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Exercising for Preparedness-Pediatric Safety and Planning

December 2015

Children have special needs that must be incorporated into emergency preparedness and response efforts and in order to adequately protect them, the health care community requires opportunities to learn new information, collaborate, and share best practices to ensure children are appropriately cared for during emergency events.

The Arizona Pediatric Disaster Coalition, a health care coalition (HCC) supported through the Hospital Preparedness Program (HPP), recognized the pressing need to prioritize pediatric patients and involve the education system in preparedness efforts. In December 2015, a joint exercise, funded in part through the Arizona Department of Health Services HPP cooperative agreement, evaluated how schools and hospitals interact in the wake of an emergency. The outcomes of the exercise played a direct role in improving relationships between hospitals and schools and helped to streamline emergency response care for the most vulnerable population. The exercise took a medical surge exercise model and creatively tailored the design to include schools and unaccompanied and injured minors. Health care workers, school administrators, and teachers participated along with law enforcement, emergency medical services, and other emergency response personnel to comprehensively test a response centered on the needs of society’s most vulnerable members. Within this revised model, health care and education partners ran through a myriad of difficult scenarios, including how best to handle multiple minors separated from guardians. They also tackled thorny issues, such as obtaining consent to care for minors and family reunification.

During each scenario, the team evaluated gaps to identify areas for improvement. The exercise highlighted the fact that many hospitals and schools do not have a clear understanding of what activities they should be performing during an emergency and who should lead these activities. Even basic terminology used across disciplines posed challenges in getting the differing groups to rapidly and effectively communicate. In addition, the exercise highlighted the clear need for HCCs and their members to have family reunification standard operating procedures to ensure that families are swiftly and correctly reunited in the wake of an emergency and prompted discussions regarding community behavioral health needs and the special support that families, hospital personnel and children need after a traumatic event.

ASPR HPP’s funding and resources were pivotal to the informative Arizona Departments of Health Services and Education joint exercise. Teresa Ehnert, the Arizona Bureau Chief for Public Health Emergency Preparedness stated that “HPP enabled the innovative thinking and planning the pediatric medical exercise provided. Unprecedented in the field, we were able to start a dialogue concerning the gaps in our current disaster preparedness, response, and recovery model, particularly as it relates to pediatric populations. HPP contributed to not only rallying the correct health care professionals together, it enabled us to employ a creative lens in addressing a pressing community need.”