Workforce preparedness for disasters: perceptions of clinical and non-clinical staff at the U.S. Department of Veterans Affairs

Abstract

Background Most U.S. studies on workforce preparedness have a narrow scope, focusing primarily on perceptions of clinical staff in a single hospital and for one type of disaster. In contrast, this study compares the perceptions of workplace disaster preparedness among both clinical and non-clinical staff at all U.S. Department of Veterans Affairs (VA) medical facilities nationwide for three types of disasters (natural, epidemic/pandemic, and manmade). Methods The VA Preparedness Survey used a stratified simple random, web-based survey (fielded from October through December 2018) of all employees at VA medical facilities. We conducted bivariate and multivariate logistic regression analyses to compare the sociodemographic characteristics and perceptions of disaster preparedness between clinical and non-clinical VA staff. Results The study population included 4026 VA employees (2488 clinicians and 1538 non-clinicians). Overall, VA staff were less confident in their medical facility’s ability to respond to epidemic/pandemics and manmade disasters. Depending on the type of disaster, clinical staff, compared to non-clinical staff, were less likely to be confident in their VA medical facility’s ability to respond to natural disasters (OR:0.78, 95% CI:0.67–0.93, p < 0.01), pandemics (OR:0.82, 95% CI:0.70–0.96, p < 0.05), and manmade disasters (OR: 0.74, 95% CI: 0.63–0.86, p < 0.001). On the other hand, clinicians, compared to non-clinicians, were 1.45 to 1.78 more likely to perceive their role in disaster response to be important (natural OR:1.57, 95% CI:1.32–1.87; pandemic OR:1.78, 95% CI:1.51–2.10; manmade: OR:1.45; 95% CI: 1.23–1.71; p’s < 0.001), and 1.27 to 1.29 more likely to want additional trainings to prepare for all three types of disasters (natural OR:1.29, 95% CI:1.10–1.51; pandemic OR:1.27, 95% CI:1.08–1.49; manmade OR:1.29; 95% CI:1.09–1.52; p’s < 0.01). Clinicians were more likely to be women, younger, and more educated (p’s < 0.001) than non-clinicians. Compared to clinicians, non-clinical staff had been employed longer with the VA (p < 0.025) and were more likely to have served in the U.S. Armed Forces (p < 0.001). Conclusions These findings suggest both a desire and a need for additional training, particularly for clinicians, and with a focus on epidemics/pandemics and manmade disasters. Training programs should underscore the importance of non-clinical roles when responding to disasters.

Predictors of nurses’ reporting for work at the time of epidemics and natural disasters; solutions for hospital surge capacity

“…Findings of several studies indicate a direct relationship between a person's actual or perceived level of disaster preparedness According to this study, the chances of attending work among nurses who had previously received trainings pertaining to disasters was higher compared to those who had not, in all three scenarios of earthquake, flood, and epidemic. These findings are consistent with the results of a national survey conducted among pediatric nurse practitioners in the United States (Goodhue et al, 2012) which showed an association between previous training on disasters and the tendency to be present at work following disasters. Past disaster education can have a direct impact on increasing the knowledge and skills needed to manage an emergency situation and a person's actual or perceived competencies (Wu et al, 2020).…”

“…The ambiguity of the causes and consequences has a negative effect on a person's preparedness to provide care to the patients, which in turn reduces the desire to attend work (Bell & Wade, 2021). Findings of several studies indicate a direct relationship between a person's actual or perceived level of disaster preparedness and willingness to attend work (Al‐Hunaishi et al, 2019; Choi & Lee, 2021; Dobalian et al, 2020).…”

Determinants of Workforce Preparedness during Pandemics Among Healthcare Workers at the U.S. Department of Veterans Affairs

“… 27 , 28 , 32 , 33 Studies have also shown that improving household preparedness will likely increase willingness or ability to report to work or improve level of workforce preparedness during disasters. 8 , 21 , 27 Common barriers to household preparedness often include lack of financial resources, time, and knowledge of how to achieve preparedness. 32 Additionally, personal health problems has been cited as a barrier to ability or willingness to respond during pandemics, 10 , 15 which is particularly poignant during the novel coronavirus outbreak, as pre-existing health conditions has been shown to have a considerable effect on COVID-19 outcomes.…”

“…For details on the questionnaire and study population refer to previously published work on the VA Preparedness Survey. 21 In accord with the policies regarding activities that constitute human subjects research at the Authors’ Institution, this quality improvement study was determined by the local Institutional Review Board to be a non-research project (#2020-000051), since the study intended to evaluate an existing practice with the intention to improve it based on existing knowledge.…”

“…Additional details regarding the study design, questionnaire, and study population are available elsewhere. 20,21 This study was determined by the local institutional review board to be a quality-improvement, nonresearch project.…”