title: Disaster preparedness and response practices among providers from the Veterans Health Administration and Veterans with spinal cord injuries and/or disorders.
abstract: OBJECTIVE
  Few empirical studies have examined the disaster preparedness and response practices of individuals with spinal cord injuries and/or disorders (SCI/D) and the healthcare providers who serve them. This study was conducted to understand the experiences of Veterans Health Administration (VHA) providers and Veterans with SCI/D in recent natural disasters, and to identify lessons learned for disaster preparedness and response in the context of SCI/D.
  
  
  METHODS
  Semi-structured interviews were conducted with providers and Veterans recruited through seven VHA facilities that had sustained a disaster since 2003. Audio recordings of the interviews were transcribed; transcripts were analyzed using constant comparative techniques.
  
  
  RESULTS
  Forty participants completed an interview, including 21 VHA SCI/D providers and 19 Veterans with SCI/D. Disasters experienced by participants were weather related. While many Veterans were evacuated or admitted to nearby VHA facilities, others chose to stay in their communities. All facilities had formal disaster plans and engaged in related training; however, participants explained that many aspects of a response take shape 'in the moment,' and must address both provider and Veteran needs. Dispersion of resources hindered well-coordinated care, but effective communication, teamwork, advanced warnings, and VHA's electronic medical record facilitated efforts.
  
  
  CONCLUSIONS
  Even in the case of thorough planning, Veterans with SCI/D and their healthcare providers are faced with pressing needs during disasters, and identifying strategies to coordinate care is critical. The lessons learned are intended to inform the efforts of healthcare providers who may be involved in the care of individuals with SCI/D in future disasters.
authors: Edward Hines Jr. VA Hospital, Hines, IL, USA. timothy.hogan@va.gov
authors: Timothy P
authors: TP
authors: Hogan
authors: Sally A
authors: SA
authors: Holmes
authors: Lauren M
authors: LM
authors: Rapacki
authors: Charlesnika T
authors: CT
authors: Evans
authors: Laurie
authors: L
authors: Lindblom
authors: Helen
authors: H
authors: Hoenig
authors: Barry
authors: B
authors: Goldstein
authors: Bridget
authors: B
authors: Hahm
authors: Frances M
authors: FM
authors: Weaver
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D004189:Disaster Planning / Q000379:methods / Q000458:organization & administration; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D016134:Organizational Policy; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010819:Physician's Role; D012308:Risk Management; D013118:Spinal Cord Diseases / Q000453:epidemiology* / Q000628:therapy; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration* / Q000706:statistics & numerical data; D014728:Veterans / Q000706:statistics & numerical data; D058014:Veterans Health