TY - JOUR
T1 - A Proactive Nursing Home Risk Stratification Model for Disaster Response
T2 - Lessons Learned from COVID-19 to Optimize Resource Allocation
AU - Ibrahim, Joseph E.
AU - Aitken, Georgia
N1 - Funding Information:
This work was supported the Department of Forensic Medicine, Monash University . None of the funders influenced the design, methods, subject recruitment, data collection, analysis, or preparation of the article. The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position Monash University, Safer Care, Victoria, the Victorian Institute of Forensic Medicine, or the Coroners Court of Victoria. The authors are affiliated with or employed by the Department of Forensic Medicine, Monash University , which is also a funding source. The authors have no other potential financial or personal interests that may constitute a source of bias.
Funding Information:
This work was supported the Department of Forensic Medicine, Monash University. None of the funders influenced the design, methods, subject recruitment, data collection, analysis, or preparation of the article. The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position Monash University, Safer Care, Victoria, the Victorian Institute of Forensic Medicine, or the Coroners Court of Victoria. The authors are affiliated with or employed by the Department of Forensic Medicine, Monash University, which is also a funding source. The authors have no other potential financial or personal interests that may constitute a source of bias.
Publisher Copyright:
© 2021 AMDA – The Society for Post-Acute and Long-Term Care Medicine
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/9
Y1 - 2021/9
N2 - A coordinated emergency management response to disaster management in nursing homes is desperately needed globally. During the most recent COVID-19 pandemic, aside from a few exemplary countries, most countries have struggled to protect their nursing home populations. Timely and appropriate allocation of resources to nursing homes during disaster response is a challenging yet crucial task to prevent morbidity and mortality of residents. The responsibility for the management of nursing homes during the pandemic was multifaceted, and responsibilities lay at the national, jurisdictional, and regional levels. Success in managing COVID-19 in nursing homes required all these levels to be aligned and supportive, ideally through management by an emergency response leadership team. However, globally there is a paucity of effective management strategies. This article uses the example of the COVID-19 pandemic to propose a risk stratification system to ensure timely and appropriate allocation of resources to nursing homes during disaster preparation and management. Nursing homes should be risk-stratified according to 4 domains: risk of intrusion, capability for outbreak containment, failure in organizational capability, and failure in the availability of community and health care supports. Risk stratification should also consider factors such as current levels of community transmission, if applicable, and geographic location of nursing homes and services. Early identification of nursing homes at risk for infectious disease, or disasters, and targeted allocation of resources might help reduce the number of outbreaks, lower the mortality, and preserve community supports such as acute hospital services. The next step is to debate this concept to validate the selected variables and then develop and pilot test a risk stratification tool for use.
AB - A coordinated emergency management response to disaster management in nursing homes is desperately needed globally. During the most recent COVID-19 pandemic, aside from a few exemplary countries, most countries have struggled to protect their nursing home populations. Timely and appropriate allocation of resources to nursing homes during disaster response is a challenging yet crucial task to prevent morbidity and mortality of residents. The responsibility for the management of nursing homes during the pandemic was multifaceted, and responsibilities lay at the national, jurisdictional, and regional levels. Success in managing COVID-19 in nursing homes required all these levels to be aligned and supportive, ideally through management by an emergency response leadership team. However, globally there is a paucity of effective management strategies. This article uses the example of the COVID-19 pandemic to propose a risk stratification system to ensure timely and appropriate allocation of resources to nursing homes during disaster preparation and management. Nursing homes should be risk-stratified according to 4 domains: risk of intrusion, capability for outbreak containment, failure in organizational capability, and failure in the availability of community and health care supports. Risk stratification should also consider factors such as current levels of community transmission, if applicable, and geographic location of nursing homes and services. Early identification of nursing homes at risk for infectious disease, or disasters, and targeted allocation of resources might help reduce the number of outbreaks, lower the mortality, and preserve community supports such as acute hospital services. The next step is to debate this concept to validate the selected variables and then develop and pilot test a risk stratification tool for use.
KW - COVID-19
KW - nursing homes
KW - risk stratification
UR - http://www.scopus.com/inward/record.url?scp=85113688242&partnerID=8YFLogxK
U2 - 10.1016/j.jamda.2021.07.007
DO - 10.1016/j.jamda.2021.07.007
M3 - Article
C2 - 34390677
AN - SCOPUS:85113688242
SN - 1525-8610
VL - 22
SP - 1831-1839.e1
JO - JAMDA
JF - JAMDA
IS - 9
ER -
