As our vulnerabilities to terrorist attack become clearer, state and local leaders are assessing their preparedness to cope with terrorism. In every state, city, and town, the readiness of the health care system to cope with an extreme medical emergency will be central to saving lives in the event of terrorism or other public health crisis. State and local officials searching for better ways to prepare for crisis should review the approach former New Democrat Mayor Wellington Webb developed for Denver. Working with Denver Health, a public health care provider with hospitals, clinics, and other medical resources throughout the metropolitan area, the mayor established the Rocky Mountain Center for the Medical Response to Terrorism, Mass Casualties, and Epidemics.
The idea is that the Center will develop and update an effective public health crisis response plan by facilitating the collaboration of regional health care providers. For example, Center collaborators have begun by assessing physicians' and health facilities' expertise so that victims can be directed to the facilities best suited to assist them. The Center and its partners pay special attention to making sure that funding is allocated efficiently and purchases of equipment and other supplies are not needlessly duplicated by the different agencies.
To develop a coordinated communications response aggressively, Center collaborators are going beyond simply convening regular meetings between personnel from the Office of Emergency Management, the Fire and Police Departments, hospitals, and public health departments, although such meetings are also vital. Collaborators are working through incompatibilities in different information technology systems, developing standards, and investing in a common infrastructure. In order to ensure communications at crucial times, the Center is also establishing redundant systems of communicating, e.g., telephone, email, broadcast fax, and radio.
As part of its leadership, Denver Health has created the Rocky Mountain Regional Care Model for Bioterrorism Preparedness (RCMB) using a grant from the Agency for Health Care Research and Quality. The RCMB is a collaboration of federal, state, and local officials from Colorado, Utah, Wyoming, Montana, North Dakota, and South Dakota. By addressing the capability of the health system to react to the needs of the public in the event of a bioterrorism attack, RCMB aims to create a model for bioterrorism preparedness that can be used at the national, state, or local level. The model prioritizes actions to deal with the surge of demand for services in a crisis. Denver Health is also working with federal agencies and local hospitals to develop a real-time electronic hospital bed availability monitoring system for use in time of mass casualty events.
The Rocky Mountain Center for Medical Response also demonstrates excellent ways for public officials to more effectively address the concerns of citizens who are healthy but worried about terrorism. The Center has created a Bioterrorism Advanced Readiness Course that is available online. One of the Center's collaborating partners, the Rocky Mountain Poison Center, publicly distributes information sheets about anthrax and offers health care providers a mini course on terrorism and toxicology. To further public education, residents and area health professionals may also find speakers through the Center to come educate them on various topics. Area residents may also find comfort knowing that the city offers multiple ways of disseminating emergency information, ranging from public phone lines and special websites to dedicated phone lines for physicians.
To ensure ongoing accountability and optimal efficiency, health care providers will test the effectiveness of the plan through simulations and other preparatory exercises. These tests allow the various agencies and health care providers to strengthen their skills, learn from one another, and work through problems before there is a health care crisis.
Policymakers should note that instead of establishing a separate system just to respond to terrorism, Denver health care providers discovered that working within the existing systems to build and expand capacity is the most effective way to develop and implement an emergency response plan. According to American's Trust for Health, states like Virginia, Delaware, and South Carolina are also leading the way in preparing existing institutions to respond effectively. The integration and sharing of new and existing resources of the various collaborators heightens the capabilities of health care providers to deal with everyday health challenges as well. So preparing health care providers to respond to terrorism and other public health crises is worthwhile even if a crisis never occurs.
"Denver Mayor Wellington Webb and City's Health System Announce New Center for Medical Response," U.S. Mayor, November 2001
http://usmayors.org/uscm/us_mayor_newspaper/
documents/11_19_01/webb.asp
Rocky Mountain Regional Care Model for Bioterrorism Preparedness
www.denverhealth.org/bioterror/
Denver Center for Public Health Preparedness
www.dcphp.org
"Ready or Not? Protecting the Public's Health from Disease, Disasters, and Bioterrorism: 2005" Trust for America's Health, December 2005
http://healthyamericans.org/reports/bioterror05/
Tara O'Toole, M.D., "Reforming Public Health for Bioterrorism," Blueprint, January 2002
www.ppionline.org/ppi_ci.cfm?contentid=250032
&kaid=124&subid=160
Robert D. Atkinson, Using Technology to Detect and Prevent Terrorism, Progressive Policy Institute, January, 2002
www.ppionline.org/ppi_ci.cfm?
knlgAreaID=124&subsecID=900018&contentID=250070
John D. Cohen and John A. Hurson, "Modernizing Homeland Security," Blueprint, March 25, 2002
www.ppionline.org/ppi_ci.cfm?contentid=250313
&kaid=124&subid=900019
"Not Waiting for the Feds: Bird Flu Preparation in Seattle" PPI Health Policy Wire, November 3, 2005
http://www.ppionline.org/ppi_ci.cfm?contentid=253611
&knlgAreaID=111&subsecid=900033#item4
"Code Orange from Public Health Officials" PPI Health Policy Wire, March 3, 2005
http://www.ppionline.org/ppi_ci.cfm?contentid=253201
&knlgAreaID=111&subsecid=900033#item1
Sheri Eisert, Ph.D.
Director of Health Services Research
Denver Health
777 Bannock, MC 8701
Denver, CO 80204
Ph. (303) 436-4072
Fax (720) 932-8485
Sheri.Eisert@dhha.org
Stephanie Thomas
Chief Operating Officer
Denver Health
777 Bannock Street
Denver, CO 80204
Ph. (303) 436-6613
David B. Kendall
Senior Fellow for Health Policy
Progressive Policy Institute
4021 Heritage Way
Missoula, MT 59802
(406) 543-2265
(772) 679-0652 (fax)
dkendall@ppionline.org
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