A systematic review of rapid needs assessments and their usefulness for disaster decision making:Methods, strengths and weaknesses and value for disaster relief policy

Disaster and humanitarian aid authorities are expected to ensure a timely responsive to the needs of populations affected by disaster. However, they typically have to operate under challenging conditions, hindered by lack of time, capacity and other practical complications. Aim of this systematic review is to provide a comprehensive overview of the methods, strengths and weaknesses and implementation factors of rapid needs assessments (RNAs) in a disaster context. A structured search was applied in PubMed, Web of Science and PsycINFO. A total of 45 assessments were included and categorized in different need categories. Most RNAs focused on health care and basic assistance needs and were mostly carried out in the first days to week post-impact using single measurements, based on questionnaires in (mostly limited) samples of affected populations or occasionally based on registries. Few examples were found that used existing data sources. The review suggests that it is certainly possible to collect information on needs on behalf of disaster decision-making. However, its practical implementation depends on two conditions: the level of preparedness (e.g. availability of standardized pre-developed methods to register the affected for follow-up, standardized measurement instruments and strategies to utilize existing data sources) on the one hand, the nature and dynamic circumstances of the incident on the other. Disaster response authorities are encouraged to give priority to strengthening the first beforehand, while anticipating on the latter, preferably as part of an all hazards approach, with the intention to repeat RNAs beyond the first part of the disaster timeline

Provision of social support by mayors in times of crisis: a cross-sectional study among Dutch mayors

Security and Global Affair

Five essential principles of post-disaster psychosocial care: looking back and forward with Stevan Hobfoll

In 2007, a leading article was published by Stevan Hobfoll and a team of international experts. The authors synthesized available scientific evidence and distinguished five essential principles of psychosocial care to people confronted with disaster, tragedy, and loss. Care givers should promote: (1) a sense of safety, (2) calming, (3) self- and community efficacy, (4) social connectedness, and (5) hope. After their publication, the "essential principles" influenced the thoughts of policy makers, care providers, and scholars from all over the world. They have been embedded in several guidelines. In this interview, Professor Hobfoll is invited to revisit the principles and to look forward: "The next step is to create passageways and mutual partnerships.

Changing hospital care: evaluation of a multi-layered organisational development and quality improvement programme

In the last decades many different policy changes have been initiated in the Dutch hospital sector to optimise health care delivery: national agenda-setting, increased competition and transparency, a new system of hospital reimbursement based on diagnosis-treatment-combinations, intensified monitoring of quality, and a multi-layered organisational development programme based on quality improvement collaboratives – the multi-level quality collaborative (MQC). The focus of this dissertation is on the implementation and effects of the MQC. Several studies are described that help to answer two main research questions: (1) Did the participation by hospitals in the MQC result in the development of an organisational infrastructure for improvement, stimulating the adoption and sustainable spread of innovations and, if so, by what mechanism? (2) Is there, judged from changes that took place at different levels within the hospitals, any evidence that the MQC contributed to aligning the behaviour of staff at unit level with norms at national level via the behaviour of the strategic management? With regard to the first question, it is probable that the programme has contributed to quality improvement. Hundreds of improvement projects have been implemented within the MQC hospitals. Individual projects have shown positive results, but the performance indicator outcomes or perceived effects of a substantial part of the teams are unknown. Furthermore, different studies point at an organisational development effect. The strategic and tactical hospital management followed a systematic strategy on behalf of sustainability and spread; a strategy based on clear norms at organisation level, performance agreements, provision of necessary facilities and resources, and recurring accountability moments. The organisational infrastructure is adjusted to facilitate the implementation of the strategy. A longitudinal analysis suggests that programme hospitals evolved faster than the other hospitals. Three assumptions were explored to answer the second question: (a) competition and public communication of feasible quality norms, trigger hospitals to maximise quality (sector level), (b) MQC participation leads to systematic quality control (hospital level), (3) medical staff implements changes to achieve quality norms defined at higher levels (unit level). This dissertation demonstrates that planned change processes at different levels took place and were interrelated. Professionals adopted quality norms, took measures to realise the goals and measured performance-indicators. Improvement rates were confirmed as predictors for the future dissemination of the projects. This is an example of the continuous quality improvement that is being embedded at institutional level throughout the sector, not only within MQC-hospitals. During the programme, moreover, the behaviour of hospital executives did influence the extent to which the behaviour of project teams and physicians at unit level was aimed at achieving the MQC norms formulated at sector level. The MQC encouraged executives to do this in two ways. In the first place by adopting the organisational strategy for sustainability and dissemination. Secondly, by stimulating physicians to join quality improvement initiatives. As such, the MQC has contributed to a mechanism, linking quality targets at sector level to processes and outcomes at unit level

Psychosociale ondersteuning en zorg na een terreuraanslag.

Aandacht voor de kwaliteit en veiligheid van de patiëntenzorg binnen ziekenhuizen is niet alleen van belang voor de zorg onder normale omstandigheden, maar ook voor de zorg onder de abnormale omstandigheden van een ‘mass casualty incident’. De nadruk van dit artikel ligt op de psychosociale ondersteuning en zorg voor getroffenen van een terroristische aanslag. Er wordt ingegaan op verschillende typen getroffenen, hun mogelijke behoeften en (psychische) problemen en de voornaamste principes uit de multidisciplinaire richtlijn Psychosociale hulp bij rampen en crises. Deze richtlijn is door overheden, zorg- en dienstverleners en experts ontwikkeld, in opdracht van het ministerie van Volksgezondheid, Welzijn en Sport. Medische professionals in ziekenhuizen zijn vooral in de eerste uren en dagen na een aanslag betrokken bij de dienstverlening aan getroffenen. Het is een chaotische periode – met gebrekkige informatie over de toestand van (ernstig) gewonden, grote onzekerheid en bezorgdheid onder families en dierbaren, en maatschappelijke aandacht – die iets extra’s vraagt van zorgverleners en de ziekenhuisorganisatie. (aut. ref.

