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This essay will narrate a nurse’s ethical dilemma as experienced in a local emergency department. In addition, the paper will discuss the relevant codes of conduct and law and make recommendations based on the nurse’s ethical dilemma.
The subject in this case is a 93-year-old Alzheimer patient who was by then in an extended care facility. As the ailment worsened, she became unable to eat or drink anything, and this was a great threat to her health. It reached that point where the patient would not respond to any touch or voice. The physician in charge of her at this extended care facility had indicated that she would not thrive with that condition. The granddaughter to this ailing patient was the power of attorney. To make matters worse, the elderly patient had no advanced directive. The patient’s family had earlier been directed to send her to the emergency…
Emergency oom Efficiency
Improving Emergency Department Flow by Using a Provider in Triage
Emergency room triage plays an essential role in the speed and quality of the emergency room departments. Triage represents only one small part of the process that determines quality of patient care. Emergency rooms can be crowded. Busy times are often unpredictable, making it difficult to avoid bottlenecks in the system. This has an affect on the amount of time between arrival and when the patient sees a physician. Patients can be in for frustrating long waits while sitting in the hospital lobby.Patients often leave the emergency room waiting areas without being seen because they get tired of waiting. These patients are referred to as left-without-being seen (LWBS). educing LWBS rates is crucial for improving quality of patient care in emergency rooms. Long waits also cause a potential liability for the hospitals, as patients that are critically…
Arkun, A,, Briggs, W., & Patel, S. et al. (2010). Emergency Department Crowding: Factors
Influencing Flow. West J. Emerg Med. 11(1): 10 -- 15. PMCID: PMC2850834
Armstrong, J., Hammond, J, & Hirshberg A, et al. (2008).Is overtriage associated with increased mortality? The evidence says "yes." Disaster Med Public Health Prep. P. D: 18388647. 2(1):4-5;
Bieler, G., Paroz, S., & Faouzi M, et al. (2012). Social and medical vulnerability factors of emergency department frequent users in a universal health insurance system. Acad Emerg Med. 19(1):63-8.
Emergency Departments (EDs) have the highest levels of violence of any hospital units, and according to a 1994 survey, 97% or nurses in these reported verbal violence and 87% physical violence. All EDs have large numbers of uninsured patients, many of them with drug, alcohol of psychiatric problems, which increase the normal stress and anxiety of this environment and make violence far more likely. This problem is compounded by the fact that only 3% of EDs had full-time security on-site, which means that "prevention is the best method to deal with violence in the ED" (Hoag-Apel, 1998, p. 60). All EDs should do a risk assessment that includes the location, design, history and security measures in the facility; the type of in-house security staff, training and weapons, communications with local police and hospital security; nighttime lighting, parking areas, numbers of chemically dependent patients. It should note whether access is monitored…
Hong-Apel, C.M. (1998). "Violence in the Emergency Department." Nursing Management, Vol. 29, No. 7, pp. 60, 63.
ange Nursing Theories
As a profession, nursing presents many challenges. Indeed, it is one of the most stress inducing jobs in the world, not only in terms of the physical toll and long hours, but also because of the emotionally exhausting nature of the work. For this reason, personnel turnover tends to be high and there is a general shortage of nursing personnel at hospitals. Because of the vital nature of the profession to the healthcare field and to humanity in general, many researchers have addressed the problem of high personnel turnover in the nursing profession, as well as factors like leadership, work efficiency and interpersonal relationships.
Of all the work environments within the nursing profession, the Emergency oom is probably the most stressful, which also leads to high personnel turnover. One approach towards a resolution is to find ways of enhancing nursing staff satisfaction. Increased satisfaction at work would…
Hopwood, C.J., Wright, A.G.C., Pincus, A.L. (2013, Jun.) The interpersonal core of personality pathology. Journal of Personality Disorders. 27(3). Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3675800/
Hwang, T.G., Younsuk, L., and Hojung, S. (2011, Jul. 1). Structure-oriented vs. process-oriented approach to enhance efficiency for emergency room operations: what lessons can we learn? Journal of Healthcare Management. 56(4). Retrieved from: http://www.biomedsearch.com/article/Structure-oriented-versus-process-approach/271594394.html
Lin, B.Y-J., Hsu, C-P.C., Juan, C-W., Lin, C-C., Lin, H-J., and Chen, J-H. (2011). The role of leader behaviors in hospital-based emergency departments' unit performance and employee work satisfaction. Social Science & Medicine. 72. Retrieved from: www.elsevier.com/locate/socscimed.
Lipsitz, J.D. And Markowitz, J.C. (2013). Mechanisms of change in interpersonal therapy. Clinical Psychology Review. 33.
ED Boading Plan
Emegency Depatment Ovecowding Due to Boading: Poposed Solution
The poposed solution fo the noted poblem of emegency depatment ovecowding due to the pactice of boading patients in the emegency depatment athe than admitting them to othe aeas of the hospital is elatively simple and staightfowad. In essence, the solution that is most suppoted by cuent eseach is to simply cease the pactice of inpatient boading in the emegency depatment, inceasing thoughput by stabilizing and admitting to othe depatments those patients that cannot be teated on an outpatient basis, and inceasing the numbe of beds and staff available in othe depatments to meet this shift (Gason et al. 2008; Viccellio et al. 2009). This solution has been found to be beneficial to medical staff and patients alike, and simply inceasing the amount of beds and staffing that exists in the emegency depatment does not have a simila effect…
references for Boarding Locations When Hospitals Are at Full Capacity. Annals of Emergency Medicine 51(1): 9-12.
Viccellio, A., Santora, C., Singer, A., Thode, H. & Henry, M. (2009). The Association Between Transfer of Emergency Department Boarders to Inpatient Hallways and Mortality: A 4-Year Experience. Annals of Emergency Medicine 54(4): 487-91.
Walsh, P., Cortez, V. & Bhakta, H. (2008). Patients Would Prefer Ward to Emergency Department Boarding While Awaiting an Inpatient Bed. The Journal of Emergency Medicine 34(2): 221-6.
2010; McCarthy et al. 2009; Zimmerman 2004). These studies have also shown that a reduction in boarding numbers and crowding can eliminate or reduce these problems.
After all of these considerations, the fourth step in osswurm and Larrabee's (1999) model for change is to design the actual changes to practice that should be implemented. In this case, this requires few additional resources other than learning materials for hospital staff to acquaint themselves with new procedures and practices -- there is no equipment necessary, and supplies used by the emergency department should actually decrease pretty much across the board as patients are more quickly sent to other departments of the hospital after stabilization (AEM 2008). The design, then, is one that is purely procedural, and should consist of clear triage and stabilization practices that effectively assess patients and determine the appropriate continuation of their care, whether that be on an outpatient…
Bair, a., Song, W., Chen, Y. & Morris, B. (2010). The Impact of Inpatient Boarding on ED Efficiency: A Discrete-Event Simulation Study. Journal of Medical Systems, 34, 919-929.
Boarding of Admitted and Intensive Care Patients in the Emergency Department. (2008). Annals of Emergency Medicine, 52(2), 188-189.
McCarthy, M., Zeger, S., Ding, R., Levin, S., Desmond, J., Lee, J. & Aronsky, D. (2009). Crowding Delays Treatment and Lengthens Emergency Department Length of Stay, Even Among High-Acuity Patients. Annals of Emergency Medicine, 54(4), 492-503.
Rosswurm, M. & Larrabee, J. (1999). Model for change to evidence-based practice. Journal of Nursing Scholarship, 31(4), 317-322.
For effective fulfillment of duties by health care professionals which will, in turn, give a quality service to patients under their care, there is a need for effective inter-professional communication among personnel in a hospital environment. While the concept of territory exists within a sector, that, however, should not be a barrier to a fluid collaboration among health workers of different backgrounds. There is a need to formulate a working communication strategy to solve the lingering inter-professional problems in hospital environments generally, and particularly, in the emergency department. As important as it is, a look at inter-professional communication in emergency department shows a seemingly unfavorable situation among practitioners involved in this one of the most significant subsectors of health profession (Varjoshani, Hosseini, Khankeh, & Ahmadi, 2014). Among other numerous issues in the department, this paper looks at the problem of boisterous atmosphere in the emergency department, explores the contributing barriers…
Gluyas, H. (2015). Effective communication and teamwork promotes patient safety. Nursing Standard (2014+), 29(49), 50.
Kessler, D., Cheng, A., & Mullan, P. (2014). Debriefing in the Emergency Department. Annals of Emergency Medicine.
Morley, L., & Cashell, A. (2017). Collaboration in Health Care. Continuing Medical Journal of Medical Imaging and Radiation Sciences, 48, 207-216.
Northouse, P. G. (2016). Leadership theory and practice (7 ed.). Thousand Oaks, CA, US: Sage Publications Inc.
Peterson, R. L., Peterson, D. R., Abrams, J. C., Stricker, G., & Ducheny, K. (2015). Training in Clinical Psychology in the United States: Practitioner Model. Wright, James D. International Encyclopedia of the Social & Behavioral Sciences, 517-523.
Varjoshani, N. J., Hosseini, M. A., Khankeh, H. R., & Ahmadi, F. (2014). Tumultous Atmosphere (Physical, Mental), The Main Barrier to Emergency Department Inter-Professional Communication. Global Journal of Health Science, 7, 1916-9744.
