Identified Gaps in Home Health Agency Disaster Preparedness Protocols

Background:

Individuals receiving in-home care are vulnerable during disasters due to chronic disease, cognitive impairment, functional limitations, physical disabilities, and dependence on life-saving equipment. Increasing disaster preparedness may decrease adverse health outcomes and lessen the burden on emergency responders. Home care providers are positioned to assess and improve patient disaster preparedness as they have regular contact with patients and caregivers and knowledge of patient home environments, medical needs, resources, and limitations.

Methods:

(1)    Thematic review of 32 peer-reviewed articles that discussed: (a) home health organization policies and procedures, (b) lessons learned in the field, and (c) expert recommendations

(2)    31 semi-structured interviews with practitioners and leadership at 6 Veterans Health Administration Home-Based Primary Care (HBPC) programs.

Results:

Disaster preparedness tools have been developed by the National Association for Home Care and Hospice and the Agency for Healthcare Research and Quality. Gaps emerged between information gathered in the review and from interviews with HBPC programs: (1) It is not always clear who is responsible for monitoring medical equipment; (2) Programs need a stronger means of identifying caregiver support; and (3) HBPC’s unique structure allows for practitioners from various disciplines to lead disaster preparedness activities.

Conclusion:

Differences exist in evaluation, classification, education, and triage between organizations. Gaps exist between recommended tools and policies and those that have been adopted in the field. Programs responsible for preparedness in home healthcare would benefit from better dissemination and evaluation of current evidence-based tools. Tools should allow professionals from different disciplines to optimize leadership regarding preparedness.