Emergency Preparedness for Home Based Primary Care Senior Veterans: Lessons Learned from Previous Experience

Abstract

Since 1972, the Veterans Health Administration (VHA) has provided primary care to patients in the setting of their homes. Disaster preparedness for Home Based Primary Care (HBPC) patients has been a program objective as well as a requirement mandated by the VHA and accrediting organizations such as The Joint Commission. Over time, HBPC programs have served patients through a variety of natural disasters and emergencies. This chapter provides background on the VHA HBPC experience with emergency planning, brief case studies from our practices, and the lessons learned from disaster exercises and actual emergencies.

Appendices

Appendix 1: Example of Risk/Acuity Assessment

Criteria for priority coding
( ) Lives alone—3
( ) No telephone access—4
( ) Special equipment—1
( ) Mobile home—1
( ) Caregiver assistance—2
( ) Lives near water—1
( ) Wound care—3
( ) Houseboat—1
( ) Tube feeding—1
( ) Travel trailer—1
( ) IV therapy—1
( ) No transportation—1
( ) Dialysis—9
( ) Medication needs—1
( ) Oxygen dependent—5
( ) Physical disabilities—1
( ) Mild cognitive impairment—1
( ) Moderate cognitive impairment—2
( ) Severe cognitive impairment—3
( ) Mobility limitations—2
( ) Ventilator—9
( ) Bed bound—9
( ) Pets—1
Total score =
Emergency preparedness code scale
( ) 0–3 = low risk (green)
( ) 4–8 = intermediate risk (yellow)
( ) 9–Above = high risk (red)

Appendix 2: Example of Emergency Preparedness Telephone Interview Template

• Discussed the types of hazards that could affect you (tornado, flooding, chemical spill, etc.):

• Designated out-of-state family member who we may contact.

  • Name:

  • Phone:

• Do you plan to evacuate?

  • If yes, where to?

• Do you have water and nonperishable foods, enough to last several days?

• Do you have adequate emergency lighting?

• Do you have portable oxygen that will last 2–3 days?

• Are you registered with your local Power Company?

• Do you have medication to last at least 3 days?

• Patient and/or family member verbalized understanding of emergency preparedness and are prepared in an event of a disaster. ( )Yes ( )No

• Veteran (Patient)/caregiver have easy access to local VHA medical facility and HBPC telephone numbers. ( )Yes ( )No

• Comments:

Appendix 3: Example of Staff Emergency Preparedness Survey

Annually, survey your staff and yourself.

Do you:

Have a family disaster plan and have you practiced it annually?

Share your plan?

Know school plans?

Have disaster supplies such as the following?

• 1 Gallon of water per person per day (3-day minimum)

• Hygiene essentials

• First aid kit/supply

• 3 Days of food

• Can opener, tools

• Portable radio, flashlights, and batteries

• Vital documents

Have alternate places for children, elders, and pets?

Keep vital documents in a safe place?

Store your emergency preparedness kit in a cool, dry place and inspect, use, and rotate its contents?

Think about space for your emergency supplies and where you will keep your emergency plan?

Know how to get home if roads are blocked or damaged?

Know how to communicate with your spouse or children if phones are not working?

Know what you would do if your home is damaged and you could not stay there?

Know where you would go to get help with shelter and food?

Think you will be able to continue working?

Good things to keep in your car and at the office:

• Sample basic supplies food (snacks) and water

• Flashlights

• Battery-operated radio (spare batteries)

• Comfortable walking shoes

• Individual prescription medications

• Emergency contact information

• Extra glasses, house/car keys

• Essential medications

• Whistle, work gloves, face mask

• Spare clothes/blankets

• Emergency cash (small bills)

• Essentials for infants, elderly, or pets