What is Situational Leadership? (2014). Retrieved from http://online.stu.edu/articles/education/what-is-situational-leadership.aspx
Workflow chart criticism: "A patient arrives in the ER"
First and foremost, this workflow could benefit from a clearer title. The flow does not merely delineate what happens when a patient is admitted to the ER but rather what transpires when a patient with a suspected cardiac condition is admitted via emergency medical services. As well as a more coherent title, this workflow could benefit from greater description in the different boxes of the flow. While it is true that a workflow chart is designed to be relatively economical in terms of verbiage, this workflow needs greater explanation of acronyms such as 'CP via EMS.' It is unclear what CP refers to at first. Presumably it refers to a suspected cardiac patient but the meaning of the acronym is ambiguous given the title and the fact that CP could refer to a variety of different things.
The next square notes…
HSBC Information Systems
asked write organization,: bank . information system problems useing switched information system. write introduction organization . background organization case HSBC bank, information system problems information system helped solve problems information system helped make business easier.
n information system is a combination of any forms of information technology and activities which are carried out by the people in the organization in order to support the management, operations and decision making process in the organization Sawy & Nanus, 1989.
The term information system frequently refers to any interaction that happens between the processes, people, technology and data in the organization hituv, 1980.
It does not only refer to the technology in use in the organization. It also refers to the processes, technology, and data that are in the organization West, 1994()
HSBC group is one of the largest financial and banking service providers in the whole wide world. The…
Also, the company was experiencing huge issues when they needed to move from one office to another. A simple move meant that the company had to pay for technicians to move each of the company's PCs individually and it also meant that the users of those computers had to lose hours or even days of productivity as a result of this move. This was unacceptable for the company since the company needed to be efficient at all times and they could not afford to lose any time Microsoft, 2007()
HSBC also experienced a huge issue since the company had to use more than one solution for its needs. This was also unacceptable since it brought in huge issues in terms of authenticating users on the different systems as well as keeping each of the systems up and running at all times. It presented a huge challenge for the technicians since they had to manage each system individually Microsoft, 2007()
Also, there were security concerns since using multiple
(Shactman; Altman, 2002)
4. ecommendations for Overcoming these Barriers:
Some of the suggestions for overcoming these barriers are (i) appointment of a General Practitioner -- GP officers to work as a Liaison Officer between the ED and the community so that the communication is streamlined as well as processes of referral and feedback and development of clinical pathways. (ii) Expansion of community off-peak facilities, including the setting up of the capacity for community access to X-rays, Scanning, ultrasound, blood tests and observation beds. (iii) Initiation of a project to deal with frequent attenders to the ED through the development of management plans contributed to by the patient, their GP, the ED as also their specialist (iv) Education of the local community such that are aware as to when and under what situations to access ED care or alternative care in the community. (Ardagh; ichardson, 2004)
Ardagh, Michael; ichardson, Sandra.…
Ardagh, Michael; Richardson, Sandra. (2004) "Emergency department overcrowding- can be
fix it" Journal of the New Zealand Medical Association, vol. 117, no. 1189, pp: 27-31.
Brewster, Linda R; Rudell, Liza; Lesser, Cara S. (2001) "Emergency Room Diversions: A
Symptom of Hospitals under Stress-Increased Demand for ER Services" Center for Studying Health System Change. Issue Brief No. 38. Retrieved May, 2009 from http://www.hschange.com/CONTENT/312/
Emergency, Planning and Operations Methodology
In your opinion what were the main issues expressed by the States
Concerning Homeland Security and states rights at the 2002 State Emergency esponse Commission Conference? Please justify your position.
Most of the states attending the 2002 State Emergency esponse Conference expressed an overall sentiment that in relation to security, things are going to vary from state to state based on the capabilities of the emergency response agencies in each state, as well as the types of hazards that states are likely to face in addition to WMD's i.e. For example, states have to take into consideration whether they have chemical facilities, nuclear facilities and similar hazardous materials to address. State also has to take into consideration whether or not they have highways that are used to transport hazardous or nuclear waste materials.
Colorado made the point that secrecy regarding Homeland Security measures will not…
Analysis for the Homeland Security Act." (2003). Retrieved November 22, 2003, http://www.whitehouse.gov/deptofhomeland/analysis/index.html
Hall, Richard., Adams, Barbara. (1998). Essentials of Firefighting, 4th Edition. Fire Protection Publications: Oklahoma
Homeland Security Act" (2003). Retrieved November 21, 2003, http://www.whitehouse.gov/deptofhomeland/bill/index.html
Homeland Security Act of 2003." Retrieved November 22, 2003, http://www.theorator.com/bills108/hr1389.html
Business Name: MWV located in Covington VA
Number of Employees 190
Emergency management plan entails a system of managing resources, information analysis and decision making in the event of a tornado hitting the facility (Hubbard, 2009). The emergency management plan acts a guide to the responsible personal, the staff and residents within the facility on the steps to take upon the occurrence of a tornado. The emergency plan gives a description of the role that the pre-appointed Emergency Management Group (EMG) is expected to carry out in the event of a tornado. The Emergency Management group will serve as the overall authority over the activities in the facility relating to the occurrence of a tornado.
The emergency management policy is to ensure the safety of every individual within the facility and bring the facility to normal operations after an accident.
The head of the Emergency Management group is…
Hubbard, C. o. (2009). Emergency Response, Windshield Survey; Hubbard, . City of Hubbard Oregon.
Safety, C. f C.P. (2002). American Institute of Chemical Engineers. Guidelines for Technical Planning for On-Site Emergencies. . New York: CCPS-AICHE.
Disasters that can critically compromise the accessibility of knowledge include floods, fires, earthquakes, hurricanes, employee sabotage, computer viruses, and theft. The effects of disasters can lengthen even after the restructure of physical damage. Simply, the earlier a business recovers from a disaster; it will experience lesser wide-ranging continuing effects of the disaster. Not only the thrashing of sales during a disaster is destructive for the company, "the loss of customers, vendors, inventory and employee records extend recovery times from weeks and months to years" (Carlson & Parker, 1998). However, if a company has a premeditated disaster recovery plan (DP), it can reduce the nuisance of a disaster, whereas inappropriate preparations can result in a business experiencing liquidation of its bank accounts (Carlson & Parker, 1998).
In the Information Technology industry, Disaster ecovery (D) security issues occur repeatedly. The critical security measures in the environment are frequently covered by…
Carlson, S.J., & Parker, D. (1998). Disaster Recovery Planning and Accounting Information Systems. Review of Business, 19(2), 10+. Retrieved July 21, 2012, from Questia database: http://www.questia.com/PM.qst?a=o&d=5001370062
Disaster Recovery Security: The Importance of Addressing Data Security Issues in DR Plans. (2011, January). Retrieved July 21, 2012 from http://searchdisasterrecovery.techtarget.com/feature/Disaster-recovery-security-The-importance-of-addressing-data-security-issues-in-DR-plans
O'Sullivan, K. (2010, September 23). Knowledge Continuity: Strategies, Approach & Tools. Retrieved July 21, 2012 from http://star-knowledge.com/websites/star-knowledge/skblog/?p=70
Emergency Terror Response
Roles and Responsibilities of Terror Response Incident Commander
In the event of an emergency incident such as the terrorist attack described in the case scenario, the National Response System (NRS) is immediately invoked. This places a previously designated Incident Commander at the helm of all efforts to control, contain and respond to a terrorist attack. In the present case, as the Incident Commander, it is incumbent upon me to employ the NRS and the resources which it has placed under my control in order to bring order to the chaos of a terror attack.
ith the initiation of the incident, my first priority is to gather together an assembly of delegates and representatives from concerned agencies. This would include personnel from local law enforcement (police, municipal personnel, HAZMAT teams), the Department of Defense (NORAD, NORTHCOM, etc.), Homeland Security and various affiliated and subordinated intelligence agencies as…
Assistant Secretary for Preparedness and Response (ASPR). (2012). Emergency Management and the Incident Command System. Public Health Emergency.
National Commission on Terrorist Attacks Upon the United States (NCTAUUS). (2004). The 9/11 Commission Report. 9-11commission.gov.
Occupational Safety & Health Administration (OSHA). (2011). Incident Commander. United States Department of Labor.
For communities and agencies alike, an emergency plan is the arrangement of dealing with a crisis that contains procedures on how to prevent injuries and fatalities, lessen damages and speed up the resumption of normal operations. It's important for these agencies and the community to have an emergency plan since it helps them to prevent multiple losses of resources and lives. Some of the major components to include in the emergency plan include possible emergencies, emergency preparedness procedures, lists of personnel and maps with evacuation routes ("Emergency Planning," 2005). This is because these elements provide the agency's staffs or the community with instructions of the possible emergencies and how to tackle them, their emergency duties and evacuation routes to enable them to handle the emergency effectively. To ensure that the agency or community is aware of the provisions in the emergency plan, community or agency awareness and education…
"Emergency Dispatch Service." (n.d.). Specialty Answering Service. Retrieved June 15, 2011,
"Emergency Planning." (2005, May 25). Canadian Centre for Occupational Health and Safety.
Retrieved June 15, 2011, from http://www.ccohs.ca/oshanswers/hsprograms/planning.html
The management of large organizations is a very crucial issue, whether they are government-related or not (Argyris, 1993; Argyris & Schon, 1978; Broom, Jackson, Harris, & Vogelsang-Coombs, n.d.; Brown & Brudney, 2003; Hatry, 1999; Haynes, 1999). Often, however, the government does not seem to realize that it must manage itself in the same way that a business would in certain aspects if it is to succeed and therefore it does not market itself to the public.
