Raising the game: nurturing research and development in the newly reconfigured ambulance services in the United Kingdom – opportunities for research for better health in prehospital settings

Ambulance services will need a new and robust structure to support the growing prehospital research agenda for the short and medium term. This structure will need to inform and be informed by effective knowledge management and dissemination and will need to ensure that research helps lead to high quality, safe (no needless harm), effective (evidence-based), patient centred (no feelings of helplessness and in accordance with patients reasonable expressed wishes), timely (no needless delay), efficient (no waste and with realistic outcomes) and equitable (fair to all patients) ambulance services which are integrated with and aligned to the wider health system. This paper recommends a structure which supports local as well as national research activity and research capacity development. In order to foster a research culture and research activity within a robust research governance framework a National Research Steering Group with representation from each ambulance service is advocated

Models of Dynamic Data for Emergency Response: A Comparative Study

The first hours after a disaster happens are very chaotic and difficult but perhaps the most important for successfully fighting the consequences, saving human lives and reducing damages in private and public properties. Despite some advances, complete inventory of the information needed during the emergency response remains challenging. In the last years several nationally and internationally funded projects have concentrated on inventory of emergency response processes, structures for storing dynamic information and standards and services for accessing needed data sets. A good inventory would clarify many aspects of the information exchange such as data sets, models, representations; a good structuring would facilitate the fast access to a desired piece of information, as well as the automation of analysis of the information. Consequently the information can be used better in the decision-making process.\ud This paper presents our work on models for dynamic data for different disasters and incidents in Europe. The Dutch data models are derived from a thorough study on emergency response procedure in the Netherlands. Two more models developed within the project HUMBOLDT reflect several cross border disaster management scenarios in Europe. These models are compared with the Geospatial Data Model of the Department of Homeland Security in USA. The paper draws conclusions about the type of geographical information needed to perform emergency response operations and the possibility to have a generic model to be used world-wide

FEMA's Integration of Preparedness and Development of Robust Regional Offices

In October 2006, Congress enacted major legislation to reform the function and organization of the Federal Emergency Management Agency (FEMA) in response to the recognized failures in preparation for and response to Hurricane Katrina. The Post-Katrina Emergency Management Reform Act of 2006 (PKEMRA) focused national preparedness responsibilities within FEMA and directed additional resources and responsibilities to FEMA's ten regional offices. Directed by Congress, in October 2008 a National Academy Panel began an independent assessment of FEMA's integration of preparedness functions and progress in development of robust regional offices.Main FindingsOver the past three years, FEMA has taken significant steps in an effort to integrate preparedness and develop more robust regional offices. These efforts, undertaken by both the previous and current Administrations, are documented throughout this report and should be recognized and applauded. However, FEMA has yet to define specific goals and outcomes that would permit it, Congress or the public to determine when preparedness has been fully integrated into all aspects of FEMA's work and whether the development and ongoing operation of robust regional offices has been achieved. In the absence of well-defined, measurable outcome indicators, the National Academy Panel relied upon the assessments of FEMA leaders and staff, documentation provided by FEMA, and a review of secondary sources material to inform its findings and recommendations. Based upon this evidence, the Panel has concluded that, while progress has been made: (1) preparedness is not fully integrated across FEMA, (2) FEMA's regional offices do not yet have the capacity required to ensure the nation is fully prepared, (3) stakeholders are not yet full partners with FEMA in national preparedness, and (4) FEMA has ineffective internal business practices, particularly with regard to human resource management. The Panel made seven recommendations for FEMA:Establish a cross-organizational process, with participation from internal and external stakeholders, to develop a shared understanding of preparedness integrationEstablish a robust set of outcome metrics and standards for preparedness integration, as well as a system to monitor and evaluate progress on an ongoing basisWork to eliminate organizational barriers that are adversely impacting the full integration of preparedness across the agencyContinue to build regional office capacity and monitor implementation consistent with the Administrator's recent policy guidanceUndertake steps to improve the ongoing working relationship between headquarters and the regions in accord with Panel-identified principlesTake steps to improve stakeholder engagement and relationships at all levels in accord with Panel-identified principles; andStrengthen internal business practices, especially in the area of human capital planning

