title: Building health care system capacity to respond to disasters: successes and challenges of disaster preparedness health care coalitions.
abstract: BACKGROUND
  This research aimed to learn from the experiences of leaders of well-developed, disaster preparedness-focused health care coalitions (HCCs), both the challenges and the successes, for the purposes of identifying common areas for improvement and sharing "promising practices."
  
  
  OBJECTIVE
  Little data have been collected regarding the successes and challenges of disaster preparedness-focused HCCs in augmenting health care system preparedness for disasters.
  
  
  METHODS
  Semi-structured interviews were conducted with a sample of nine HCC leaders. Transcripts were analyzed qualitatively.
  
  
  RESULTS
  The commonly noted benefits of HCCs were: community-wide and regional partnership building, providing an impartial forum for capacity building, sharing of education and training opportunities, staff- and resource-sharing, incentivizing the participation of clinical partners in preparedness activities, better communication with the public, and the ability to surge. Frequently noted challenges included: stakeholder engagement, staffing, funding, rural needs, cross-border partnerships, education and training, and grant requirements. Promising practices addressed: stakeholder engagement, communicating value and purpose, simplifying processes, formalizing connections, and incentivizing participation.
  
  
  CONCLUSIONS
  Strengthening HCCs and their underlying systems could lead to improved national resilience to disasters. However, despite many successes, coalition leaders are faced with obstacles that may preclude optimal system functioning. Additional research could: provide further insight regarding the benefit of HCCs to local communities, uncover obstacles that prohibit local disaster-response capacity building, and identify opportunities for an improved system capacity to respond to, and recover from, disasters.
authors: National Center for Disaster Medicine and Public Health,Uniformed Services University of the Health Sciences,Rockville,MarylandUSA.
authors: Lauren
authors: L
authors: Walsh
authors: National Center for Disaster Medicine and Public Health,Uniformed Services University of the Health Sciences,Rockville,MarylandUSA.
authors: Hillary
authors: H
authors: Craddock
authors: National Center for Disaster Medicine and Public Health,Uniformed Services University of the Health Sciences,Rockville,MarylandUSA.
authors: Kelly
authors: K
authors: Gulley
authors: National Center for Disaster Medicine and Public Health,Uniformed Services University of the Health Sciences,Rockville,MarylandUSA.
authors: Kandra
authors: K
authors: Strauss-Riggs
authors: National Center for Disaster Medicine and Public Health,Uniformed Services University of the Health Sciences,Rockville,MarylandUSA.
authors: Kenneth W
authors: KW
authors: Schor
mesh_terms: D057191:Capacity Building; D003299:Cooperative Behavior; D004189:Disaster Planning; D006265:Health Care Coalitions; D006801:Humans; D040841:Resource Allocation; D014481:United States
keywords: ASPR Office of the Assistant Secretary for Preparedness and Response; CDC Centers for Disease Control and Prevention; EMS Emergency Medical Services; HCC health care coalition; HHS US Department of Health and Human Services; HPP Hospital Preparedness Program; MMRS Metropolitan Medical Response System; MOU memorandum of understanding; PHEP Public Health Emergency Preparedness Program; learning