The spending that has been involved with the Department of Homeland Security is also crucial, because it has changed over time to reflect the needs and the realization of what it takes to make the Department work (Eggen & Mintz, 2003). This spending is important to discuss, because it indicates how much of the government's money - and by extension how much of the tax dollars of Americans - is going toward funding this…
Argyris, C., (1993). Knowledge for action: A guide to overcoming barriers to organizational change. San Francisco: Jossey-Bass.
Argyris, C. & Schon, D.A. (1978). Organizational learning, a theory of action perspective. Boston, MA: Addison-Wesley.
Broom, C., Jackson, M., Harris, J., & Vogelsang-Coombs, V. (n.d.). Performance measurement: Concepts and techniques (3rd ed.), workbook. Washington, DC: American Society for Public administration.
Brown, M.M., & Brudney, J.L. (2003). Learning organizations in the public sector? A study of police agencies employing information and technology to advance knowledge. Public Administration Review. 63(1), 30-43.
The exercises and training divisions work with similar divisions in Delaware, Pennsylvania, and Virginia, a Continuity of Operations department designed to work with the federal Department of Homeland Security, and an Office of Domestic Preparedness and Law Enforcement Liaison work with local and federal authorities to coordinate comprehensive disaster planning efforts. (Maryland Emergency Management Homepage, 2006, Official Website)
Different organizations that are involved, how the organizations interact with or are apart of the EOC/What is the responsibilities of each member to the EOC
The federal government, including FEMA (Federal Emergency Management Authority), the Department of Homeland Security, and the state Emergency Management offices of Delaware, Virginia, and Pennsylvania are all involved, as is the National Guard. These organizations do not have specifically delineated legal responsibilities to the state of Maryland's EOC, other than to serve the citizens of the U.S. In the case of the federal government. (Maryland Emergency Management…
Droneburg, John. (2006) "Letter from the Director: John Droneburg III." Maryland
Emergency Management. Retrieved 3 Nov 2006 at http://www.mema.state.md.us/MEMA/content_page.jsp?TOPICID=domprepare#
Florida State Warning Point." (2006). Florida Division of Emergency Management. Retrieved 3 Nov 2006 at http://www.floridadisaster.org/bpr/Response/Operations/swp.htm
Maryland Emergency Management Homepage. (2006) Official Website. Retrieved 3 Nov 2006 at http://www.mema.state.md.us/MEMA/index.jsp
Regarding Border ecurity, "the Department of Homeland ecurity prevents and investigates illegal movements across our borders, including the smuggling of people, drugs, cash, and weapons" (DH.gov. Border ecurity. 2012. PP. 1). Customs, Coast Guard, and Immigration (IN) are working departments in this area.
Preparedness, Response, Recovery refers to "providing a coordinated, comprehensive federal response and mounting a swift and effective recovery effort" (DH.gov. Preparedness. Response. Recovery. 2012. PP. 1). FEMA is the direct provider of government action and coordination in this realm.
On Immigration, "the Department is responsible for providing immigration-related services and benefits such as naturalization and work authorization" (DH.gov. Immigration. 2012. PP. 1). IN is the primary vehicle in this context however, cross-over with Border ecurity functions are common.
Lastly, DH engages in cyber security "keeping our federal civilian networks secure, and secure the cyberspace and critical infrastructure on which we all depend" (DH.gov. Cyber ecurity. 2012. PP.…
Succinctly, no! The encompassing mission of the DHS is so broad as to incorporate far too many active departments, agencies directorates, and components for the structure to effectively work. The flow chart itself is complex in its reporting and layered approach. The unification which is necessary to protect the U.S. from threats is not possible under the auspices of a broad tent approach to control and information dissemination. As an example, a recent report indicated "86 reported attacks on computer systems in the U.S. that control infrastructure, factories, and databases between October 2011 and February 2012" (Schmidt, M. March 13, 2012. PP. 1); yet no one Federal agency "has the authority to compel businesses that run the nation's infrastructure to improve their security" (Schmidt, M. March 13, 2012. PP. 1). If the DHS were to assume control of this task, the assumption would be that economies of scale in resources and scope would allow for greater efficacy. The counter is that the nimbleness and coordination necessary to prevent such hacking is anathema under a monolithic structure. Decentralization would be a more logical method of countering the multiple risks to homeland security.
2. Are there any federal, state, and/or local agencies present in DHS that do not belong? If so, explain why / if not, explain why. Be detailed.
The best example, and most obvious is FEMA, the
Emergency, Planning and Operations Methodology
The Department of Homeland Security is fully aware of the importance of local and state first responders. Currently managed under the Department of Justice, the Department of Health and Human Services, and the Federal Emergency Management Agency and other various offices, local firefighters, state and local law enforcement, and local emergency medical personnel would be subject to the Department of Homeland Security's authority (http://www.whitehouse.gov/deptofhomeland/sect4.html).Moreover, the Department is prepared to "develop and manage a national training and evaluation system to design curriculums, set standards, evaluate, and reward performance in local, state, and federal training efforts" (http://www.whitehouse.gov/deptofhomeland/sect4.html).Through FEMA, emergency supplies, food and shelter would be allocated to supplement the work of local agencies that are already providing such needs at the community level (http://www.fema.gov).Moreover, FEMA would coordinate "private industry, the insurance sector, mortgage lenders, the real estate industry, homebuilding associations, citizens, and others" in high-risk areas (http://www.whitehouse.gov/deptofhomeland/sect4.html).…
American Red Cross." http://www.redcross.org/services/disaster/0,1082,0_319_,00.html accessed 11-17-2003).
The Department of Homeland Security." http://www.whitehouse.gov/deptofhomeland/sect4.html .
A accessed 11-17-2003).
Emergency Food and Shelter." Federal Emergency Management Agency. http://www.fema.gov .(accessed 11-17-2003).
Second, Iowa City had quick connections with State level disaster response crews that allowed for quick clean-up and rebuilding. They also coordinated with outside communities to provide shelter and other basic needs through local Red Cross organizations.
On the other hand the small, rural community of Holy Cross, also hit by a severe storm, was not as well prepared to respond. The main reason for this lack of efficient response was because of a lack of a centralized network. Due to the small size of the city, there is no permanent emergency relief plan. The community's response was reactionary and thus took longer and was very unorganized. Much of the response came from the State.
Stehr, Steven D. (2002): "Community Recover and Reconstruction Following Disasters," Handbook of Crisis and Emergency Management. New York: Marcel Dekker, Inc.
Stehr, Steven D. (2002): "Community Recover and Reconstruction Following Disasters," Handbook of Crisis and Emergency Management. New York: Marcel Dekker, Inc.
..and it is unlikely that the military will attempt to take over the executive branch by a coup." (2007) the media is not informing the citizens of what is occurring in many cases and a recent attempt to make a citizens arrest by over 8,000 individuals in Washington of President ush relating to war crimes resulted in many of those individuals being tasered and arrested.
SUMMARY and CONCLUSION
The future of the United States, according to what is known of the history of Rome, the predecessor upon which the U.S. originally based the form of its democratic government, appears to be bleak indeed. However, there is hope that the next presidential election will progress in a democratic manner and that the newly elected president will have the stamina and integrity required to see the United States return to the democracy upon which it was based and with the least pain…
Smitha, Frank E. (1998) From Republic to Emperor Augustus:. MacroHistory Online available at http://www.fsmitha.com/h1/ch18.htm
Urbinati, Nadia (2002) the Criticism of Intellectual Critics. Online available at http://logosonline.home.igc.org/urbinati.htm
Johnson, Chalmers (2007) Republic or Empire: A National Intelligence Estimate on the United States. Harper's Magazine. Jan 2007. Online available at http://www.harpers.org/archive/2007/01/0081346
Tomgram: Chalmers Johnson on the Fall of the Republic (2003) TomDispatch.com 9 Sept. 2003. Online available at http://www.tomdispatch.com/post/938/chalmers_johnson_on_the_fall_of_the_republic/
These insights are equally applicable to forecasting how global events will potentially impact the United States and its trading partners. The same techniques used for anticipating terrorism threats can use used for anticipating conditions of genocide and political upheaval, even in countries that appear to be economically and politically stable (Goldsmith, utcher, Semenovich, Sowmy (2012), et.al.). The DHS has also had to architect it systems that overcome bureaucratic inertia and protecting bureaucracy instead of flattening it (Larson (2004), pp. 29). Having had to streamline not just their own structure but the integration points with many other departments and divisions also shows how unique their cross-functional structure is (Mitchell (2003), p. 18). Using the lessons learned of organizational structure efficiencies and dynamics of cross-functional performance in more expanded areas could solve the impasse on budgeting within the broader U.S. government as well. There is also the potential to combine…
Goldsmith, Benjamin E., Charles Robert Butcher, Dimitri Semenovich, and Arcot Sowmya. Forecasting the Onset of Genocide and Politicide: Annual Out-of-Sample Forecasts on a Global Dataset, 1988-2003. Rochester, Rochester: 2012.
Hewitt, Ronald T. "Valuing it Human Capital." It Professional Magazine 14, no. 1 (2012): 58-60.
