Courtney Brooke, Toner Eric, Waldhorn Richard, Franco Crystal, Rambhia Kunal, Norwood Ann, Inglesby Thomas V, O'Toole Tara
Center for Biosecurity of the University of Pittsburgh Medical Center, Baltimore, Maryland 21202, USA.
Biosecur Bioterror. 2009 Jun;7(2):153-63. doi: 10.1089/bsp.2009.0020.
After 9/11 and the 2001 anthrax letters, it was evident that our nation's healthcare system was largely underprepared to handle the unique needs and large volumes of people who would seek medical care following catastrophic health events. In response, in 2002 Congress established the Hospital Preparedness Program (HPP) in the U.S. Department of Health and Human Services (HHS) to strengthen the ability of U.S. hospitals to prepare for and respond to bioterrorism and naturally occurring epidemics and disasters. Since 2002, the program has resulted in substantial improvements in individual hospitals' disaster readiness. In 2007, the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) contracted with the Center for Biosecurity of the University of Pittsburgh Medical Center to conduct an assessment of U.S. hospital preparedness and to develop tools and recommendations for evaluating and improving future hospital preparedness efforts. One of the most important findings from this work is that healthcare coalitions-collaborative groups of local healthcare institutions and response agencies that work together to prepare for and respond to emergencies-have emerged throughout the U.S. since the HPP began. This article provides an overview of the HPP and the Center's hospital preparedness research for ASPR. Based on that work, the article also defines healthcare coalitions and identifies their structure and core functions, provides examples of more developed coalitions and common challenges faced by coalitions, and proposes that healthcare coalitions should become the foundation of a national strategy for healthcare preparedness and response for catastrophic health events.
在9·11事件和2001年炭疽信件事件之后，很明显我们国家的医疗保健系统在很大程度上没有做好准备，无法应对灾难性健康事件后寻求医疗护理的人群的独特需求和大量人员。作为回应，2002年国会在美国卫生与公众服务部（HHS）设立了医院应急准备计划（HPP），以增强美国医院应对生物恐怖主义以及自然发生的流行病和灾难的准备和应对能力。自2002年以来，该计划已使各医院的灾难准备情况有了实质性改善。2007年，HHS应急准备与响应助理部长办公室（ASPR）与匹兹堡大学医学中心生物安全中心签约，对美国医院的应急准备情况进行评估，并开发用于评估和改进未来医院应急准备工作的工具及建议。这项工作最重要的发现之一是，自HPP启动以来，医疗保健联盟——由当地医疗机构和应急机构组成的共同为应对紧急情况做准备并做出响应的协作团体——已在美国各地涌现。本文概述了HPP以及该中心为ASPR开展的医院应急准备研究。基于这项工作，本文还对医疗保健联盟进行了定义，确定了其结构和核心功能，列举了发展较为成熟的联盟的例子以及联盟面临的常见挑战，并提议医疗保健联盟应成为国家灾难性健康事件医疗应急准备与响应战略的基础。
