title: Assessing Hospital Disaster Readiness Over Time at the US Department of Veterans Affairs.
abstract: Introduction There have been numerous initiatives by government and private organizations to help hospitals become better prepared for major disasters and public health emergencies. This study reports on efforts by the US Department of Veterans Affairs (VA), Veterans Health Administration, Office of Emergency Management's (OEM) Comprehensive Emergency Management Program (CEMP) to assess the readiness of VA Medical Centers (VAMCs) across the nation. Hypothesis/Problem This study conducts descriptive analyses of preparedness assessments of VAMCs and examines change in hospital readiness over time.
  
  
  METHODS
  To assess change, quantitative analyses of data from two phases of preparedness assessments (Phase I: 2008-2010; Phase II: 2011-2013) at 137 VAMCs were conducted using 61 unique capabilities assessed during the two phases. The initial five-point Likert-like scale used to rate each capability was collapsed into a dichotomous variable: "not-developed=0" versus "developed=1." To describe changes in preparedness over time, four new categories were created from the Phase I and Phase II dichotomous variables: (1) rated developed in both phases; (2) rated not-developed in Phase I but rated developed in Phase II; (3) rated not-developed in both phases; and (4) rated developed in Phase I but rated not- developed in Phase II.
  
  
  RESULTS
  From a total of 61 unique emergency preparedness capabilities, 33 items achieved the desired outcome - they were rated either "developed in both phases" or "became developed" in Phase II for at least 80% of VAMCs. For 14 items, 70%-80% of VAMCs achieved the desired outcome. The remaining 14 items were identified as "low-performing" capabilities, defined as less than 70% of VAMCs achieved the desired outcome.
  
  
  CONCLUSIONS
  Measuring emergency management capabilities is a necessary first step to improving those capabilities. Furthermore, assessing hospital readiness over time and creating robust hospital readiness assessment tools can help hospitals make informed decisions regarding allocation of resources to ensure patient safety, provide timely access to high-quality patient care, and identify best practices in emergency management during and after disasters. Moreover, with some minor modifications, this comprehensive, all-hazards-based, hospital preparedness assessment tool could be adapted for use beyond the VA. Der-Martirosian C , Radcliff TA , Gable AR , Riopelle D , Hagigi FA , Brewster P , Dobalian A . Assessing hospital disaster readiness over time at the US Department of Veterans Affairs. Prehsop Disaster Med. 2017;32(1):46-57.
authors.affiliation: 1Veterans Emergency Management Evaluation Center,US Department of Veterans Affairs,North Hills,CaliforniaUSA.
authors.forename: Claudia
authors.initials: C
authors.lastname: Der-Martirosian
authors.affiliation: 1Veterans Emergency Management Evaluation Center,US Department of Veterans Affairs,North Hills,CaliforniaUSA.
authors.forename: Tiffany A
authors.initials: TA
authors.lastname: Radcliff
authors.affiliation: 1Veterans Emergency Management Evaluation Center,US Department of Veterans Affairs,North Hills,CaliforniaUSA.
authors.forename: Alicia R
authors.initials: AR
authors.lastname: Gable
authors.affiliation: 3VA Health Services Research and Development Center for the Study of Healthcare Innovation, Implementation, and Policy,VA Greater Los Angeles Healthcare System,North Hills,CaliforniaUSA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Riopelle
authors.affiliation: 1Veterans Emergency Management Evaluation Center,US Department of Veterans Affairs,North Hills,CaliforniaUSA.
authors.forename: Farhad A
authors.initials: FA
authors.lastname: Hagigi
authors.affiliation: 6Department of Veterans Affairs,Veterans Health Administration,Office of Emergency Management,Martinsburg,West VirginiaUSA.
authors.forename: Pete
authors.initials: P
authors.lastname: Brewster
authors.affiliation: 1Veterans Emergency Management Evaluation Center,US Department of Veterans Affairs,North Hills,CaliforniaUSA.
authors.forename: Aram
authors.initials: A
authors.lastname: Dobalian
mesh_terms: D004189:Disaster Planning / Q000458:organization & administration*; D004632:Emergency Medical Services / Q000458:organization & administration*; D006801:Humans; D007373:Interinstitutional Relations; D010043:Outcome and Process Assessment, Health Care; D014481:United States; D014493:United States Department of Veterans Affairs
keywords:  AHRQ Agency for Healthcare Research and Quality;  CEMP Comprehensive Emergency Management Program;  HRSA Health Resources and Services Administration;  MA Mission Area;  MCE mass-casualty emergency;  OEM VA’s Office of Emergency Management;  SOP standard operating procedure;  VA US Department of Veterans Affairs;  VAMCs VA Medical Centers; assessment; capabilities; disaster readiness; emergency management; hospital preparedness