Larson, Richard C. "Emergency Response: Operations Research Models for Homeland Security." or-MS Today 31, no. 5 (2004): 22-9.
Mitchell, Kenneth. "The Other Homeland Security Threat: Bureaucratic Haggling." Public Manager 32, no. 1 (2003): 15-18.
Emergency response is critical component to a natural disaster. In some instances, natural disasters are unexpected in regards to both their duration and destructive capabilities. In other instances, natural disasters can be seen ahead of time, while the damage can still be unknown, as is the case for hurricanes. In either circumstance, a proper response can mitigate hardships within a particular community. The proper response is often a coordinated and integrated approach to remedying a situation. Florida is a state that is particularly prone to natural disasters and in particular hurricanes. In recent occurrences, it was not the actual hurricane that caused so much destruction, but instead the residual effects. For example, flooding, power outages, and debris often cause more damage than the actual hurricane did. It is for these reasons that a robust emergency support system is needed.
In regards to the emergency support system of Florida, it appears…
1) Doss, Daniel; Glover, William; Goza, Rebecca; Wigginton, Michael (2015). The Foundations of Communication in Criminal Justice Systems (1 ed.). Boca Raton, Florida: CRC Press. p. 301.
2) McElreath, David; Doss, Daniel; Jensen, Carl; Wigginton, Michael; Nations, Robert; Van Slyke, Jeffrey; Nations, Julie (2014). Foundations of Emergency Management (1st ed.). Dubuque, IA: Kendall-Hunt Publishing Company. p. 25.
Emergency personnel occupying the fire and emergency services make day-to-day decisions and their behavior contributes to the constant evolving of public perceptions. The negative perception of the public due to their scrutiny of fire and emergency operations, budgets, and behavior has slowly tarnished the image of these departments. Therefore, measures should be undertaken in saving the image of the fire and emergency services field through talking openly, reflecting on honesty, working collaboratively, taking responsibility for upcoming issues and acting professionally. The following study looks at the perceptions of the public concerning the Fire Department and the factors influencing their opinions. In addition, the paper looks at what they do in an attempt to either increase or decrease the perceptions of their communities. Furthermore, it identifies the Fire Department’s activities aimed at establishing positive perceptions from community members.
Fire Departments continue to be under scrutiny, and they continue to…
Wait Time in the Emergency Center Can Be Decreased
How Could the Wait Time in the Emergency Center be Decreased?
This paper discusses how long wait times and overcrowding can be reduced in emergency centers as a way of improving healthcare quality for all patients.
Physicians working in emergency departments are dedicated to offering high quality emergency care, as fast as possible, to all the patients brought into the emergency center. However, long wait times and crowding hamper patient safety. The ever increasing emergency patient numbers, coupled with critical shortages in the entire system of emergency medical care, play a role in limiting patients' access to emergency care on a timely manner. Patients with the need to see physicians in 1 to 15 minutes get attended to in 37 minutes, a figure twice the expected timeframe. The long wait times and crowding in emergency departments have been attributed to patients…
Brimhall, J. (2012). SQL server 2012 T-SQL recipes: A problem-solution approach. New York: Apress.
Chan, P. L.-K. (2010). Predictive Modeling of Emergency Department Wait Times for Abdominal Pain Patients.
Hernandez, M. J. (2013). Database design for mere mortals: A hands-on guide to relational database design.
Kindt, E. J. (2013). Privacy and data protection issues of biometric applications: A comparative legal analysis.
Our study is however geared towards the assessment of applicability of the universal triage system in emergency clinical work. The current triage systems are somehow one-sized-fits it all in their design (Veenema,2007).He points out that the main problem with the existing triage methodologies is the fact that they are not tailored for all situations such as weapons victims but are just normal pediatric scenarios. This therefore means that some of the components of the various triage systems are most likely to fail under certain circumstances as a result of the disparity in the physiological baselines used in coining the various triage systems.Veenema then ponders if the solution tom these dilemmas are held in the coining and adoption of a universal triage system.
The research questions that are to be used as the basis of forming hypothesis for the research they are:
Hypothesis 1: Does the use a universal triage…
Australasian College for Emergency Medicine.( 1993a) Triage (policy document).
Australasian College for Emergency Medicine (1993b)). A National Triage Scale for Australian Emergency Departments (position paper).
Canadian Association of Emergency Physicians. (1999) Canadian Emergency Department Triage and Acuity Scale. Journal of the Canadian Association of Emergency Physicians, 1, 1-24
George, J.E. (1995) Triage protocols. Journal of Emergency Nursing, 21, 65-66
Hospital Emergency Plan
According to a study, about 99% of hospitals have plans to cope with disaster, and 95% of them even had committees for that purpose. There were reports from 90% or more of the hospitals which showed that they were in collaboration with emergency treatment services (96%), emergency agencies for management (94%), agencies for law enforcement (95%), fire sectors (95%), along with health sectors (92%). 96% of the respondents sated that there were plans to cope with disaster throughout the hospital, and that they were accessible easily (Higgins et al., 2004, p. 328). Meridian Health has made it its responsibility to better the welfare and health of New Jersey residents. They do this by giving the best quality health services in the community, homes and hospitals, which put their focus on patients, and also by conducting clinical research and education for the enhancement of medicine (Meridian Health, 2016).…
GOI-UNDP. (2002-2008). Guidelines for Hospital Emergency Preparedness Planning. Government of India --United Nations Development Programme. Retrieved 22 July 2016 from http://asdma.gov.in/pdf/publication/undp/guidelines_hospital_emergency.pdf
Higgins, W., Wainright III, C., Lu, N. & Carrico, R. (Oct. 2004). Assessing Hospital Preparedness Using an Instrument Based on the Mass Casualty Disaster Plan Checklist: Results of a State-wide Survey. Department of Public Health, 32(6), 327-332. doi: 10.1016/j.ajic.2004.03.006
Meridian Health. (2016). Meridian Health: New Jersey's Leader in Integrated Care.Retrieved 22 July 2016 from https://www.meridianhealth.com/about-meridian/index.aspx
Merrill, M. (Jun 2011). Top 5 Security Threats in Healthcare. Healthcare IT News.Retrieved 22 July 2016 from http://www.healthcareitnews.com/news/top-5-security-threats-healthcare
Mass Casuality Decontamination
Mass Causality Decontamination
Throughout the past era, worries about possible terrorist acts concerning weapons of mass destruction (WMD) directed Congress and the President to obtain a complete counteract terrorism strategy that was aimed at stopping a chemical, biological, or nuclear attack and improving domestic attentiveness. The organization of choice for national significance management has been the Department of Defense. Of the $1.2 billion taken in the FY 2000 business plan purposely for WMD reply, most of it went to DOW Overreliance on the military for domestic (Wynd, C. 2006) WMD defense, nevertheless, may reduce the military's war combating capacity and holds the potential for breach of individual rights. Given that these attacks are confronting to avoid and may take place anywhere and at any time, mass decontamination is one of the significant factors to controlling the distresses of such an occurrence, saving lives, and limiting the number…
10th european congress of trauma and emergency surgery. (2010). European Journal of Trauma and Emergency Surgery, 35, 1-1-188. doi:10.1007/s00068-009-8001-z
Cabrera, Suzanne Lobaton, R.N., M.N., & Beaton, Randal D, PhD., E.M.T. (2009). The role of occupational health nurses in terrorist attacks employing radiological dispersal devices. AAOHN Journal, 57(3), 112-112-9; quiz 120-1.
DA-az, G. (2005). Different approaches to the difficult relationship between intelligence and policy: A case study of the cuban missile crisis of 1962 vs. The 2003 war in iraq. UNISCI Discussion Papers, (9), 93-93-126.
Disaster Response: Principles of Preparation and Coordination. (1989). St. Louis: Center of Excellence and Disaster Management.
Affordable Care Act and EMS
The affordable care act is a medical insurance program that came into existence during the Obama regime. This came as a subsequent addition to the Medicaid and Medicare programs as fronted in the year 1965. The motive behind the creation of this scheme was to improve the affordability and accessibility of medical care to all the American citizens. Just like America, every society around the globe is made up of the less privileged and the rich. Therefore, the country's leadership opted to have this kind of insurance scheme so that everyone, regardless of the economic status can access cheap medical attention and in a convenient way. This forms the basis of the Affordable care act. This program offers many opportunities in the future for the Emergency Medical Services (EMS) organization. In this case, there are chances for the people to benefit from the same.
Catalano, J.T. (2015). Nursing Now! Today's Issues, Tomorrow's Trends. New York: F.A. Davis
Cone, D. et al., (2014). Emergency Medical Services: Clinical Practice and Systems Oversight, 2 Volume Set. New York: John Wiley & Sons
Copeland, C.W. & Carey (au), M.V. (2011). Upcoming Rules Pursuant to the Patient Protection and Affordable Care Act (PPACA). New York: DIANE Publishing
Faguet, G. (2012). The Affordable Care Act: A missed opportunity, a better way forward. New York: Paperbag.
If the country is safe, then that is all that matters to the department. If any group was to be considered as a form of competition, drug traffickers and terrorists may be the closes groups to fall into that category.
In the economic arena, the Department of Homeland Security does not have the best standings. There were 30 reportable internal control weaknesses in the department, 18 of which were considered material weaknesses. The four inherited component agencies did not even conform with the Federal Financial Management Improvement Act. It has been recommended that the Department of Homeland Security improves its financial management. It is important to keep in mind that making a profit is not the goal of this department, though it is also important that the department follows the financial improvement laws (http://www.gao.gov/products/GAO-04-774).
