Primary health care disaster preparedness: A review of the literature and the proposal of a new framework

Lamberti-Castronuovo, Alessandro; Valente, Martina; Barone-Adesi, Francesco; Hubloue, Ives; Ragazzoni, Luca

doi:10.1016/j.ijdrr.2022.103278

Cited by 24 publications

(10 citation statements)

References 113 publications

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“…Moreover, studies assessing the relevance of the HSI tool for the PHC setting are lacking [ 20 , 39 ]. An operational framework conceptualising specific characteristics of primary care disaster preparedness, categorised according to the WHO health system building blocks [ 44 ], was recently published by members of this research team [ 45 ]. This can be considered for future adaptations of the HSI, as well as for the creation of primary care-specific tools aimed at strengthening all-hazard preparedness.…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Study on the Use of the Hospital Safety Index and the Formulation of Recommendations for Future Adaptations

Lamine

Lamberti-Castronuovo

Singh

et al. 2023

IJERPH

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The Hospital Safety Index is a tool developed by the World Health Organization and the Pan American Health Organization in 2008 and updated in 2015. Although it is the most widely used instrument of its kind to assess the level of hospital preparedness, scientific literature on its application in real life is scarce. This study aimed to investigate the use of the Hospital Safety Index to assess disaster preparedness in healthcare facilities. A retrospective, qualitative study employing semi-structured online interviews was conducted to gather the opinions and perspectives of professionals who have experience in applying the Hospital Safety Index. Authors of scientific publications using the Hospital Safety Index were recruited. A semi-structured interview guide was developed. It addressed different phases of data collection with the Hospital Safety Index, the challenges and facilitators of using it, and recommendations for future adaptations. Data were analysed using inductive thematic analysis. Nine participants who were from three countries (Serbia, Sri Lanka, and Indonesia) and had different professional backgrounds (medical doctors, engineers, spatial planners, etc.) participated in this study. A total of 5 themes and 15 subthemes emerged during data analysis. Most of the participants reported their reasons for choosing the Hospital Safety Index as being its comprehensiveness and the fact that it was issued by the World Health Organization. The tool appears to be very specific and allows investigators to spot details in hospitals; however, it is not easy to use, and training is highly encouraged to learn how to navigate the different components of the tool. Governmental support is a crucial facilitator for investigators to be able to enter hospitals and conduct their evaluations. Overall, the tool has a lot of potential, and it should be used to reach a broader audience, such as community members, and assess the preparedness of other facilities that can take part in the response to disasters (hotels, stadiums, schools, etc.). Nevertheless, it still needs more adaptations to be tailored to different contexts and settings.

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Section: Discussionmentioning

confidence: 99%

A Qualitative Study on the Use of the Hospital Safety Index and the Formulation of Recommendations for Future Adaptations

Lamine

Lamberti-Castronuovo

Singh

et al. 2023

IJERPH

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“…The research team (ALC, HL, and MV) developed the first iteration of checklist questions using the results of an extensive literature review surveying existing characteristics of disaster preparedness at the PHC level (Lamberti-Castronuovo et al ., 2022 ).…”

Section: Methodsmentioning

confidence: 99%

“…Its three main components (the primary care network of professionals, the people-centered approach, and the whole-of-society strategy to protect health and to reduce risks) form a fundamental backbone for effective disaster management (World Health Organization, 2018 ). Nevertheless, the body of literature focusing on PHC and disasters is still scant (Lamberti-Castronuovo et al ., 2022 ). More research needs to be done on how to render primary care systems better prepared for disasters and on how to practically ensure the integration of PHC into national H-EDRM plans.…”

Section: Introductionmentioning

confidence: 99%

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Assessing primary healthcare disaster preparedness: a study in Northern Italy

