The ideal approach to developing plans for rebounds and restoration initiatives within the healthcare industry—covering prehospital services, hospital treatments, and non-hospital care systems—would focus on a variety of needs in the community, all the way from short-term needs soon after the event to the longer-term goals of a healthier community.

If managed well, these objectives can assist communities in addressing not only the effects of a disaster, but also on-going difficulties involving healthcare services access.

At the beginning of the healing process, a review of remaining capacities and issues in the healthcare system should be completed, with acknowledgement of any current or upcoming modifications in the delivery and financing mechanisms of healthcare for future planning.

When this report was written, thinking about the long-term health run of the community might include taking into account the broader availability of preventive care that the Patient Protection and Affordable Care Act (ACA) offers.

The committee advises local medical systems to keep on or start making advances plans focused on recovery to reinforce the strength of the healthcare industry.

This preparation will help set in motion activities that (1) keep steady, energize, and incorporate existing resources; (2) point out resources that need to be reconstructed or supplanted; and (3) recognize original preventive and healthcare delivery methods that are viable and reasonable and will prompt improved health and public health results in the area.

In order to speed up the revival of health care facilities in the case of a disaster, it is important to review the current health care services and create an accepted, detailed plan for the community’s reaction and restoration before the disaster takes place.

This plan should use data gathered from health care technology and involve opinion and comments from all those invested in establishing and continuing a strong and reliable medical system within the community.

In the course of short- and mid-term recuperation, the health care industry could detect both individual and system issues that happened during the reaction which could be better if another calamity arises.

During the curing process over a long period of time, weaknesses in the patient and the system should be identified and objectives should be determined in order to have a more vigorous society.

Disasters can lead to changes in the delivery of healthcare which may involve moving medical services away from medical centers into the general public and using teamwork to attend to the varied requirements of individuals affected (DeSalvo, 2013).

These changes are beneficial for patients and align with current regulations like those in the Affordable Care Act.

When a community is dealing with the aftermath of a disaster, they should try to find ways to use their disaster experiences, connections they have made and recovery resources to move towards a different system of care.

This chapter offers the committee’s evaluation of crucial healthcare sector tools and activities across the continuum from preparation for a disaster before it occurs to recovery following one. Moreover, it gives advice for boosting and supporting the most effective use of these resources to make healthier communities following disasters.

The chapter addresses four key strategies that drive the success of recovery for the health care sector and ultimately the building of a healthier community:

• Use multidisciplinary team-based care strategies to meet multifaceted health care needs.
• Ensure continuity of access to health care services.
• Use health information technology to drive decision making for individual and community health, and to inform future planning.
• Leverage health care coalitions and other relationships with local care providers for health services strategic decision making and alignment of clinical resources.

Health Care in The Context of a Healthy Community

The integration level of medical services among each other and through public health, behavioral health, and social services has a great effect on the overall wellbeing of a community and the community’s capacity to endure a calamity.

This idea of a comprehensive and unified outlook to health has been included in multiple influential projects that appraise the wellbeing of the nation, including America’s Health Rankings, the Commonwealth Fund’s Scorecard, and the Robert Wood Johnson Foundation’s County Health Rankings (County Health Rankings, 2014; Radley et al., 2014; United Health Foundation, 2013).

It has long been clear that the American healthcare system is inadequate when it comes to providing populations and towns with the highest level of health and resilience. This fact has been established for quite some time (IOM, 2000, 2001, 2013a).

As outlined in Chapter 1, the United States has higher per person spending on health care when compared to other similar countries, yet it’s overall health isn’t as good.

In an effort to address this disparity, the Institute for Healthcare Improvement developed the Triple Aim—better experience of care at lower cost and improved population health—which serves as the foundation for organizations and communities to transition from a focus on health care to a focus on optimizing health for individuals and populations (IHI, 2007). Key strategies for the Triple Aim include

• “Innovative financing approaches;
• New models of primary care, such as patient-centered medical homes” to meet comprehensive needs of individuals (see
   
  Box 6-1
   for characteristics of optimal coordinated care systems);
• “Sanctions for avoidable events, such as hospital readmissions or infections; and
• Integration of information technology”—advancing data and knowledge sharing

As communities make plans to reinforce the stability and sustainability of healthcare services, get ready to quickly act in the event of an emergency, and strive to bounce back from a disaster, the Triple Aim principle and its related concepts give an advantageous and consistent tactical paradigm to focus the actions of the various people with a vested interest in healthcare issues related to disaster planning.