I can bring dedication to this position. My strong sense of patriotism is what drives me…
United States. Department of Homeland Security. .
United States. USA Jobs. 22 Apr. 2010. 12 May. 2010.
he other major component of the Department of Homeland Security that doesn't belong is FEMA, the Federal Emergency Management Agency. his is the only component of the Department that is not involved in preventing security threats that human in nature; its main purpose is to aid citizens and local governments in times of natural disaster. Again, communication with the Department would be necessary, but involving the response agency's involvement in a department whose main goal is detection and prevention of criminally threatening or destructive acts against the nation seems a very inefficient way to handle emergency situations.
here are also several agencies not represented in the Department of Homeland Security whose role in the protection of our nation and its citizens has long been a vital part of the United States' defense system. Most notable among the missing are the Federal Bureau of Investigation, Central Intelligence Agency, and the National…
There are also several agencies not represented in the Department of Homeland Security whose role in the protection of our nation and its citizens has long been a vital part of the United States' defense system. Most notable among the missing are the Federal Bureau of Investigation, Central Intelligence Agency, and the National Security Agency. The functions of these three independent government are often nebulously defined and seem to be rather redundant. All are involved in the detection and prevention of acts against the United States; though the FBI tends to be more involved in home-soil affairs and the CIA and NSA are known -- at least in the popular folklore -- for their infiltration of foreign governments and other international activities, they ostensibly share the same collective goals of keeping the people of the United States safe, which is also the primary function of the Department of Homeland Security. Again, the creation of this Department was to in large part to create a consolidation of the information and powers that could be effectively used in the protection of our national security. The exclusion of these organizations from under the umbrella of the Department can only have been politically motivated, and makes no practical sense.
In it's brief history spanning slightly less than seven years, the Department of Homeland Security has undergone several massive reorganizations. It's first proposal by President Bush in 2002 was a stated attempt to consolidate the patchwork of office concerned wit national security into one centralized and coordinated department, and the 2003 organization structure did much to accomplish that, with approximately nine offices and three directorates -- Border and Transportation Security, Emergency Preparedness and Response, and Information Analysis and Infrastructure Protection. This set-up seems far more streamlined and efficient tan the current system, which was set up in 2005, though many of the redundancies and inefficiencies that exist today were problems then, too. The 2005 reorganization was a further attempt at centralization, but meant to accomplish this through the creation of new offices such as the Office of Intelligence and Analysis and the Office of Operations Coordination. A more effective way to streamline the Department would have been to consolidate current offices under more direct leadership, rather than the creation of new ones.
The current structure of the Department of Homeland Security is not as well equipped to handle issues of national security as its older incarnations. The increased division and redundancies of the component offices and agencies makes the operation of this Department far less efficient. Specifically, the various offices meant to handle information gathering and sharing, and those devoted to day-to-day operations of law enforcement personnel in multiple agencies, ought to be consolidated into single office to maximize synthesis of information and action. The ever-increasing number of components at each tier of the Department's organization increases the inefficiency of the Department, which could lead to an unawareness of vital information or a hindrance of necessary action.
In February of 2006 changes to the structure of FEMA were proposed. According to an article found in the Washington Post, the proposed changes would create a fulltime response force of 1,500 and expanding 10 regional offices (Hsu). The changes to the Agency bring into question whether or not the agency should remain a response agency with a small workforce that has the primary responsibility of processing disaster claims and providing assistance in times of emergency or should FEMA be expanded to an agency that has the capacity to take charge whenever it is required.
According to the article the proposed changes which also include improving vendor databases, adding reconnaissance teams, and strengthening claims management are only the beginning of what needs to be changed to ensure that the agency operates more efficiently (Hsu). The article also asserts that a cultural change must occur as it relates to the way…
Brown, Sharon P., Sandra L. Mason, and Richard B. Tiller. "The Effect of Hurricane Katrina on Employment and Unemployment: After BLS and Its State Partners Made Critical Modifications to Estimation Procedures, Local Area Data Show That Hurricane Katrina Depressed Employment Levels Sharply in Louisiana and Mississippi;" the Initial Effect on Unemployment, Though Also Strong, Was Temporary." Monthly Labor Review 129.8 (2006): 52+.
Clayton, Richard L., and James R. Spletzer. "Worker Mobility before and after Hurricane Katrina: A Substantial Number of Workers Were Displaced from the New Orleans Metropolitan Statistical Area after Hurricane Katrina; Those Who Quickly Found Jobs in Texas Experienced a Substantial Decline in Their Short-Term Earnings." Monthly Labor Review 129.8 (2006): 11+.
Hsu Spencer S. Experts Question Proposed FEMA Changes
Washington Post. Wednesday, February 15, 2006; Page A04
Planning for a larger center in the future eliminates the need to build an entire new center if it is someday required. The director should also do a risk analysis of the type of threats that face the community, and the facility. Another writer notes, "The Federal Emergency Management Agency has developed guidelines to assist a community in a risk assessment process" (Vaughn, 2008, p. 26). While hurricanes are the main concern, there can also be other treats, such as safety, security, staff health, and the overall operation of the facility.
The easiest way to organize the center is to follow the National Incident Management System (NIMS). It contains an incident command structure that is a common method of organizing the center. Commanders within the structure all have different areas of responsibility, including communications, damage assessment, available resources, and other key responsibilities (Editors, 2010, p. 8). Overseeing the activity…
Editors. (2010). Emergency operations center planning and design. Retrieved 12 Nov. 2010 from the Department of Defense Web site: http://www.wbdg.org/ccb/DOD/UFC/ufc_4_141_04.pdf .
Vaughn, M.R. (2008). Evaluating the need for a local emergency operations center. Retrieved 12 Nov. 2010 from the U.S. Fire Administration Web site:
Their casualties go uncounted, their actions largely unmonitored and their crimes unpunished." Scahill relates that four years into the Iraq occupation "there is no effective system of oversight or accountability governing contractors and their operations, not is there any effective law - military or civilian being applied to their activities." (2007) According to Scahill's report: "Since the launch of the "global war on terror," the administration has systematically funneled billions of dollars in public money to corporations like lackwater USA, DynCorp, Triple Canopy, Erinys and ArmorGroup. They have in turn used their lucrative government pay-outs to build up the infrastructure and reach of private armies so powerful that they rival or outgun some nation's militaries." (2007)
III. The EFFECTIVENESS of DHS
The work of Ahlers (2007) entitled: "Auditor's: Homeland Security Gets Mixed Grades" reports that congressional auditors gave "mixed grades to the Department of Homeland Security on its efforts to…
Labott, Elise (2004) U.S.: Probe into Iraq Trafficking Claims. CorpWatch 5 May 2004. Online available at http://www.corpwatch.org/article.php?id=14174
Miller, Steven E. (2003) After the 9/11 Disaster: Washington's Struggle to Improve Homeland Security." Axess Stockholm, Sweden 2 (2003 Mar): 8-11. Online available at http://belfercenter.ksg.harvard.edu/publication/254/after_the_911_disaster.html
Phinney, David (2006) AU.S. Fortress Rises in Baghdad: Asian Workers Trafficked to Build World's Largest Embassy. 17 Oct 2006. CorpWatch. Online available at http://www.corpwatch.org/article.php?id=14173
Scahill, Jeremy (2007) the Mercenary Revolution: Flush with Profits from the Iraq War, Military Contractors See a World of Business Opportunities. The Indypendent 15 Aug 2007. Online available at http://www.indypendent.org/2007/08/10/the-mercenary-revolution-flush-with-profits-from-the-iraq-war-military-contractors-see-a-world-of-business-opportunities/
training in the field of emergency management is particularly complicated. The reason for the complication is the astonishingly broad latitude of situations for which emergency services and personnel might ultimately be required. Now obviously there are certain limitations that are based on simple geography: emergency management personnel in California may be called upon to deal with mudslides or earthquakes, and emergency management personnel in Kansas will be summoned for tornados. But a large-scale terrorist incident could conceivably occur anywhere that is populated. Meanwhile certain types of disaster almost perfectly defy any attempt at preparation altogether -- the example of the 2004 Indian Ocean tsunami, which killed over two hundred thousand people, is particularly pertinent, because there existed no detection system for such an event. Tsunamis are rare events, but common enough in the Pacific Ocean that a detection system existed there -- but they are so rare in the Indian…
Canton, L.G. (2006). Emergency management: Concepts and strategies for effective programs. New York: Wiley.
Haddow, G.D., Bullock, J.A., Coppola, C.P. (2013). Introduction to emergency management. Fifth edition. New York: Butterworth-Heinemann.
Perry, RW, Lindell, MK. (2006) Emergency planning. New York: Wiley.
Crisis management refers to the process of comprehensive risk assessment and strategic planning. A Community Emergency Response Team (CERT) provides proactive strategies for mitigating risk and managing crises through effective mobilization of human, financial, and technological resources, coordination of different support agencies and allies, and the implementation of recovery and response missions. There is no one central crisis management protocol, for each organization or community will have its own specific risks and resources (“Crisis Management and Emergency Response Plans,” n.d.). The CERT team works within the parameters of its community contingencies.
