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Aims of this study

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Aims of this study

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  1. Emergency preparedness and its implications for healthcare : What further research is needed?Alan Boyd1, Duncan Shaw2, Naomi Chambers1, Simon French2, Russell King3 andAlison Whitehead41 Manchester Business School, 2 University of Warwick, 3 Royal Free Hampstead NHS,4 Wrightington, Wigan and Leigh NHS Foundation Trust These projects were commissioned by the NIHR Service Delivery and Organisation (NIHR SDO) programme under the management of the National Institute for Health Research Evaluations, Trials and Studies Coordinating Centre (NETSCC) based at the University of Southampton. From January 2012, the NIHR SDO programme merged with the NIHR Health Services Research (NIHR HSR) programme to establish the new NIHR Health Services and Delivery Research (NIHR HS&DR) programme. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the NIHR HS&DR programme, NIHR, NHS or the Department of Health.

  2. Aims of this study Identify research and development needs with regard to emergency management in health care Large-scale disasters, not smaller emergencies

  3. National Risk Register (2010 edition)

  4. London 2005 7/7 attacks 56 deaths >700 injured Injuries not commonly seen Ongoing psychological care

  5. Health emergency planning ‘A coordinated, cyclical process of planning, implementation, evaluation and learning which aims to increase the capability of society to prevent, protect against, respond to, and recover from any occurrence which presents a serious threat to the health of the community, or disrupts the health care system, or causes (or is likely to cause) such numbers or types of casualties as to require special arrangements to be implemented by one or more health care organisations’. Public health preparedness planning (Nelsonet al, 2007) UK NHS definition of a major incident (DoH, 2005)

  6. A picture of healthcare emergency planning:Balancing supply & demand through resistance & resilience of systems Implementation Major incident • Emergency planning system • Structures • Processes • Resources • Governance • Resistance and resilience • Vulnerability • Prevention + mitigation • Vulnerability • Resistance and resilience • Warning • Demand for healthcare • Supply of healthcare • Plans • Preparedness • Response • Incidence + prevalence of illness • Service user expectations • Structures • Processes • Resources • Governance • Recovery Evaluation and learning

  7. Scoping studies: What are they? A research tool for when it is beyond the capacity of specialists to read/synthesise all relevant papers Aim to create a broad map of research • potential size/scope (Grant et al, 2009), • key concepts (Arksey and O’Malley, 2005) • conceptual clarity (Davis et al, 2009) • setting this within policy/practice (Anderson et al, 2008) Quickly getting a sense for ‘what’s already out there’ – dimensions of interest

  8. Scoping study Systematic review Context: Scoping studies and systematic reviews For a methodological framework see: ArkseyH, O’Malley L (2005) Scoping studies: Towards a Methodological Framework. Int J Soc Res Methodol, 8:19-32. Broader topic; range of study designs relevant No quality assessment For researchers and research funders Well-defined question; determines relevant study designs Narrow range of quality assessed studies For practitioners and policy makers

  9. Our approach Identified 18 R&D areas Narrowed to 4 clusters Literature review Researcher survey Debriefs and case studies Interviews Prioritisation workshop and survey Advisory group

  10. 18 topic areas Learning (systems, measuring preparedness, quality improvement systems) Incident Level (Definitions, factors determining escalation/declaration, business continuity) Public Recovery (Early response, social support networks, vulnerable groups) Re-organisation (Minimise adverse effects, wide area emergency, long-running emergency) Risk communication (Public perception and communication, good practice, communicating expectations) Priority (Characteristics of effective planning, investment in preparedness) Training (Effective exercises, impact, developing emergency planners) International research (Transferability, multi-nation research) Strategic modelling (Criteria, good practice, local NHS good practice) Social networking (Public communication, intelligence gathering, trust) Surveillance (Lab capacity, enviro data, usefulness to decision makers) Community Groups (vulnerable groups, Access if infrastructure disrupted, involvement in processes) Willingness to work (Factors, increasing it) Infectious diseases (Predicting impact, assessing cross-species transmission risk, bioterrorism) ICT Resilience (Systems at risk, NHS-Net, National Resilience Extranet) ICT developments (Planning for ICT innovation, training and education, smart phones) System Recovery (Systems, prevention and recovery of responders) Collaboration (“mixed economy”, external “navigation”)

  11. Potential research topics vary in the extent to which they address the needs of the public and of organisations  ? People’s needs High ------------------- Low  ? Organisations’ needs Low ------------------- High

  12. Potential research topics vary in the extent to which they address the needs of the public and of organisations  ? People’s needs High ------------------- Low  ? Organisations’ needs Low ------------------- High

  13. Affected public Recovery and long-term health impacts Engagement with community groups and vulnerable populations Public risk communication and information dissemination Use of social networking Inter- and intra- organisational collaboration Factors affecting multi-agency working Linking emergency planning with other planning Suggested research topics to be commissioned

  14. Preparing responders and their organisations Learning and quality improvement Exercises and training Prioritisation and decision making Priority and resourcing given to emergency planning and management Issues relating to organisational change Social, administrative and political contexts Leadership and decision support systems during crises

  15. Suggested actions for research commissioners Collaborate within the UK and internationally • Compare research priorities • Coordinate commissioning • Develop commissioning models Strengthen UK research capacity

  16. Further information More details http://www.netscc.ac.uk/hsdr/projdetails.php?ref=09-1005-01 Executive summary: http://www.netscc.ac.uk/hsdr/files/project/SDO_ES_09-1005-01_V01.pdf Full report http://www.netscc.ac.uk/hsdr/files/project/SDO_FR_09-1005-01_V01.pdf

  17. Thank you for listening Prof Duncan Shaw duncan.shaw@warwick.ac.uk

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