At the same time, the steps from pre-disaster planning to direct- and long-term revival that make up the disaster management cycle allow for the use of fresh resources, making it possible to rearrange health care systems and work towards creating the healthiest communities as possible.

Likewise, as societies interact in the variety of health care initiatives related to disaster preparation, reaction, and recovery, they should capitalize on existing changes in the provision and financing of medical services.

Two relevant and related movements are occurring synergistically. The Institute of Medicine’s 2001 publication, Crossing the Quality Chasm: A New Health System for the 21st Century, put forward ideas concerning client-focused health care, which still direct the collective provision of services toward a system set-up that better satisfies individuals’ needs by boosting collaboration and the consistent connection of health treatments over multiple practice areas and treatment facilities.

Making progress in sharing data and expertise using new healthcare technology and data networks is necessary to make this vision happen.

Population health, according to Kindig and Stoddart (2003, p. 380) is the collective health statuses determined by internal and external factors, as well as the policies and initiatives that lead to these outcomes. This concept has now moved beyond the public health realm into the medical practice setting, due to the increase of value being sought by those who purchase healthcare services.

The idea behind “value” can be understood as the ratio of the results of medical care in relation to the amount of money it costs to provide the care. This concept involves taking into account not only individual patients but also all patients receiving care from a care delivery system.

With payment models moving away from a fee-for-service system to ones based on value, there is now financial support to prioritize prevention activities such as avoiding hospital visits and readmissions.

This contemporary population-based approach to the healthcare system mirrors the familiar population-based focus traditionally associated with population health and is a beneficial way of unifying healthcare delivery with the objective of crafting healthier communities.

It also encourages the formation of working partnerships between different care-providing organizations in the vicinity, which is essential for increasing strength and stability.

The Strategic Planning Process of a Framework

In strategic planning, numbers and a steady, organized method of examining data are utilized to craft objectives, uncover alternatives, and construct criteria for making decisions.

Though the exact words used may not be the same, the overall shape of the process is nearly identical, even when it’s to make a comprehensive plan, a health improvement plan, or a disaster recovery plan.

Once the initial steps have been taken, a vision for the future often becomes the focus and a review of the condition of the community, requirements, resources, and any other external elements (e.g., governmental landscape) is typically performed.

By looking at the results of the two processes, the gaps between where the community currently is and its desired state can be identified. This allows us to then set goals and prioritize based on the community’s vision.

Various tactics are formulated with the help of feedback from contributors (which include the general public) and by examining various alternatives. A plan is created that includes these tactics, and collaborations (or operational systems) are created for implementation.

Finally, the plan is implemented. Figuring out what resources are necessary and utilizing them, tracking progress through pre-set milestones, and measuring progress are all done in an ongoing manner.

Even if it’s not feasible to immediately focus on every important subject area, having a list of priorities makes it so that it’s possible to assess potential opportunities in the future and figure out how to use them to realize the shared goal of the community.

In this way, a recurrent cycle of evaluation, preparation, and application is formed by the execution procedure.

If done properly, the strategic planning process will produce more ways to communicate and develop a collective agreement about what the community needs most in the future.

It is important to form agreement in order to ensure those responsible for making decisions stay focused on the planned aims for the future, instead of reacting to the everyday issues that come up. Gaining support from management is a critical stage to guarantee that the plan is executed.

When discussing how to incorporate health into a disaster recovery planning process, every step of the strategic planning process offers chances for progress. A summary of the information can be found below, and further details are discussed in the subsequent section of this chapter.

It is essential to understand that while this sequence is described in a particular way, the order of steps can actually be changed, and some may even be done at the same time.

For instance, foresighting can be done before, alongside, or after examining something, and due to the fact that this cycle is continual, the following of activities results in a different assessment that is utilized to review the effects of what was done.

• Visioning:
   Recovery is viewed as an opportunity to advance a shared vision of a healthier and more resilient and sustainable community.
• Assessment:
   Community health assessments and hazard vulnerability assessments provide data that show the gaps between the community’s current status and desired state and inform the development of goals, priorities, and strategies.
• Planning:
   Health considerations are incorporated into recovery decision making across all sectors. This integration is facilitated by involving the health sector in integrated planning activities and by ensuring that decision makers are sensitized to the potential health impacts of all recovery decisions.
• Implementation:
   Recovery resources are used in creative and synergistic ways so that the actions of the health sector maximize health outcomes and the actions of other sectors yield co-benefits for health. A learning process is instituted so that the impacts of recovery activities on health and well-being are continuously evaluated and used to inform iterative decision making.