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The Disaster Recovery Plan Discussion Paper

The Disaster Recovery Plan Discussion Paper

DISASTER RECOVERY SCENARIO INFORMATION

HOPE FOR THE BEST, PLAN FOR THE WORST

Op-ed by Anne Levy, Valley City Herald

Valley City has had a great year, growing on a number of fronts. But all of our growth and success exists in the shadow of the recent past, a case of recent wounds slowly healing and fading to scars.

No one who was in Valley City two years ago will ever forget the catastrophic derailment of an oil-tanker train and the subsequent explosion and fire. While fatalities were fewer than they could have been, six residents of our city lost their lives. Nearly two hundred were hospitalized, and much of the city was temporarily evacuated. Several homes near the railroad tracks were leveled, and our water supply was contaminated by oil leakage for several months. The Disaster Recovery Plan Discussion Paper

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Life has resumed, and we have begun to thrive again, in our fashion. But the nagging feeling recurs: When the disaster struck, were our institutions properly prepared? No one wakes up in the morning expecting a train derailment, of course. But responsible institutions think about things that could go wrong within the realm of possibility, and make a plan. Many individuals performed brave, inspired, selfless service in the chaos of the derailment, but it is clear in retrospect that much of the work was improvised, disorganized, and often circular or at cross-purposes. The Disaster Recovery Plan Discussion Paper

For the first two hours of the crisis, the Valley City Fire Department was caught unprepared by the damage to the city water supply caused by the explosion, which was more extensive than had been considered possible. The Fire and Police departments had trouble coordinating radio communications, and a clear chain of command at the scene between departments was painfully slow to emerge. The hospital was woefully understaffed for the first six hours of the crisis, taking far too long to find a way to bring additional staff and resources onto the scene. The city health department was unacceptably dilatory in testing the municipal water supply for contaminants.

A call from the Herald’s offices to City Hall confirmed that the city’s disaster plan is over a decade old, and is unfortunately myopic both in the events it considers as possible disasters and in the agencies it plans for. It is of utmost importance to the future of our city that this plan be revised, revisited, and expanded. All city agencies should review their own disaster plans and coordinate with the city for a master plan. The same goes for crucial non-government agencies, most especially the Valley City Regional Hospital. Of course, this all exists in the shadow of budget cuts both at city hall and the hospital. The Disaster Recovery Plan Discussion Paper

The sun is shining today, without a cloud in the sky. This is the time to make sure we are ready for the next storm, so to speak, to hit our city. No one knows what the next crisis will be or when it will come. But we can count on the fact that no one will get up that morning expecting it.

 

 

Valley City, ND, Demographics

Population: 8,295 (up from 6,585 in 2010 census)

Median Age: 43.6 years. 17.1% under age 18; 14.8% between 18 and 24; 21.1% between 25 and 44; 24.9% 46 – 64; 22% 65 or older.

Officially, residents are 93% white, 3% Latino, 2% African-American, 1% Native American, 1% other.

—additionally, unknown number of undocumented migrant workers with limited English proficiency

Special needs: 204 residents are elderly with complex health conditions; 147 physically disabled and/or use lip-reading or American Sign Language to communicate.

Note that the Valley City Homeless shelter runs at capacity and is generally unable to accommodate all of the city’s homeless population. Also, the city is in the midst of a financial crisis, with bankruptcy looming, and has instituted layoffs at the police and fire departments.

Valley City Region Hospital Fact Sheet

105-bed hospital (currently 97 patients; 5 on ventilators, 2 in hospice care.)The Disaster Recovery Plan Discussion Paper

NOTEWORTHY: Both of 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; may be looking at downsizing nursing staff.

 

 

 

Jennifer Paulson

Administrator, Valley City Hospital

Hello, thanks for stopping by. I hope you’re settling in well.

I’d been planning on talking to you about disaster planning in the near future anyway, but now it looks like it’s a lot more urgent. I’m not sure if you’ve heard, but the National Weather Service says we’re going to be at an elevated risk for severe tornadoes in Valley City this season. I’m taking that as a clear sign that it’s time we get serious about disaster planning. And it’s not just me… The mayor just called me and asked the hospital to check our preparedness for a mass-casualty event, given recent qualms about the way the derailment was handled. For instance, did you see that op-ed in the paper about disaster planning? The Disaster Recovery Plan Discussion Paper

Anyway. My particular concern is patient triage in the near term and recovery efforts over the next six months. As I work on a more formal response to the Mayor about where we’re at for this threat, I’d appreciate it if you could do some research and planning on this matter. Even if we dodge the bullet on these tornadoes, there’ll be something else in the future. We need to stop putting it off and get serious about our disaster planning.

