Original Research
Perceived Attitudes and Staff Roles of Disaster Management at CBOCs
Community-based outpatient clinics can play an important role in disaster response, but significant barriers exist, which must be addressed.
Following 2 days of closures, the Clearlake VA Clinic in California has been reopened for all medical appointments on Wednesday with limited lab service and no blood draws after 12:30 PM.
The Valley Fire broke out over the weekend, burning about 70,000 acres to date. The fire has destroyed 585 homes and claimed at least 1 life—a 72-year-old woman with multiple sclerosis, whom the Lake County Sherriff’s Department said they couldn’t reach before flames engulfed her home.
About 13,000 residents of Lake, Napa, and Sonoma counties have been displaced, some to shelters and unable to return to their communities, either due to continuing fire threat or the devastating consequences of the blaze, including downed power lines and other damaged infrastructure. These victims are now relying on community and government aid for shelter, food, water, cleaning supplies, and support services.
The American Red Cross (ACA) is offering medicines and health services, but any VA patient affected by the wildfire and requiring medication refills should call the Telephone Linked Care line at (800) 733-0502.
During a disaster, CBOCs can play an important role, according to “Perceived Attitudes and Staff Roles of Disaster Management at CBOCs,” written by Hilton and colleagues last month in Federal Practitioner. Whereas some organizations are fully equipped to respond to disasters, such as the National Guard or the ACA, others are not. This study outlined the important role of CBOCs in disaster response but admitted that significant barriers to a successful response exist and must be addressed.
Among the recurrent themes that emerged from the study were emergency preparedness barriers, including lack of staff training, tools, and direction; as well as acknowledgment of limited available resources and personal family fears: many CBOC employees said that during an emergency, they would prefer to be home caring for their families.
The VHA mandates CBOCs develop an emergency preparedness plan. To achieve this, Hilton and colleagues suggest the following:
- Develop a more structured approach to disaster management in a CBOC setting to provide staff with a clear understanding of their roles and responsibilities;
- Conduct a comprehensive assessment of each clinic to determine staff knowledge, skills, and resources required to provide emergency preparedness and institute a disaster management training curriculum;
- Provide clinic leadership with direction on developing a disaster plan as well as how to partner with their primary and local VA health care system, especially onsite physicians, to provide effective disaster management leadership;
- Recruit staff into routine drills for natural disasters and expand to an all-hazard approach to manmade disasters to identify gaps in delivering disaster management in a disaster;
- Facilitate partnerships and a standardized approach to disaster management between CBOCs within the VISN by scheduling routine video and teleconferencing, live meetings, and webinars so that procedures and language are clearly understood and communicated between facilities; and
- Identify key barriers to clinic preparedness by assessing emergency preparedness elements through mock disaster drills and offer solutions to fill disaster management gaps.
Additional postdisaster resources, including cleanup efforts and financial relief, are available at https://www.usa.gov/disasters-and-emergencies.