Barriers and Enablers to Using an Emergency Operations Center in Public Health Emergency Management: A Scoping Review.

OBJECTIVES: The aim of this study was to review the role of public health emergency operations centers in recent public health emergencies and to identify the barriers and enablers influencing the effective use of a public health emergency operations center (PHEOC) in public health emergency management. METHODS: A systematic search was conducted in 5 databases and selected grey literature websites. RESULTS: Forty-two articles, consisting of 28 peer-reviewed studies and 14 grey literature sources matched the inclusion criteria. Results suggest that PHEOCs are used to prepare and respond to a range of public health emergencies, including coronavirus disease (COVID-19). Factors found to influence the use of a PHEOC include the adoption of an incident management system, internal and external communications, data management, workforce capacity, and physical infrastructure. CONCLUSIONS: PHEOCs play an important role in public health emergency management. This review identified several barriers and enablers to using a PHEOC in public health emergency management. Future research should focus on addressing the barriers to using a PHEOC and looking at ways to evaluate the impact of using a PHEOC on public health emergency outcomes.

Pausing the Pandemic: Understanding and Managing Traveler and Community Spread of COVID-19 in Hawaii.

In the absence of a vaccine, nonpharmaceutical interventions such as social distancing and travel reductions were the only strategies for slowing the spread of the COVID-19 pandemic. Using survey data from Hawaii (n = 22,200) collected in March through May of 2020 at the onset of the pandemic, the differences between traveler spreaders who brought the disease into the state and community spreaders were investigated. In addition to describing the demographic attributes and comparing them with attributes of those who were vulnerable to COVID-19, logit models explaining travel behaviors were developed and tested. Traveler spreaders were likely to be male, younger, and returning students. Community spreaders were more likely to be male, essential workers, first responders, and medical personnel at the highest risk of exposure. Using spatial statistics, clusters and hotspot locations of high-risk individuals were mapped. As transportation researchers are in a position to combine their critical analytical capabilities and experience with relevant databases on mobility and the spread of infectious diseases, this analysis could support efforts to respond to and slow the spread of the pandemic.

Conceptual Framework for Understanding Incident Management Systems During Public Health Emergencies.

OBJECTIVE: Effective incident management is essential for coordinating efforts of multiple disciplines and stakeholders when responding to emergencies, including public health disasters such as the ongoing coronavirus disease 2019 (COVID-19) pandemic. METHODS: Existing research frameworks tend to focus on formal structures and doctrine (eg, ICS-NIMS); however, organizational processes that underlie incident management have not been systematically assessed and synthesized into a coherent conceptual framework. RESULTS: The lack of a framework has hindered the development of measures of performance that could be used to further develop the evidence base and facilitate process improvement. To address this gap, we present a conceptual framework of incident management drawn from expert feedback and a review of literature on incident management and related fields. The framework features 23 measurement constructs grouped into 5 domains: (1) situational awareness and information sharing, (2) incident action and implementation planning, (3) resource management and mobilization, (4) coordination and collaboration, and (5) feedback and continuous quality improvement. CONCLUSIONS: As such, the article provides a first step toward the development of robust measures for assessing the performance and effectiveness of incident management systems.

Campaign Disaster Response - What Makes It Different.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has seen health systems adapt and change in response to local and international experiences. This study describes the experiences and learnings by the Central Adelaide Local Health Network (CALHN) in managing a campaign style, novel public health disaster response. METHODS: Disaster preparedness has focused on acute impact, mass casualty incidents. In early 2020, CALHNs largest hospital the Royal Adelaide Hospital (RAH) was appointed as the state primary COVID-19 adult receiving hospital. Between the period of February 1, 2020, when the first COVID-19 positive patient was admitted, through to December 31, 2020, the RAH had admitted 146 inpatients with COVID-19, 118 admitted to our hospital in the home service, 18 patients admitted to Intensive Care, and 4 patients died while inpatients. During this time CALHN has sustained an active (physical and virtual) Network Incident Command Centre (NICC) supported by a Network Incident Management Team (NIMT). RESULTS: This study describes our key lessons learnt in relation to the management of a campaign style disaster response including the importance of disaster preparedness, fatigue management, and communication. Also described, were the challenges of operating in a command model and the role of exercising and education and an overview of our operating rhythm, how we built capability, and lessons management. CONCLUSIONS: Undertaking a longer duration disaster response, relating to the COVID-19 pandemic has shown that, although traditional disaster principles still are important, there are many nuances that need to be considered to retain a proportionate response. Our key lessons have revolved around the key tenants of disaster management, communication, capability, and governance.