 

What I’d like for you to do first is take some time to talk to a good cross-section of people here at the hospital about what happened last time, and about our disaster plan in general. Make sure you get people from administration as well as frontline care staff; after all, problems can be visible in one area but not another a lot of times. So spread it around! Since you weren’t here for the train crisis, I think you’re in a unique position to have a fresh, unbiased outlook on it. Actually, first you might find it useful to take a look at the hospital fact sheet, just to brush up on our basics here.

After you’ve looked at the fact sheet and done some talking to people, I’d like you to swing back by and we’ll talk about next steps. The Disaster Recovery Plan Discussion Paper

Thanks!

Kate McVeigh

RN

Hey there! Yeah, I think I have a minute or two to talk about the derailment. Wow. It’s crazy. I guess that’s been a while, but it still feels like it just happened. It’s all so vivid!

I was on shift when it happened, so I was here for the whole thing. The blast, the first few injuries, and then the wave. I think I was working for 16 hours before Heather, the former head nurse, told me to leave before I passed out.

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I just remember a big jumble. We had waves of people coming in before we were really aware of what we were up against. Someone actually brought out the disaster plan but it was kind of useless. Just a bunch of words about using resources wisely and what have you, no concrete steps or plan. And then people started pouring in and we started treating them and there just wasn’t time to figure out how to make that stuff about using resources wisely into an actual, concrete plan. I mean, of course it’s good advice to use your damned resources wisely in an emergency! But just saying that doesn’t help. Without a plan, we were just working our way through a line, or really more like a crowd, without any thought of triage or priorities or anything. You knew as you were doing it that it was bad, but what could you do? There was always a next person to help.

You know what would have been useful in that damn disaster plan? Strict, functional checklists and lists of steps and such. Concrete plans for a chain of command. Clear lists of what to do and what our priorities should have been. And I’m just talking doctor and nurse time here, as far as waste goes. I know we had critical problems with supplies and such, but I was too focused on patient care to really know what was going on there.

  1. I have to go do rounds. Good luck. Yikes. I’m all anxious just thinking about that again. The Disaster Recovery Plan Discussion Paper

 

Megan Campbell

RN

Oh, I remember the night of the derailment really well. I’ll never forget it. I was off that night, out for dinner with my family. Heard the boom and the word spread through the Pizza Hut about what had happened pretty quickly. I kept expecting a call telling me to come in to the hospital, but none ever came. After maybe ten minutes of that, I figured I’d better just come in on my own. It was pretty clear there were going to be a lot of people moving through the hospital.

I guess that was a little bit of a failure, but it’s nothing compared to what I saw when I showed up at the hospital. I just hustled into the ER and started helping out. It wasn’t clear who was in charge, and nobody was making any decisions. People just started piling in with burn wounds, smoke inhalation, blunt trauma from the explosion, you name it. And we were just dealing with them first-come, first serve, more or less. Just working our way through the room while people kept coming in and piling up. I knew that this wasn’t the right way to be doing this – heck, we all knew – but the room was too chaotic for anyone to take a second and say “stop” and impose some kind of systematic approach. I don’t know for sure if any lives were lost because of the muddle, but I know people with some very serious injuries suffered a lot longer than they needed to while we were treating people with minor sprains and contusions who’d just happened to get to the ER a little earlier. The Disaster Recovery Plan Discussion Paper

Hope this helps!

 

Andrew Steller

Hospital CFO

Well, welcome to the house of gripes.

Sorry. It’s just that this is kind of a tough stretch, since the budget realities we’re facing make everything extra difficult and fraught. Believe me, I understand the importance of planning for the next disaster. It’s just that this is one more thing that our shortfalls are going to make really, really difficult.

It’s looking pretty likely that we’re going to need to cut our nursing staff pretty soon. Aside from the day-to-day problems that’ll cause, it’ll have a huge impact in a disaster. But it’s worse than that. Impact from a disaster doesn’t just happen in the midst of the crisis. It lingers, just like we saw with the derailment. And we’re going to have a hell of a time in that aftermath phase if we’re dealing with a reduced workforce and reduced resources.