Emergency management refers to specific plans for responding to specific emergencies. While not all emergencies can be fully planned for, and unexpected situations will arise, CERT teams are trained and equipped to provide emergency management services for preventing fatalities, minimizing injuries, reducing loss and damage to property, reducing the environmental hazards resulting from an emergency, and…
Emergency Medical Services System Act of 1973 helped to establish national standards for emergency medical systems, with broad implications for education and public health. The Act follows a series of seminal events that drew attention to weaknesses in emergency response, including the lack of proper, regulated, or consistent training for personnel. Moreover, the Act helped to ensure that healthcare infrastructure would be modernized to minimize instances and costs related to accidental injury and death. The Act includes provisions for training in emergency medical services, offering funding and support for training programs that conform to a set of federal standards. Interestingly, Nixon had initially vetoed the Emergency Medical Services System Act, and it was subsequently reworded to omit mandate for a Public Health Service Hospital system -- something Nixon believed was "unnecessary," (Shah, 2006, p. 1). Passing the EMS Systems Act of 1973 meant that the Department of Health, Education, and…
EMS Systems Act of 1973. Public Law 93-154
Shah, M.N. (2006). The formation of the Emergency Medical Services System. American Journal of Public Health 96(3): 414-423.
Role of National Strategies in Emergency Operations Plan
Emergency and disaster planning is a process that entails development of a cooperative, coordinated process of dealing with urgent situations using available resources. Generally, this process is exploratory in nature and culminates in development of a plan that offers general procedures for management of unforeseen impacts. According to Alexander (2015), emergency planning basically entails preparing systematically for probable contingencies in the future such as major disasters and incidents. When creating emergency operation plans (EOPs), national strategies like the National Response Framework (NRF) and National Incident Management System (NIMS) should be taken into consideration. These national strategies provide guidance and a framework for creation of emergency operations plan. This paper reviews the NRF, NIMS and NECP in terms of their most useful elements for the county’s emergency management plan.
Brief Review of the NRF, NIMS and NECP
The National Response Framework (NRF) is…
Finally, consideration of the Intel-based server function is relevant for support of the Microsoft Exchange email environment. In all cases, the Company holds licensure but is not the manufacturer of the solutions to the products used in the HR Department recovery strategy. Only it engineering staff with assistance from those product suppliers will offer full provision to risk management and immediacy during the recovery.
Recovery time objectives (RTO) and Recovery Point Objectives (RPO) to the CLIENT's Human Resource network in Lincoln are targeted as > 24 hours to point of completion. To this end, in terms of cost, the CLIENT's highest cost to risk factor is where Electronic Vaulting listed as #4 might be determined as priority during the course of initial assessment of a disaster at the site. The Lincoln location is a Warm Site #3 to Cold Site #2 in reference to the reported Survey data. It is…
S. Customs and the Animal and Plant Health Inspection Services were combined to form U.S. Customs and Border Protection. Overall, DHS incorporates 22 government agencies. The major agencies of DHS are the TSA, Customs and Border Protection, Citizenship and Immigration Services, ICE, FEMA, the U.S. Secret Service, and the U.S. Coast Guard (Borja).
The Drug Enforcement Administration (DEA) was formed on July 1, 1973 and is headquartered in Arlington, VA. Former drug enforcement related agencies are the Bureau of Narcotics and Dangerous Drugs and the Office of Drug Abuse Law Enforcement. The parent agency of the DEA is the U.S. Department of Justice. The DEA is the lead agency for domestic enforcement under the Controlled Substances Act. The DEA's primary goal is to combat drug smuggling and use within the U.S. The DEA shares jurisdiction with the FBI and ICE and shares communications systems with the Department of Defense. DEA…
Borja, Elizabeth. "Brief Documentary History of the Department of Homeland Security
2001-2008." Department of Homeland Security History Office. 2008. Print.
"DEA History." Drug Enforcement Adminstration. 3 February 2011. Web.
Quality Improvements in Emergency Services
Consumers in the form of patients and other stakeholders are increasingly demanding for proof that the care being delivered or rendered to them is of high quality. In general, the public is cognizant of, demand quality from the medical sector or industry, and anticipates action and improvements to be undertaken when quality is not existent. There are very clear expectations and anticipations for improved health, improved efficiency and in overall improved quality. It is important for an Emergency Medical Services agency or organization to have programs and agendas in place that not only analyze, evaluate and assess the manner in which the organization and its employees are operating. The purpose of this paper is to analyze the aspect of quality improvement in Emergency Medical Services. The paper will take a look into the background of quality improvement and advancement in the emergency medical services sector.…
Angelini, K., Klein, S. (1989). The QA guarantee. Emergency, 20-23.
Bingaman, D. (1994). Continuous quality improvement in emergency service: what and why. Dallas: American College of Emergency Physicians.
El Sayed, M. J. (2011). Measuring quality in emergency medical services: a review of clinical performance indicators. Emergency medicine international.
Estepp, M., Crabtree, S. (1988). Quality assurance in EMS. Fire Command, 20-23.
Federal disaster recovery assistance has long been taken for granted in the United States, embedded in federal laws such as the Stafford Act and the Flood Insurance Act. Federal disaster recovery efforts have been further supported by key organizations including those directly involved in crisis scenarios, such as FEMA. Moreover, a number of ancillary national organizations directly or indirectly provide disaster relief assistance, including the United States Department of Transportation, and most notably the U.S. Department of Housing and Urban Development, which offers Community Development Block Grants for Disaster ecovery (Schwab, 2014). If the federal government should one day determine that its role no longer supported disaster relief services, then a number of regional, state, and local organizations would step up to fill the void in resources and management. Some of those organizations would be from the private sector and others from the public sector. In fact, a situation in…
Anderson, M.B. & Woodrow, P.J. (1998). Rising from the Ashes. Boulder, CO: Lynne Reinner.
Partnership for Disaster Resilience (2007). Post-Disaster recovery planning forum: How-to guide. Retrieved online: http://www.crew.org/sites/default/files/Post-Disaster-Recovery-Planning-Forum_UO-CSC.pdf
Rodriguez, H., Quarantelli, E.L., et al. (2007). Handbook of Disaster Research. Handbooks of Sociology and Social Research. New York: Springer Science
Schwab, J.C. (2014). Planning for post-disaster recovery: Next generation. American Planning Association.
Included in the reserve components are the following capabilities:
(1) Accurate and timely data on personnel assets;
(2) Standard data for comparison across services and components;
(3) Proper tracking of reservists for pay and service credit;
(4) Tracking of all military personnel into and around the theater; and (5) Integrated personnel and pay functions. (Ladra, 2005)
IV. DIMHRS: A Web-based Tool
The work of Wilson (2008) entitled: "New and Improved" states that DIMHRS is "...a web-based tool that will be available 24 hours a day making personnel and pay records available to human resource professionals, combatants commanders and other authorized users throughout the armed services." (Wilson, 2008)
The DIMHRS system is one that will be the "largest fully integrated HR system in the world and deliver timely and accurate pay and benefits to all service members and their families." (Wilson, 2008) DIMHRS will "fix shortfalls" as it takes "the place…
Heathfield, Susan M. (2009) Human Resources Information System (HRIS). 2009. Human Resources. Online available at: http://humanresources.about.com/od/glossaryh/a/hris.htm
Koch, Douglas J. (2009) Positioning the Reserve Headquarters Support (RHS) System for Multi-Layered Enterprise Use. Sept. 2009. Online available at: http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA509263&Location=U2&doc=GetTRDoc.pdf
Ladra, Christopher L. (2005) Personnel Transformation -- Consolidation of the Department of Defense Human Resource System into a Joint System. USAWC Strategy Research Project. Online available at: http://www.dtic.mil/cgi-bin/GetTRDoc?AD=ADA431767&Location=U2&doc=GetTRDoc.pdf
Wilson, Celena (2008) New and Improved. Citizen Airman. Vol. 60 No. 6 December 2008. Online available at: http://www.citamn.afrc.af.mil/shared/media/document/AFD-090728-077.pdf
Emergency Operations Plan Outline
disruption of basic infrastructure (utilities, roadways, communication)
degradation of sanitary facilities iii. direct injuries/fatalities and property damage
Critical esource Dependencies
medical care needs could reach critical mass
clean water and hygiene needs must be managed
Characteristics and Policies of the EOP Authority That May Affect esponse
intercommunication and cooperation of disparate departments is essential
chain of command changes during emergency could prove problematic
Concept Of Operation
disaster notification should go straight to the top member of the hierarchy
proper chains of command and task hierarchies must be maintained
Overall Plan Priorities
protection of life, health, and property
effective coordination of relief efforts and resources iii. maintenance of basic physical and organizational infrastructure
Town / CITY Handling Of Emergencies
i. establish refuge/information centers for the population
ii. establish emergency communication procedures and hierarchies
Emergency Action Levels
i. plan for cessation of public transportation during/following event
ii. reorganization/prioritization plan for transportation redeployment
Emergency Readiness Annotated Bibliography
Biochemical terrorism, nuclear or other terrorism is everyone's nightmare since the anthrax scares in Washington D.C. In September of 2001 and the Al-Qaeda attacks on September 11, 2001. The purpose of this annotated bibliography is to document the effectiveness of emergency management and readiness in Connecticut. It has been more than 5 years since the TOPOFF 3 emergency exercises in 2006 and literature published since then needs to be annotated and review for homeland security studies.
