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Quality of response is focus of study

Emergency medicine study focuses on how to provide services to disaster survivors who do not have existing social or family networks.


"I would like to have a five question tool that any disaster manager could take to every fifth person in a line and say, 'did you do this' or 'did you do that,'"

—Dr. Thomas D. Kirsch, MD, MPH

A recent case study examining how well the increased needs for shelter, food and clothing in a disaster situation were met by disaster response organizations found much work remains to be done.

Dr. Thomas D. Kirsch, MD, MPH, presented the findings of the study at the 2009 Emergency Management Summit. Kirsch has formal education in emergency medicine as well as having experience working with the American Red Cross. Kirsch said he wants organizations to examine their practices and develop a tool to determine how well they are serving the population's needs.

"We don't measure outcomes well in disaster response," Kirsch said. "We don't really measure them at all."

They asked what needs people had and how well those needs were met. Kirsch's team based some of its research on the 2007 California Wildfires in San Diego County. Interviews were conducted with people at evacuation sites as well as local response centers.

What the team found was that most of the people who were at the shelters had their needs met, but that there was a part of the population who were hard to reach. Kirsch said those populations needed help that they didn't get.

"In terms of services needed, we didn't look at a trend over time," he said. "Job finding and communication were the two biggest needs. People lost their livelihoods and needed help finding their family. That was not well met."

Kirsch said his biggest goal was to get organizations to create a tool to measure the success of their disaster response.

"I would like to have a five question tool that any disaster manager could take to every fifth person in a line and say, 'did you do this' or 'did you do that,'" he said.

The case study was completely population based, according to Kirsch. He said having a similar tool for small situations for hospitals would be a big help, too.

"It's hard to say well, three of those people should have died, but we saved them. The smaller we get in population, the harder it gets to measure," he said.

The survey also looked at risk factors for staying at a shelter in situations like a wildfire.

"If you rented, which implied you were not quite as wealthy was a high risk factor," he said. "Being unmarried was also a high risk factor. We speculated it was because these people weren't as socially connected and didn't have people they could go stay with."

Kirsch said he believes the survey could be used in disasters other than wildfires, too.

"We did the survey based on experience during disasters. We sat around as a group before the disaster and asked what things we could measure and what things we couldn't measure," he said.

Kirsch said he and his team were continuing to develop the tool and looking for other valid models that can measure the quality of response.

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