I mean, think about who gets impacted when something major happens. The impact, especially long-term, doesn’t affect everyone equally. Think about any kind of special-needs population: people who don’t speak English, people with grave health problems who need ongoing care, people with serious economic problems… Those people are going to be affected up-front at least as much, if not more than, the baseline population, but then their recovery is going to be that much harder. That’s a reality that’s been borne out over and over. You see it with health impact, economic impact, even physical impact. If you were a little bit behind before, you’ll be a bit further behind after. We need, as both a moral and legal imperative, to provide equal access and service for all of the different parts of a diverse community. And again, we’ll be facing that situation with reduced capacity. The Disaster Recovery Plan Discussion Paper

Another thing that’s going to be a factor in our post-disaster recovery is government. Does FEMA step in? How long do they stay? Is there a disaster declaration, with some recovery funding? How about at the state level? Who’s coordinating all of this? This sort of thing requires a ton of communication and collaboration with governmental entities at all levels. We like to pretend we’re autonomous in these situations but we aren’t at all. There’s always a minefield of government funding and health policy to dig through as we try to put ourselves back together.

Sorry to be the voice of gloom and doom here. This stuff isn’t impossible, but god knows it’s difficult.

Jennifer Paulson

Administrator, Valley City Hospital

Thanks for talking to everyone! I bet you heard a lot.

I’d like you to take some time to sit and think about what you’ve heard and seen, and try to knit it all together into some overall conclusions that we can use to work up a plan to be ready for the next disaster.

Ultimately, I’d like you to be able to present a compelling case to community stakeholders (mayor and city disaster relief team) to obtain their approval and support for the proposed disaster recovery plan. I’d like you to use MAP-IT, and work up an approach supported by Healthy People 2020, and put it all into a PowerPoint. We’ll save the PowerPoint deck and the audio of its accompanying presentation at the public library so that the public can access it and see that we’re serious. Ideally, I’d like this to be used as a prototype for other local communities near Valley City, and possibly other facilities in the Vila Health organization. The Disaster Recovery Plan Discussion Paper

Assessment 3 Instructions: Disaster Recovery Plan

Top of Form

Bottom of Form

  • PRINT
  • Develop a disaster recovery plan to lessen health disparities and improve access to community services after a disaster. Then, develop and record a 10-12 slide presentation (please refer to the PowerPoint tutorial) of the plan with audio and speaker notes for the Vila Health system, city officials, and the disaster relief team.

As you begin to prepare this assessment, you are encouraged to complete the Disaster Preparedness and Management activity. The information gained from completing this activity will help you succeed with the assessment as you think through key issues in disaster preparedness and management in the community or workplace. Completing activities is also a way to demonstrate engagement.

Introduction

Nurses perform a variety of roles and their responsibilities as health care providers extend to the community. The decisions we make daily and in times of crisis often involve the balancing of human rights with medical necessities, equitable access to services, legal and ethical mandates, and financial constraints. In the event of a major accident or natural disaster, many issues can complicate decisions concerning the needs of an individual or group, including understanding and upholding rights and desires, mediating conflict, and applying established ethical and legal standards of nursing care. As a nurse, you must be knowledgeable about disaster preparedness and recovery to safeguard those in your care. As an advocate, you are also accountable for promoting equitable services and quality care for the diverse community. The Disaster Recovery Plan Discussion Paper

Nurses work alongside first responders, other professionals, volunteers, and the health department to safeguard the community. Some concerns during a disaster and recovery period include the possibility of death and infectious disease due to debris and/or contamination of the water, air, food supply, or environment. Various degrees of injury may also occur during disasters, terrorism, and violent conflicts.

To maximize survival, first responders must use a triage system to assign victims according to the severity of their condition/prognosis in order to allocate equitable resources and provide treatment. During infectious disease outbreaks, triage does not take the place of routine clinical triage.

Trace-mapping becomes an important step to interrupting the spread of all infectious diseases to prevent or curtail morbidity and mortality in the community. A vital step in trace-mapping is the identification of the infectious individual or group and isolating or quarantining them. During the trace-mapping process, these individuals are interviewed to identify those who have had close contact with them. Contacts are notified of their potential exposure, testing referrals become paramount, and individuals are connected with appropriate services they might need during the self-quarantine period (CDC, 2020)The Disaster Recovery Plan Discussion Paper.