The Benefits of Expanding the Incident Management Program in Utah

A 2018 study of performance measures for the Utah Department of Transportation's (UDOT) Incident Management Team (IMT) program concluded that the program was cost effective and benefited Utah motorists. During the 2018 legislative session, UDOT received funding to expand its IMT program. To determine the benefits of expanding the IMT program, a comparison of performance measures for 2018 and 2020 incident data was conducted. In addition, data regarding the affected volume, the excess travel time, and the excess user cost associated with incident congestion were gathered. The effects of the COVID-19 pandemic affected traffic volumes during this study, and statistical analyses were utilized to account for volume differences between the two years. Results indicated that the expansion of the IMT program has allowed UDOT to respond more consistently to incidents and respond to a larger quantity of incidents over a larger coverage area and in extended operating hours. © ASCE.

Advancing a social identity perspective on interoperability in the emergency services: Evidence from the Pandemic Multi-Agency Response Teams during the UK COVID-19 response.

Previous research shows there are persistent challenges with multi-agency response centring on problems of communication and coordination. The Social Identity Approach provides an important psychological framework for analysing relations within and between groups which can be used to understand why challenges in multi-agency response occur, and what can be done to prevent them re-occurring in the future. To explore this issue, we conducted semi-structured interviews with 14 responders from the Police, and Fire and Rescue Services who were involved in Pandemic Multi-Agency Response Teams (PMART) during the initial months of the COVID-19. These teams responded to suspected COVID-19 deaths in the community. Interviews were analysed using thematic analysis. Results show that responders appeared to share the pre-existing superordinate identity of all being members of the blue-light service. This identity was made salient as a result of responders experiencing positive contact with each other. Responders also shared the situational superordinate identity of PMART which was both created, and then made salient, through positive contact with each other, as well as responders sharing difficult experiences. At the same time though, structural factors such as inequalities in building access and different shift patterns increased the salience of sub-group identities in ways that created conflict between these identities, as well as operational challenges for joint working. This research advances our understanding of multi-agency working from a social identity perspective by providing evidence of a shared social identity at an operational level of emergency response. Practical implications of this research are discussed.

Pandemic Preparedness.

Pandemic preparedness is a key function of any health care facility. Activities pertaining to pandemic preparedness should be developed and maintained within a broader emergency management plan. The use of a Hospital Incident Command System can centralize coordination of the response and facilitate internal and external communication. This review addresses several components of pandemic preparedness, including incident management, health care personnel safety, strategies to support ongoing clinical activities, and organizational communication during a pandemic. Preparations addressing potential ethical challenges and the psychological impact associated with pandemic response are also reviewed.

Implementing the National Incident Management System at schools of nursing in response to COVID-19.

Unprecedented financial and logistical barriers in educating nurses during COVID-19 have threatened nursing education. The purpose of this article is to provide a template to facilitate the maintenance and stability of teaching and learning in a pandemic environment for nursing school administration and faculty leaders. The National Incident Management System (NIMS), previously used in training nurses for emergency preparation and response, has been applied as a guiding framework. The framework consists of five elements: Preparedness, Communication/Information Management, Resource Management, Command and Ongoing Management/Maintenance. This paper addresses how schools of nursing may apply each of these elements to address both the needs of the institution and community. The Comprehensive Vulnerability Management paradigm is further offered as a lens for professional development. Free preparedness education is showcased from leading nursing and healthcare professional and government organizations. Finally, the Quality and Safety Education for Nurses competencies are used for integrating NIMS and social dimensions of disaster. Such tools may equip academic leaders at schools of nursing to surmount challenges posed by the pandemic, and to ensure educational readiness to respond to global health crisis through use of the NIMS framework.