Petersen, R.E., Lindsay, B.R., Kapp, L., Liu, E.C., & Peterman, D.R. Congressional Reporting
Service, United States Congress. (2008). Homeland emergency preparedness and the national exercise program: Background, policy implications, and issues for congress. Washington, D.C.:
Government Printing Office.
In the CRS report, the series of ongoing TOPOFF exercises is documented in detail, including the 2006 exercise in Connecticut as well as other exercises are documented in detail. The…
Emergency Planning and the LAUSD
Los Angeles, California is not a stranger to emergency situations. The city has faced major natural disasters, as well as intense social unrest, all of which have affected education. As one of the largest districts in the state of California, the Los Angeles Unified School District has some serious challenges related to effective emergency planning and execution of emergency strategies when they are needed. As budget issues continue to reduce resources required for effective emergency preparedness, the district has some serious issues to face before other major emergency surfaces in order to ensure that the students and staff within the education system remain safe and can continue their part in the education system after the emergency has subsided.
The district covers a huge portion of the city, with hundreds of thousands of children attending LAUSD schools. As a central headquarters for emergency operations, the district…
Sinclair, M. (2004). Planning Education in and after Emergency. Fundamentals of Education Planning. Institute for International Educational Planning, 2002. Retrieved April 21, 2010 from http://unesdoc.unesco.org/images/0012/001293/129356e.pdf
Los Angeles Unified School District. (2010). Emergency Operations Plan. Retrieved October 18, 2015 from http://notebook.lausd.net/pls/ptl/docs/PAGE/CA_LAUSD/LAUSDNET/OFFICES/SCHOOL_OPS/SCHOOL_OPERATIONS_DIVISION/EMERGENCY_SERVICES/EMERGENCY_SERVICES_EMERGENCY_OPERATIONS_CENTER/LAUSD%20EOP%202010%20UPDATE.PDF
U.S. Office of Safe and Drug-free Schools, U.S. Department of Education (2007). Practical Information on Crisis Planning: A guidebook for schools and community. The Office of Safe and Drug-free Schools. Retrieved February 2008 from http://www.ed.gov/admins/lead/safety/emergencyplan/crisisplanning.pdf
Zach, L., & McKnight, M.. (2010). Innovative Services Improvised During Disasters: Evidence-Based Education Modules to Prepare Students and Practitioners for Shifts in Community Information Needs. Journal of Education for Library and Information Science, 51(2), 76-85. Retrieved November 10, 2010, from Research Library. (Document ID: 2012698591).
Emergency Management: Hurricane Katrina and Lessons Learned
In late August, 2005, Hurricane Katrina became the 11th named storm of the Atlantic hurricane season and was its most deadly and destructive. The federal and state governments' responses to this natural disaster have been heavily criticized in the mainstream media as well as by the hundreds of thousands of victims of this disaster in the years that followed. Although it is far too late for the victims of Hurricane Katrina, there were some valuable lessons learned from the disaster that have been used to help formulate improved responses in the future. This paper provides a review of the relevant peer-reviewed and scholarly literature concerning the emergency management of Hurricane Katrina, followed by an assessment of the various lessons that were learned. A summary of the research and important findings concerning these lesson learned are provided in the conclusion.
eview and Discussion
Birkland, T.A. (2006). Lessons of disaster: Policy change after catastrophic events. Washington,
DC: Georgetown University Press.
Bitto, A. (2007, January-February). Say what? Who? Me? Right here in the trenches?
Collaborate on what? Seeking common ground in regional all-hazards preparedness training. Journal of Environmental Health, 69(6), 28-31.
Principal Directorates of Department of Homeland Security
Border and Transportation Security
The largest component of the Department of Homeland Security is the Directorate of Border and Transportation Security (BTS). This division is responsible for maintaining the security of the nation's borders and transportation systems. BTS employees about 58% of DHS's total employees, has nearly half of its operating budget, and includes what was formerly TSA, Customs, the border security functions of INS, the Animal and Plant Health Inspection Service, and FLETC. Just like the other directorates of DHS, it is managed by an undersecretary of homeland security (United States Department of Homeland Security, 2012).
This department brought together several agencies from such departments as the Treasury Department, the Department of Justice, the Department of Transportation, and the Department of Agriculture. The mission of this directorate is to secure the borders and transportation systems of the United States and to…
About the Directorate for Management. (2011). Retrieved from http://www.dhs.gov/xabout/structure/editorial_0096.shtm
About the Science and Technology Directorate. (2011). Retrieved from http://www.dhs.gov/xabout/structure/editorial_0530.shtmUnited States Department of Border and Transportation Security. (2010). Retrieved from http://homelandsecurity.uslegal.com/department-of-homeland-security/components -
Department of Homeland Security. (2012). Retrieved from http://www.gov.com/agency/dhs/
Government of Western Australia Department of Education's Excursions: Off School Site Activities. The document describes the policies and procedures necessary for off school site activities.
Background of the Policy
It is recognized that off school site excursions have higher degrees of risk than being at the school. However, the Department of Education recognizes that off school site excursions can provide significant learning opportunities, so it does not want to eliminate them because of the risk. Therefore, it has promulgated regulations to minimize the risk during these excursions.
Purpose/Objective of My eport
The objective of this report is to provide a brief overview of the Department of Education's approach to excursions.
The document describes excursions as beginning with a teacher-in-charge, who is responsible for the investigation into the risks inherent with the excursion. Some of the excursions may be overnight, and those excursions require a special analysis of the risk.…
The Government of Western Australia Department of Education. (2003). Excursions: Off
School Site Activities. Neals.
Balance between Emergency Powers, Abuse of Law by the State and Civil Liberties of People within and Beyond the U.S.
ithin the United States of America especially after the terrorists' attack of 9/11, there seems to be a delicate balance between emergency powers, abuse of law by the authorities and the citizens' liberty. There appears to be significant connection between increase of liberty and insecurity (Gearty 1). However the question here is what security means, in some instances, security could be national threats such as terror attacks or internal forces threatening the political establishments, those that advance particular ideological ends such as those witnessed in Most North African such as Libya and Arabian countries such as Yemen. Nonetheless, in instances of such threats, civil liberties suffer and it becomes a challenge reconciling it with national security. There are many aspects of liberal democracy such as freedom of expression, association and…
A and others v Secretary of State for the Home Department  UKHL 56 .
Feingold, Russell. "On Opposing the U.S.A. Patriot Act." 14 April 2002. 8 December 2012 .
Gearty, Conor. Terror. London: Faber & Faber, 1991.
Greenhouse, Linda. "A Nation Challanged: The Supreme Court." The New York Times 29 September 2001.
Breadth of Responsibilities
All of the DHS responsibilities relate back to the primary jurisdiction and mission responsibilities listed above. Information sharing and analysis, prevention and protection, preparedness and response, research, commerce and trade, travel security, and immigration all are functions of keeping our country safe from terrorists and responding to both manmade and natural disasters.
The auxiliary functions of the department such as the Secret Service, U.S. Coast Guard, FEMA, Immigration and Customs, the Transportation Security Administration, and the Office of the Inspector General (OIG) all add to the breadth of DHS functionality, and fall under the primary mission statement of the department. Even the OIG, which is responsible for auditing the internal functioning of DHS including fraud and abuse indirectly operates as a function of ensuring this primary mission is carried out effectively.
Is the DHS Effectively Organized?
After a couple of re-organizations over the years, yes, it is,…
It comes with a built-in tripod, so heavy recovery workers needing an auxiliary source of light can adjust its stream of light exactly where it is needed, and keep it there. The flashlight is 2.5 kg, 340 mm long and 160 mm in diameter.
Wearable Lights: The Pelican manufacturer offers a hands-free light (#2680 "Headsup Lite") that is ideal for recovery professions who have their hands full dealing with emergencies and other demanding, and the last thing they need is to have to fiddle with off-and-on switches, and worry about battery staying power.
The light is an LED flashlight that puts out the illumination of a high performance incandescent -- and yet the manufacturer claims the Headsup doesn't project those "dark spots and irregular beam pattern" which are part and parcel of most standard filament lamps. How are they able to produce a clear, clean flood of light with no…
Babin, Bob. "Harness the power: trolley beam style systems vs. safety cables: which is
Better for fall protection?" Pit & Quarry 97.5 (2004): 28.
Big Rig Products. "Stand-Alone Truck Mounted Generator Sets: Rigmaster Power."
5 March 2005 http://www.bigrigproducts.com/generator.htm .
Department of Homeland Security Grants
The HSGP (Homeland Security Grant Program) for the fiscal year 2017 contributes significantly to NPS (National Preparedness System) implementation through promoting the creation, delivery and sustenance of key capabilities vital to the achievement of America’s NPG (National Preparedness Goal) geared at improving its security and resilience. The provision of key capabilities necessitates integrated community-wide efforts and not the sole, independent endeavors of a particular governmental level or agency. HSGP’s allowable expenses foster attempts at developing and sustaining key capabilities over the Protection, Prevention, Mitigation, Recovery and Response mission domains, with the following prioritized:
· Development and Maintenance of Terrorism Prevention Competences by Law Enforcers
· Development and Upgradation of Key Urban Area and State Fusion Centers
FEMA (Federal Emergency Management Agency)
This Homeland Security agency was first established under the 1978 Presidential Reorganization Plan III, and put into service under a couple of Executive Orders…
Slide 9: Technological innovations in emergency management
The starting point in the creation of a plan on how to improve our program from a technological standpoint has been constituted by the review of the it industry. The scope of this research has been that of identifying the innovations in the field and their relevance for our agency and its mission. The results of the research endeavor are briefly presented below:
GIS is an important tool to use in the collection of data necessary and its usage is credited with overall successful emergency operations as it allows the intervention teams to gather data pivotal at all stages of the emergency management process.
emote sensing technology is enhancing the quality of the emergency management act at the stages of mitigation and preparedness and it has proven efficient in the management of both natural hazards as well as man made disasters.