An example of such disaster is the COVID-19 pandemic of 2020. People who had contact with someone who were in contact with the COVID-19 virus were encouraged to stay home and maintain social distance (at least 6 feet) from others until 14 days after their last exposure to a person with COVID-19. Contacts were required to monitor themselves by checking their temperature twice daily and watching for symptoms of COVID-19 (CDC, 2020). Local, state, and health department guidelines were essential in establishing the recovery phase. Triage Standard Operating Procedure (SOP) in the case of COVID-19 focused on inpatient and outpatient health care facilities that would be receiving, or preparing to receive, suspected, or confirmed COVID- 19 victims. Controlling droplet transmission through hand washing, social distancing, self-quarantine, PPE, installing barriers, education, and standardized triage algorithm/questionnaires became essential to the triage system (CDC, 2020; WHO, 2020)The Disaster Recovery Plan Discussion Paper.

This assessment provides an opportunity for you to apply the concepts of emergency preparedness, public health assessment, triage, management, and surveillance after a disaster. You will also focus on evacuation, extended displacement periods, and contact tracing based on the disaster scenario provided.

Note: Complete the assessments in this course in the order in which they are presented.

Preparation

When disaster strikes, community members must be protected. A comprehensive recovery plan, guided by the MAP-IT (Mobilize, Assess, Plan, Implement, Track) framework, is essential to help ensure everyone’s safety. The unique needs of residents must be assessed to lessen health disparities and improve access to equitable services after a disaster. Recovery efforts depend on the appropriateness of the plan, the extent to which key stakeholders have been prepared, the quality of the trace-mapping, and the allocation of available resources. In a time of cost containment, when personnel and resources may be limited, the needs of residents must be weighed carefully against available resources.

In this assessment, you are a community task force member responsible for developing a disaster recovery plan for the Vila Health community using MAP-IT and trace-mapping, which you will present to city officials and the disaster relief team.

To prepare for the assessment, complete the Vila Health: Disaster Recovery Scenario simulation.

In addition, you are encouraged to complete the Disaster Preparedness and Management activity. The information gained from completing this activity will help you succeed with the assessment as you think through key issues in disaster preparedness and management in the community or workplace. Completing activities is also a way to demonstrate engagement. The Disaster Recovery Plan Discussion Paper

Begin thinking about:

    • Community needs.
    • Resources, personnel, budget, and community makeup.
    • People accountable for implementation of the disaster recovery plan.
    • Healthy People 2020 goals and 2030 objectives.
    • A timeline for the recovery effort.

You may also wish to:

    • Review the MAP-IT (Mobilize, Assess, Plan, Implement, Track) framework, which you will use 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 goals or 2030 objectives.
      • Track community progress.
    • Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete.

Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.

Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact [email protected] to request accommodations. The Disaster Recovery Plan Discussion Paper

Instructions

Every 10 years, The U.S. Department of Health and Human Services and the Office of Disease Prevention and Health Promotion release information on health indicators, public health issues, and current trends. At the end of 2020, Healthy People 2030 was released to provide information for the next 10 years. Healthy People 2030 provides the most updated content when it comes to prioritizing public health issues; however, there are historical contents that offer a better understanding of some topics. Disaster preparedness is addressed in Healthy People 2030, but a more robust understanding of MAP-IT, triage, and recovery efforts is found in Healthy People 2020. For this reason, you will find references to both Healthy People 2020 and Healthy People 2030 in this course.

Complete the following: The Disaster Recovery Plan Discussion Paper

  1. Develop a disaster recovery plan for the Vila Health community that will lessen health disparities and improve access to services after a disaster. Refer back to the Vila Health: Disaster Recovery Scenarioto 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 and 2030 objectives.
      • Include a timeline for the recovery effort.
  1. Apply the MAP-IT (Mobilize, Assess, Plan, Implement, Track) framework to guide the development of your plan:
      • Mobilize collaborative partners.
      • Assess community needs.
        • Use the demographic data and specifics related to the disaster to identify the needs of the community and develop a recovery plan. Consider physical, emotional, cultural, and financial needs of the entire community.
        • Include in your plan the equitable allocation of services for the diverse community.
        • Apply the triage classification to provide a rationale for those who may have been injured during the train derailment. Provide support for your position.
        • Include in your plan contact tracing of the homeless, disabled, displaced community members, migrant workers, and those who have hearing impairment or English as a second language in the event of severe tornadoes.
      • Plan to lessen health disparities and improve access to services.
      • Implement a plan to reach Healthy People 2020 goals and 2030 objectives.
      • Track and trace-map community progress.
        • Use the CDC’s Contract Tracing Resources for Health Departments as a template to create your contact tracing.
        • Describe the plan for contact tracing during the disaster and recovery phase.
  1. Develop a slide presentation of your disaster recovery plan with an audio recording of you presenting your assessment of the Vila Health: Disaster Recovery Scenariofor city officials and the disaster relief team. Be sure to also include speaker notes. The Disaster Recovery Plan Discussion Paper