Lamberti-Castronuovo,

Lamine,

Valente

et al. 2024

Prim Health Care Res Dev

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Aim: The aim of this paper is to outline the steps taken to develop an operational checklist to assess primary healthcare (PHC) all-hazards disaster preparedness. It then describes a study testing the applicability of the checklist. Background: A PHC approach is an essential foundation for health emergency and disaster risk management (H-EDRM) because it can prevent and mitigate risks prior to disasters and support an effective response and recovery, thereby contributing to communities’ and countries’ resilience across the continuum of the disaster cycle. This approach is in line with the H-EDRM framework, published by the World Health Organization (WHO) in 2019, which emphasizes a whole-of-health system approach in disaster management and highlights the importance of integrating PHC into countries’ H-EDRM. Nevertheless, literature focusing on how to practically integrate PHC into disaster management, both at the facility and at the policy level, is in its infancy. As of yet, there is no standardized, validated way to assess the specific characteristics that render PHC prepared for disasters nor a method to evaluate its role in H-EDRM. Methods: The checklist was developed through an iterative process that leveraged academic literature and expert consultations at different stages of the elaboration process. It was then used to assess primary care facilities in a province in Italy. Findings: The checklist offers a practical instrument for assessing and enhancing PHC disaster preparedness and for improving planning, coordination, and funding allocation. The study identified three critical areas for improvement in the province’s PHC disaster preparedness. First, primary care teams should be more interdisciplinary. Second, primary care services should be more thoroughly integrated into the broader health system. Third, there is a notable lack of awareness of H-EDRM principles among PHC professionals. In the future, the checklist can be elaborated into a weighted tool to be more broadly applicable.

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“…However, very few large-scale or national studies have evaluated whether existing telehealth infrastructure facilitates delivery of health care during crisis times. 8 , 13 The lack of studies on this topic may, in part, be attributed to the historically low uptake of telehealth by health systems prior to the COVID-19 pandemic. The U.S. Veterans’ Health Administration (VA) is an important exception as it was a leading provider of telehealth services in the USA even prior to the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

The Clinical Resource Hub Telehealth Program and Use of Primary Care, Emergency, and Inpatient Care During the COVID-19 Pandemic

Gujral,

Scott,

Dismuke-Greer

et al. 2024

J GEN INTERN MED

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Background The COVID-19 pandemic disrupted delivery of health care services worldwide. We examined the impact of the pandemic on clinics participating in the Veterans Affairs (VA) Clinical Resource Hub (CRH) program, rolled out nationally in October 2019, to improve access to care at under-resourced VA clinics or “spoke” sites through telehealth services delivered by regional “hub” sites. Objective To assess whether the CRH program was associated with increased access to primary care, we compared use of primary, emergency, and inpatient care at sites that adopted CRH for primary care (CRH-PC) with sites that did not adopt CRH-PC, pre-post pandemic onset. Design Difference-in-difference and event study analyses, adjusting for site characteristics. Study Cohort A total of 1050 sites (254 CRH-PC sites; 796 comparison sites), fiscal years (FY) 2019–2021. Intervention CRH Program for Primary Care. Main Measures Quarterly number of VA visits per site for primary care (across all and by modality, in-person, video, and phone), emergency care, and inpatient care. Results In adjusted analyses, CRH-PC sites, compared with non-CRH-PC sites, had on average 221 additional primary care visits (a volume increase of 3.4% compared to pre-pandemic). By modality, CRH-PC sites had 643 fewer in-person visits post-pandemic (− 14.4%) but 723 and 128 more phone and video visits (+ 39.9% and + 159.5%), respectively. CRH-PC sites, compared with non-CRH-PC sites, had fewer VA ED visits (− 4.2%) and hospital stays (− 5.1%) in VA medical centers. Examining visits per patient, we found that CRH-PC sites had 48 additional telephone primary care visits per 1000 primary care patients (an increase of 9.8%), compared to non-program sites. Conclusions VA’s pre-pandemic rollout of a new primary care telehealth program intended to improve access facilitated primary care visits during the pandemic, a period fraught with care disruptions, and limited in-person health care delivery, indicating the potential for the program to offer health system resilience.

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Primary health care disaster preparedness: A review of the literature and the proposal of a new framework

Cited by 24 publications

References 113 publications

A Qualitative Study on the Use of the Hospital Safety Index and the Formulation of Recommendations for Future Adaptations

A Qualitative Study on the Use of the Hospital Safety Index and the Formulation of Recommendations for Future Adaptations

Assessing primary healthcare disaster preparedness: a study in Northern Italy

The Clinical Resource Hub Telehealth Program and Use of Primary Care, Emergency, and Inpatient Care During the COVID-19 Pandemic

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