Gareth Eck, MD.

Hurricane Katrina made landfall on the U.S. Gulf Coast on August 29, 2005. Thousands of Gulf Coast residents evacuated and dispersed across the country, moving into hotels, private homes, and evacuation centers (ECs) in 30 states and the District of Columbia (DC). One goal of public health responders was to identify and prevent hurricane-related morbidity and mortality among affected populations, especially among those with limited access to health care and those who were living in crowded conditions. This report summarizes the challenges of conducting national surveillance after Hurricane Katrina, focusing on the role of CDC in coordinating surveillance and consolidating and interpreting morbidity data from jurisdictions that used diverse surveillance approaches. Aggregate morbidity data that were reported through Arkansas, Louisiana, Mississippi, and Texas to CDC during September 1-22, 2005 (before the Gulf Coast landfall of Hurricane Rita on September 24) are presented from ECs and health-care facilities (HCFs) that served affected populations in these states. Chronic diseases and injuries were the most common conditions reported by ECs and HCFs, respectively. To better prepare for future large-scale disasters with widespread impact, public health agencies and other partners are actively working to establish standardized guidelines and tools for morbidity surveillance. These guidelines will facilitate the interpretation and exchange of health information among multiple jurisdictions and public and private agencies during a disaster response to identify outbreaks and monitor health concerns.

Arkansas↗

PubMed2006

Interdepartmental problem-solving as a method for teaching and learning systems-based practice.

RATIONALE AND OBJECTIVES: Systems-based practice (SBP) has been the most difficult competency to implement in radiology residency programs, and methods for teaching and learning SBP concepts are needed. Because systems problems are usually multifactorial, a multidisciplinary approach is required. In our institution, survey data indicated patient dissatisfaction with emergency care. Prolonged wait times for radiology procedures were identified as a systems problem. When hospital administration asked the emergency medicine and radiology departments to work together to improve patient care, residents had a "real-world" opportunity to achieve the SBP competency. MATERIALS AND METHODS: Systems problems were identified and categorized. Data on patient transport were collected. Accurate time logs documenting when studies were ordered, performed, and interpreted were maintained. Data were analyzed at interdepartmental meetings and three improvements were planned and implemented. RESULTS: A direct line of communication was established between radiology and emergency medicine via a dedicated cellular telephone. A joint emergency medicine/radiology teaching conference was established. Additional transport personnel were employed. Residents in both departments increased their understanding of their role in the health care system, demonstrated an ability to identify systems problems and appropriately implement improvements, and enhanced their professional relationships. CONCLUSION: This innovative method integrated educational goals with patient care goals, was grounded in "real-life" experience, and held residents accountable for results. Competence in SBP, patient care, professionalism, and interpersonal and communication skills were demonstrated. We recommend this approach as an efficient and effective way to integrate SBP into everyday clinical practice.

Arkansas↗