Presentation Format and Length

You may use Microsoft PowerPoint (preferred) or other suitable presentation software to create your slides and add your voice-over along with speaker notes. If you elect to use an application other than PowerPoint, check with your instructor to avoid potential file compatibility issues.

Be sure that your slide deck includes the following slides:

    • Title slide.
      • Recovery plan title.
      • Your name.
      • Date.
      • Course number and title.
    • References (at the end of your presentation)The Disaster Recovery Plan Discussion Paper.

Your slide deck should consist of 10–12 content slides plus title and references slides. Use the speaker’s notes section of each slide to develop your talking points and cite your sources as appropriate. Be sure to also include a transcript that matches your recorded voice-over. The transcript can be submitted on a separate Word document. Make sure to review the Microsoft PowerPoint tutorial for directions.

The following resources will help you create and deliver an effective presentation:

      • This Microsoft article provides steps for recording slide shows in different versions of PowerPoint, including steps for Windows, Mac, and online.
    • Microsoft Office Software.
      • This Campus page includes tip sheets and tutorials for Microsoft PowerPoint.
    • PowerPoint Presentations Library Guide.
      • This library guide provides links to PowerPoint and other presentation software resources.
    • SoNHS Professional Presentation Guidelines [PPTX].
      • This presentation, designed especially for the School of Nursing and Health Sciences, offers valuable tips and links, and is itself a PowerPoint template that can be used to create a presentation.

Supporting Evidence

Cite at least three credible sources from peer-reviewed journals or professional industry publications within the past 5 years to support your plan.

Graded Requirements

The requirements outlined below correspond to the grading criteria in the scoring guide, so be sure to address each point:

    • 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.
    • 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.
    • 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).
    • Present specific, evidence-based strategies to overcome communication barriers and enhance interprofessional collaboration to improve the disaster recovery effort.

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      • 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.
    • Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years)The Disaster Recovery Plan Discussion Paper.
    • Slides are easy to read and error free. Detailed audio and speaker notes are provided. Audio is clear, organized, and professionally presented.
      • Develop your presentation with a specific purpose and audience in mind.
      • Adhere to scholarly and disciplinary writing standards and APA formatting requirements.

Additional Requirements

Before submitting your assessment, proofread all elements to minimize errors that could distract readers and make it difficult for them to focus on the substance of your presentation.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

    • Competency 1: Analyze health risks and health care needs among distinct populations.
      • Describe the determinants of health and the cultural, social, and economic barriers that impact safety, health, and disaster recovery efforts in a community.
    • Competency 2: Propose health promotion strategies to improve the health of populations.
      • Present specific, evidence-based strategies to overcome communication barriers and enhance interprofessional collaboration to improve disaster recovery efforts.
    • Competency 3: Evaluate health policies, based on their ability to achieve desired outcomes.
      • Explain how health and governmental policy impact disaster recovery efforts.
    • Competency 4: Integrate principles of social justice in community health interventions.
      • Explain how a proposed disaster recovery plan will lessen health disparities and improve access to community services.
    • Competency 5: Apply professional, scholarly communication strategies to lead health promotion and improve population health.
      • Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years).
      • Slides are easy to read and error free. Detailed audio, transcript, and speaker notes are provided. Audio is clear, organized, and professionally presented The Disaster Recovery Plan Discussion PaperThis should include a transcript of what was on the speaker notes for this powerpoint, I added the 2 pages for the transcript part.

        ive included some resources below that may be helpful but the attached documents should be enough

        https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-resources.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fphp%2Fopen-america%2Fcontact-tracing-resources.html

        Centers for Disease Control and Prevention. (n.d.). Emergency preparedness and response. https://emergency.cdc.gov/

        U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (n.d.). Healthy People 2030. https://health.gov/healthypeople