Paradoxes and parallels in the global distribution of trauma-related mental health problems.

One can hardly overestimate the value of a healthy mind or underestimate the sacrifices people are willing to make in the pursuit of health and happiness. Yet, during the course of their lives people are likely to be confronted with well-established factors connected to poor health. In this chapter, we focus on mental health, although we are aware of the multifaceted relation between physical and mental health issues. Among the risk and protective factors that are linked to developing mental health problems are female gender, lack of social support, existing mental health problems, lower socioeconomic status, and above all, exposure to adversity and stress (Brewin, Andrews, & Valentine, 2000; Ozer, Best, Lipsey, & Weiss, 2003; Bonanno, Brewin, Kaniasty, & La Greca, 2010; Yehuda et al., 2015). The negative health effect of exposure to external events such as disasters, accidents, severe illness, and loss of close family or a friend has been confirmed in many studies (Bonde et al., 2016; Galea, Nandi, & Vlahov, 2005; Kessler et al., 2017; Neria, Nandi, & Galea, 2008; Reifels, Mills, Dückers, & O’Donnell, 2017; Scott et al., 2013; Yzermans, Van Der Berg, & Dirkzwager, 2009). What the chapters of this book have in common is that they explore cultural aspects of posttraumatic stress disorder (PTSD); however the current chapter is slightly different because of its emphasis on cross-national patterns and the relevance of country-level factors that turn out to be risk and protective factors themselves. Understanding prevalence and predictive factors at the individual and group level is important to design and implement promising prevention, detection, mitigation, and amelioration strategies. On the other hand, cross-national differences in the prevalence of mental illness are important for promoting global mental health, but their determinants are poorly understood. Mental disorders specifically associated with trauma and stress are exceptional in needing external events to have caused psychiatric symptoms for a diagnosis to be made (Maercker et al., 2013). In this chapter, we will present differences in prevalence of trauma-related mental health problems across countries. Also, we will describe how exposure to trauma in national populations, together with cultural and socioeconomic country characteristics, can explain differences in prevalence between countries. By taking interactions between a number of factors into account, we illustrate how national receptive contexts for trauma vary across the world. After having presented findings from recent studies, we will discuss some implications for research and practice. (aut. ref.

Disaster mental health risk reduction: appraising disaster mental health research as if risk mattered.

Until recently, the intersection of Disaster risk reduction (DRR) and Mental Health and Psychosocial Support (MHPSS) has received relatively little systematic attention. Despite a growing recognition of the importance of mental health in global disaster policy (such as the UNDRR Sendai and WHO Health EDRM Frameworks), the intersections of our current approaches to disaster risk reduction and efforts to address mental health and psychosocial aspects in disaster and emergency contexts are still relatively poorly understood. As such, it is pivotal that we deepen our understanding of this intersection and develop the practical and scientific knowledge required to advance this field in the future. This article belongs to the Special Issue Disaster Mental Health Risk Reduction, that provides a unique opportunity to further examine insufficiently explored themes and intersections of MHPSS and DRR across the various stages of the disaster life cycle and across geographies. The contributions in this Special Issue are brought together through the integrative perspective of Disaster Mental Health Risk Reduction, with the aim to better understand, manage, and reduce future mental health and psychosocial risks associated with disasters and emergencies

Self-correcting mechanisms and echo effects in social media: an analysis of the “gunman in the newsroom” crisis.

The positive and negative effects of social media in crises are currently receiving an increased amount of scholarly attention. This study focuses on Twitter users in the context of a crisis in the Netherlands on January 29, 2015. After having made a bomb threat, an armed man managed to get access to the national news broadcasting station around 8 pm, where he demanded airplay to share “an important message” with Dutch citizens. Three weeks after the terrorist attack on Charlie Hebdo in Paris, approximately 1.5 million viewers were anxious that a similar attack was taking place in the television studio. The crisis, also followed by social media users, reached a climax when armed policemen arrested the man, which was later shown on national TV. We analyzed 58,931 tweets, posted in the six hours after the incident. By examining shared facts and rumors during the gunman crisis, we identified an “echo-effect”: the dissemination of older tweets continued after the posting of new facts by the same source. Moreover, we found that two rumors were based on misinterpreted humor in Twitter messages. The study adds insight into the self-correcting mechanism of social media communities when verifying and dispelling online rumors during crises. (aut. ref.

Post-disaster psychosocial support and quality improvement: a conceptual framework for understanding and improving the quality of psychosocial support programs.

This article is original in that it addresses post-disaster psychosocial support programs from a quality-improvement perspective, not from the traditional viewpoint of mental health services. Based on a combination of renowned quality models, a framework is sketched that offers chances to better understand and optimize the quality of post-disaster psychosocial service delivery. The quality is reflected in the program's structure, process, and outcome. Moreover, quality can be expressed in scores per criterion (i.e. need centeredness, effectiveness, safety, timeliness, efficiency, and equity) that are proposed to be related to the “attitude” (more passive or active) toward affected people. When quality and attitude are combined in a 2-D parabolic model, psychosocial support is preferably found in the middle of the attitude-axis (high quality); extremely passive or active positions are to be avoided (low quality). Well-timed assessments of structure, process, and outcome aspects, and associations between them, will help planners, providers, and evaluators understand if the optimum is reached, as well as provide guidance for quality improvement. (aut. ref.