. & Hilmi, L. M. (2016). Increasing Emergency Preparedness.

AJN, American Journal of Nursing, 116(1), 49–53. doi:

10.1097/01.NAJ.0000476169.28424.0b.

 Describe the determinants of health and the cultural, social, and

economic barriers that impact safety, health, and recovery efforts in
the community.
 Consider the interrelationships among these factors.
o Explain how your proposed disaster recovery plan will
lessen health disparities and improve access to community services.
 Consider principles of social justice and cultural sensitivity
with respect to ensuring health equity for individuals, families, and
aggregates within the community.
o Explain how health and governmental policy impact disaster
recovery efforts.
 Consider the implications for individuals, families, and
aggregates within the community of legislation that includes, but is not
limited to, the Americans with Disabilities Act (ADA), the Robert T.
Stafford Disaster Relief and Emergency Assistance Act, and the
Disaster Recovery Reform Act (DRRA).
o Present specific, evidence-based strategies to overcome
communication barriers and enhance interprofessional collaboration to
improve the disaster recovery effort.
 Consider how your proposed strategies will affect members
of the disaster relief team, individuals, families, and aggregates within
the community.
 Include evidence to support your strategies.
o Present a compelling case to community stakeholders to
obtain their approval and support for the proposed disaster recovery
plan.

1. Develop a disaster recovery plan for the Vila Health community

that will lessen health disparities and improve access to services after
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a disaster. Refer back to the Vila Health: Disaster Recovery Scenario to

understand the Vila Health community.
 Assess community needs.
 Consider resources, personnel, budget, and community
makeup.
 Identify the people accountable for implementation of the
plan and describe their roles.
 Focus on specific Healthy People 2020 goals.
 Include a timeline for the recovery effort.
o Use the MAP-IT (Mobilize, Assess, Plan, Implement, Track)
framework to guide the development of your plan:
 Mobilize collaborative partners.
 Assess community needs.
 Plan to lessen health disparities and improve access to
services.
 Implement a plan to reach Healthy People 2020 objectives.
 Track community progress.