Bea, K., 2006, Federal emergency management policy changes after Hurricane Katrina: a summary of statutory provisions, Federation of American Scientists, http://www.fas.org/sgp/crs/homesec/RL33729.pdf last accessed on December 7, 2010
Durmaz, H., 2007, Understanding and responding to terrorism, IOS Press
Freitag, B., How can emergency managers address our warming climate? University of Washington, http://www.google.com/url?sa=t&source=web&cd=8&sqi=2&ved=0CE8QFjAH&url=http%3A%2F%2Ftraining.fema.gov%2FEMIWeb%2Fedu%2Fdocs%2FFreitag%2520-%2520How%2520can%2520emergency%2520managers%2520address%2520our%2520warming%2520cli.doc&rct=j&q=global%20warming%20and%20emergency%20management&ei=iK0ATY7aIc7xsgaxxKDzDg&usg=AFQjCNEz6tI4T6-ThuYIsw1_oXTxhx2SoQ&cad=rja last accessed on December 9, 2010
Goodman, a., 2007, Global warming link to natural disasters, Seattle PI, http://www.seattlepi.com/opinion/336682_amy25.html last accessed on December 9, 2010
An emergency and disaster preparedness plan and program is an important aspect for an organization due to its significance in promoting workplace safety. The preparedness program helps in enhancing safety in the workplace through inclusion of initiatives for lessening injuries and loss of lives, minimizing insurance claims, lessening property damage, and improving employee morale. While emergencies still happen despite of measures to prevent them, an organization's preparedness plan is critical in preventing the frequency of their occurrences, minimizing injury and property damage, and establishing ways for mitigating their impacts. This is largely because the plan consists of basic procedures to handle emergencies in the workplace. In most cases, organizations use preparedness plans and programs to protect workers from fire incidents and other emergencies.
Threats and Vulnerabilities in the Workplace:
Since an organization's workplace involves several employees, threats and vulnerabilities are likely to occur both from within and outside the…
Ball, J.L. (2001). Employee Fire and Life Safety: Developing a Preparedness Plan and Conducting Emergency Evacuation Drills. Retrieved May 25, 2012, from http://www.nfpa.org/assets/files/pdf/evacuation.pdf
"Fire Preparedness & Response: What the OHS Laws Require." (n.d.). Labor Tek Safety
Training Inc. Retrieved May 25, 2012, from http://www.labortek.com/images/articles/24.pdf
"Fire Prevention Plan." (2009, April 21). JSRCC Fire Prevention Plan. Retrieved from J.
Military Emergency Management/Terrorism Preparedness
It is reported in the work of Prelas, et al. (2009) entitled "Science and Technology of Terrorism and Counterterrorism" that the Federal Emergency Management Agency (FEMA) became part of the U.S. Department of Homeland Security on March 1, 2003, and is charged with the reduction of the "loss of life and property and protect the national from all hazards" including acts of terrorism. FEMA is to accomplish this through providing leadership and support to the national in a "risk-based, comprehensive emergency management system of preparedness, protection, response, recovery, and mitigation." (Prelas, et al., 2009, p.539) DHA/FEMA is reported to be under the leadership of the secretary and to coordinate "with the Commandment of the Coast Guard, the Commissioner of Customs, and Border Protection, the Assistant Secretary of Immigration and Customs Enforcement, the NOC and other agencies and offices in the department to take full advantage of…
Department of Defense Report to Congress Volume I: Preparedness Program in the Defense Against Weapons of Mass Destruction (nd) DOD Retrieved from: http://www.fas.org/spp/starwars/program/domestic/toc.html
Keefer, Philip and Loayza, Norman (2008) Terrorism, Economic Development and Political Openness. Cambridge University Press. 2008.
Prelas, Mark A., et al. (2009) Science and Technology of Terrorism and Counterterrorism. CRC Press 2009.
Stopa, Peter J., et al. (2004) Technology for Combating WMD Terrorism. Springer 2004.
hether involvement is through full time employment or volunteer service, the challenges of today's fire service demand commitment to training, education, experience and self-development. One's professional development is a journey, not a destination. Remember Patience, persistence and perspiration make an unbeatable combination for success.
You've achieved success in your field when you don't know whether what you're doing is work or play.
First In, Last Out Review in Publishers eekly, Reed Business Information, a division of Reed Elsevier Inc. (2004)
International Association of Fire Chiefs Officer Development Handbook First Edition, November 2003, Published in partnership with the IAFC Foundation, (2003), New York: International Association of Fire Chiefs, http://www.iafc.org/associations/4685/files/OffrsHdbkFINAL3.pdf (Retrieved August 20, 2006).
Salka, John, and Neville, Barret. First In, Last Out: Leadership Lessons from the New York Fire Department (New York, Penguin Group, USA, Inc. 2004).
Thomas M. Cunningham, Emergency Services Information Site: Leadership…
First In, Last Out Review in Publishers Weekly, Reed Business Information, a division of Reed Elsevier Inc. (2004)
International Association of Fire Chiefs Officer Development Handbook First Edition, November 2003, Published in partnership with the IAFC Foundation, (2003), New York: International Association of Fire Chiefs, http://www.iafc.org/associations/4685/files/OffrsHdbkFINAL3.pdf (Retrieved August 20, 2006).
Salka, John, and Neville, Barret. First In, Last Out: Leadership Lessons from the New York Fire Department (New York, Penguin Group, USA, Inc. 2004).
Thomas M. Cunningham, Emergency Services Information Site: Leadership 101: Integrity, http://www.withthecommand.com/2002-Aug/MD-TMC-leader-integ101.html (Retrieved August 20, 2006)
Demands That Emergency Workers Are Exposed To
In this day and age, where no one is safe and emergency situations arise all the time, the people behind keeping the peace intact play a very important role. In recent studies it has been observed that emergency workers go through immense pressure and stress, which if gone undiagnosed can lead to major psychological problems. In this paper we will discuss at length the trauma that emergency workers suffer form and how to cope with it.
In the present day, United States is no more considered a safe and peaceful place to feel free, but rather it is more like an everyday war zone. Places like schools, offices, homes and even churches are no longer a safe ground like they were once considered to be, violence and hostility somehow find their way into them as well. Things like homicide, sexual and child abuse…
Jensen, SB (1999) Taking care of the care takers under war conditions, who cares? European University Centre for Mental Health and Human Rights.
Kahill, S (1988) 'Interventions for burnout in the helping professions: a review of the empirical evidence' in Canadian Journal of Counseling Review 22 (3):310342. Journal of Counseling Review 22 (3):310342.
Markey, K (1998) 'Reports on risks to health and safety identified by Concern Worldwide's international personnel ', Concern.
McCall, M & Salama, P (1999) 'Selection, training and support of relief workers: an occupational health issue ' in British Medical Journal 318:1136.
Function #1: Mitigation
At this stage, gradual and long-term steps are taken to ensure that disasters do not occur, or that, when they do, they cause minimal damage. Actions at this stage include the identification of hazards, the research of the causes which generate the disaster, the creation of means in which to modify the causes of the disasters, the development of means which reduce the community's vulnerability to the disaster, the efforts to better consolidate old buildings, the construction of disaster-resistant buildings, the education of the population or the provision of insurance.
At this stage, the responsibilities of the central government include:
The identification of hazards and the research of their causes
The research as to how the causes of the disaster can be modified
The offering of research and development grants to local projects
The promulgation of buildings safety standards
elative to the competencies of the local governments…
Arnstein, S.R., 1969, A Ladder of Citizen Participation, AIP Journal
Boyce, W., 2002, A Seat at the Table: Persons with Disabilities and Policy Making, McGill-Queen's Press -- MQUP, ISBN 077352181X
Branigan, T., 2009, More than 500 dead in Typhoon Morakot, The Guardian, Edition of August, 14
Canton, L.G., 2007, Emergency Management: Concepts and Strategies for Effective Programs, Wiley-Interscience, ISBN 047173487X
Federal Emergency Management Agency FEMA is primarily charged with ensuring that the Americans are all safe in case of any emergency. This is the basis of all their engagements and departments that exist therein. The range of emergencies that are included in the FEMA field of operation are natural disasters like floods, hurricanes, wild fires, earthquakes and man made (both internal and external aggression) disasters that can adversely affect the lives of the Americans.
The roles of FEMA in a situation of emergency are conventionally grouped into the following categories as indicated by FEMA (2010a);
Life safety: this is usually the first and most important priority of FEMA since it is the sole reason for the existence of the agency and the agenda for their response to any emergency situation.
ecovery and restoration; this involves ensuring that the businesses run normally and that the population is employed once again after…
Church World Service, (2011). Responding to Emergencies-Our Approach. Retrieved August 1,
2011 from http://www.churchworldservice.org/site/PageServer?pagename=action_what_emerg_approach
FEMA (2010a). Emergency Management Guide. Retrieved August 1, 2011 from