Preparing for Public Health Emergencies
The Agency for Healthcare Research and Quality (AHRQ) supports research and the development of
models, tools, and reports to assess, plan, and
improve the ability of the U.S. health care
system to respond to public health emergencies
that result from natural, biological, chemical,
nuclear, and other infectious disease events.
These initiatives focus on an array of issues
related to clinicians, hospitals, and health care
systems, including the need to establish linkages
among these providers with local and State
public health departments, emergency
management personnel, and others preparing to
respond to events that have the potential to
cause mass casualties.
Computer Model Helps States Predict Health Care Staff Required During Public Health
Emergencies
The Vermont Department of Health relied on an AHRQ computer model to help forecast public health
staffing needs in the event of a major public health emergency. The AHRQ tool, called the Bioterrorism
and Epidemic Outbreak Response Model (BERM), helps health officials predict the number and type of
staff needed to dispense drugs and triage patients after a bioterrorism attack or during a disease
epidemic. The model was developed by Nathaniel Hupert, M.D., M.P.H., Assistant Professor of Public
Health and Medicine at Weill Medical College of Cornell University. The AHRQ tool helps estimate
requirements for numerous staff categories, including nurses, pharmacists, EMS personnel, doctors,
clinic greeters, security guards, and traffic monitors. The BERM tool also helps health officials estimate
how much extra time would be needed to treat special populations, such as children, non-English
speakers, and people with disabilities. The BERM tool is available at http://www.ahrq.gov/research/biomodel3/.
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In 2006, AHRQ released two new resources for
emergency response planners and health care
providers:
- Pediatric Terrorism and Disaster Preparedness: A
Resource for Pediatricians. This resource is
intended to increase awareness of the unique
needs of children and encourage
collaboration among pediatricians, State and
local emergency response planners, health
care systems, and others involved in
planning and response efforts for natural
disasters and terrorism. The publication
provides an overview of the role of national, regional, and local emergency response
systems before, during, and after disasters
and terrorism events. The pediatrician's role
in collaborating with this infrastructure and
local emergency departments, schools, and
daycare facilities is highlighted. Children's
emotional and mental health needs are also
described, including the treatment of post-traumatic
stress disorder, depression, and
behavioral problems that often result from
these incidents. The resource is available
online at http://www.ahrq.gov/research/pedprep/resource.htm.
- Mass Medical Care With Scarce
Resources: A Community Planning Guide. This
guide provides community planners, as well
as planners at the institutional, State, and
Federal levels, with valuable information to
help plan for and respond to a mass casualty
event (MCE). This planning guide examines
MCE response and preparedness challenges
across a wide range of health care settings
and provides recommendations for planners
in specific areas. The guide can be found
online at http://www.ahrq.gov/research/mce.
In January 2006, AHRQ also sponsored a Web
conference, "Strategies and Tools for Meeting the
Needs of Children." This Web conference
explored key issues surrounding the
preparedness planning for the care of children.
It highlighted innovative research, tools, and
models that can be used in developing effective
preparedness strategies for addressing the unique
needs of children. The presentations given
during the Web conference are available on the
AHRQ Web site at http://www.ahrq.gov/news/ulp/btpediatric/.
AHRQ Report Assists Health System in Reopening Shuttered Hospital after Hurricane
Katrina
CHRISTUS Schumpert Health System of Shreveport, Louisiana, drew on an AHRQ report, Use of Former
("Shuttered") Hospitals to Expand Surge Capacity, when it reopened 29 acute care hospital beds in the
wake of Hurricane Katrina, which struck the region August 29, 2005. These acute care beds are in
CHRISTUS Schumpert's Bossier facility, which had previously operated primarily as a scaled-down
provider of rehabilitation services. The AHRQ report gives emergency responders and public health
officials useful, practical tools for opening shuttered hospitals when an emergency is underway or as a
part of community preparedness planning efforts. It provides information including lists of supplies and
medications needed by stable medical/surgical patients and checklists to assess facility readiness, staffing
needs and levels, and patient transport readiness. The report also contains a tool kit with a list of
supplies and equipment needed for operation of a reopened facility.
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To learn more about all AHRQ-supported
research, tools, and activities related to
bioterrorism and public health emergency
preparedness, visit the AHRQ Web site at
http://www.ahrq.gov/prep/.
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Looking to the Future
In 2007, AHRQ will continue its mission to
improve the quality, safety, and cost-effectiveness
of health care in America with a
focus on prompting greater uptake and use of its
tools and research. Examples of key programs
and initiatives follow.
Questions are the Answer Campaign
AHRQ has joined with the Ad Council to launch
a national public service advertising campaign
designed to encourage adults to take a more
proactive role in their health care. The campaign
entitled "Questions Are the Answer: Get More
Involved With Your Health Care" was
launched during national Patient Safety
Awareness Week in March 2007 and will run for
1 year. The campaign encourages all patients
and caregivers to become more active in their
health care by asking questions and will be
supported through media advertising and a Web
site where consumers can obtain tips on how to
help prevent medical mistakes and become a
partner in their health care.