Public-private Partnerships (PPP) in Disaster Management in Developing Countries: A Conceptual Framework

With loss and damages from disasters increasing globally, reports from international agencies show that developing and the least developed countries are most affected by natural disasters. Much of the literature refers to two major problems that these countries face when managing disaster: the role of government and financial restrictions. As a result, it is difficult for these countries to develop a comprehensive disaster management framework and programs. Public-private partnerships (PPP) have become a popular way for governments to engage private actors in the delivery of government infrastructure and services with the aim of increasing quality and providing better value for money. This study will explore whether Public-Private Partnerships (PPP) can be used as a strategic approach to overcome or at least to minimise the negative impacts of disasters in developing countries. Based on a study of previous literature, this paper develops a conceptual framework that describes how the partnership between public and private actors, with certain characteristics, can establish a platform for all actors to contribute towards the objectives of disaster management in developing and least developed countries

Committed to Safety: Ten Case Studies on Reducing Harm to Patients

Presents case studies of healthcare organizations, clinical teams, and learning collaborations to illustrate successful innovations for improving patient safety nationwide. Includes actions taken, results achieved, lessons learned, and recommendations

Seafloor characterization using airborne hyperspectral co-registration procedures independent from attitude and positioning sensors

The advance of remote-sensing technology and data-storage capabilities has progressed in the last decade to commercial multi-sensor data collection. There is a constant need to characterize, quantify and monitor the coastal areas for habitat research and coastal management. In this paper, we present work on seafloor characterization that uses hyperspectral imagery (HSI). The HSI data allows the operator to extend seafloor characterization from multibeam backscatter towards land and thus creates a seamless ocean-to-land characterization of the littoral zone

Knowledge-Intensive Processes: Characteristics, Requirements and Analysis of Contemporary Approaches

Engineering of knowledge-intensive processes (KiPs) is far from being mastered, since they are genuinely knowledge- and data-centric, and require substantial flexibility, at both design- and run-time. In this work, starting from a scientific literature analysis in the area of KiPs and from three real-world domains and application scenarios, we provide a precise characterization of KiPs. Furthermore, we devise some general requirements related to KiPs management and execution. Such requirements contribute to the definition of an evaluation framework to assess current system support for KiPs. To this end, we present a critical analysis on a number of existing process-oriented approaches by discussing their efficacy against the requirements

Support for Drought Response and Community Preparedness: Filling the Gaps between Plans and Action

This chapter examines which levels of government handle various aspects of drought, as well as interactions between levels of government, providing examples from states across the western United States. It also takes a look at aspects of drought that fall outside traditional lines of authority and disciplinary boundaries. As part of a discussion on how states support local drought response, the chapter details and contrasts how California and Colorado track public water supply restrictions, and describes Colorado’s process for incorporating input from river basins across the state into its water plan. Case studies focus on drought planning in the Klamath River and Upper Colorado River basins through the lens of collaborative environmental planning. The chapter concludes that drought planning will be more effective as more states coordinate and align goals and policies at multiple levels of government

Supporting research and development in ambulance services: research for better healthcare in prehospital settings

Background This paper discusses recent developments in research support for ambulance trusts in England and Wales and how this could be designed to lead to better implementation, collaboration in and initiation of high-quality research to support a truly evidence-based service. Method The National Ambulance Research Steering Group was set up in 2007 to establish the strategic direction for involvement of regional ambulance services in developing relevant and well-designed research for improving the quality of services to patients. Results Ambulance services have been working together and with academic partners to implement research and to participate, collaborate and lead the design of research that is relevant for patients and ambulance services. Conclusion New structures to support the strategic development of ambulance and prehospital research will help address gaps in the evidence for health interventions and service delivery in prehospital and ambulance care and ensure that ambulance services can increase their capacity and capability for high-quality research