AHRQ is also working with the Ad Council to
encourage preventive health care in the Spanish-speaking
population.
Annual State Snapshots
In 2006, AHRQ will release its annual State
Snapshots, an application that helps State health
leaders, researchers, consumers, and others
understand the status of health care quality in
individual States, including each State's
strengths and weaknesses. The 51 State
Snapshots—every State plus Washington, D.C.—are based on 129 quality measures, each of
which evaluates a different segment of health
care performance. While the measures are the
products of complex statistical formulas, they
are expressed on the Web site as simple, five-color
"performance meter" illustrations. The
data, drawn from AHRQ's 2006 National
Healthcare Quality Report, come from various data
sources that cover multiple years. Preliminary
findings show that some shortcomings in health
care quality are widespread. On average, for
example, States reported that only about 59
percent of adult surgery patients insured by
Medicare receive appropriate timing of
antibiotics.
NHQRnet and NHDRnet
The release of the annual State Snapshots will be
complemented by the launch of NHQRnet and
NHDRnet, a pair of new, interactive Web-based
tools for searching AHRQ's storehouse of
national health care data. These online search
engines will allow users to create spreadsheets
and customize searches of information in the
2006 National Healthcare Quality Report (NHQR) and the
2006 National Healthcare Disparities Report (NHDR).
Health Care Report Card Compendium
A new Web tool that demonstrates a variety of
approaches for health quality report cards will
be released in 2006. The new Health Care Report
Card Compendium will be a searchable directory
of over 200 samples of report cards produced by
a variety of organizations. The samples will show formats and approaches for providing
comparative information on the quality of
health plans, hospitals, medical groups,
individual physicians, nursing homes, and other
providers of care.
Improving Patient Safety Through
Simulation Research
In April 2006, AHRQ issued its Request for
Applications (RFA) to fund $2.4 million in grants for
research and evaluation of simulation as a
strategy to improve the safe delivery of health
care. Such projects would include research that
involves team training, the effects of
implementing health information technology (health IT), the use of
"standardized patients," and the impact of
virtual reality across diverse settings of care.
Ambulatory Safety and Quality Grant
Program
AHRQ announced in December 2006 that the
Agency will fund up to $26 million in new
research projects to improve the safety and
quality of ambulatory health care. These projects
will focus on:
- The development of health IT to
assist clinicians, practices, and systems improve
the quality and safety of care delivery and
medication management.
- The development of
health IT to assist clinicians, practices, and
systems measure the quality and safety of care in
ambulatory care settings.
- Projects to support
proactive risk assessments and model risks and
known hazards that threaten patient safety.
- Demonstration projects that will explore the use
of health IT and related policies and practices to
establish and enhance patient-centered care.
Consumer Assessment of Healthcare Providers and Systems (CAHPS®)
New Items for People with Mobility Impairments
The CAHPS® Consortium is developing a set of
survey items that would allow survey sponsors
to assess the experiences of adults age 18-64 who
have a mobility impairment with health care
services. The Consortium expects to release this
item set for public use by early 2007.
CAHPS® III RFA Published
In 2006, AHRQ published the RFA for CAHPS® III. The scope of
work for CAHPS® III differs from that for
CAHPS® I and II in that there is a greater
emphasis on two areas: quality improvement
projects and research on reporting survey results
to consumers, purchasers, and other audiences.
Developing new surveys and maintaining
existing surveys continue to be a part of the
work, as does disseminating and promoting
CAHPS® products. AHRQ intends to commit
$4.5 million annually to CAHPS® III.
Value-Driven Health Care Initiative
AHRQ will play a central role in creating
Chartered Value Exchanges throughout the
country. Under the initiative, Chartered Value
Exchanges are seen as the focal points of health
care transformation. They will comprise multi-stakeholder
organizations which will bring
together a community's purchasers, health
plans, providers, consumers, and other
interested stakeholders to implement
meaningful changes at the local level where
health care is actually delivered.
For more
information about Chartered Value Exchanges,
please visit http://www.hhs.gov/valuedriven.
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In Conclusion
The evidence developed through ARHQ-sponsored
research and analyses helps everyone
involved in patient care make more informed
choices about what treatments work, for whom,
when, and at what cost. Health care quality is
improving, but much more remains to be done
to achieve optimal quality. AHRQ will continue
to invest in successful programs that develop
and translate useful knowledge and tools so that
the end result of the Agency's research will be
measurable improvements in health care in
America through improved quality of care and
patient outcomes and value gained for what we
spend.
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AHRQ Publication No. 07-0037
Current as of July 2007
Internet Citation:
AHRQ Annual Highlights 2006. AHRQ Publication No. 07-0037, July 2007. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/highlt06.htm
540 Gaither Road Rockville, MD 20850