Wednesday, February 20, 2013

Thoughts from the CHI Symposium

by Dr. K.C. Rondello

The recent CHI Symposium served as reminder to all in government, medicine and the emergency services that continuity of care in a crisis can only be secured through collaboration of the participating agencies that cut across the spectrum of public health and medical services.  As anyone involved in emergency management will tell you, there is no straightforward disaster response — and as the three speakers appropriately explained, cross-discipline communication and cooperation are essential to meet the ever-changing demands of an evolving healthcare crisis.  

In times of non-disaster, the interconnectivity of the public, private and not-for-profit sectors is important – but in times of emergency, it is imperative.  In the past, medical disaster responders have too often viewed the continuum of care following emergencies through a single lens, most often through that of their own particular discipline.  The problem with such a perspective is that no health or medical concern is unifactorial.  In the increasingly complex U.S. healthcare system, patients must routinely rely on the interconnectivity of their healthcare providers.  In the same way, in order to optimally address our most vulnerable populations following a disaster, we must employ a more holistic model of disaster healthcare – one that simultaneously considers a patient’s social, behavioral and emotional well being in addition to their physical health.  

While this may sound intuitive, this ‘whole patient’ approach has only recently been considered in most disaster plans.  In the past, disaster health plans have typically addressed matters of physical health in isolation from other factors.  Adaptation of alternate standards of care, the establishment of temporary medical treatment sites and the maintenance of healthcare business continuity are all usually considered, along with plans for addressing mental, behavioral and emotional health independent of one another.  But only the most robust plans consider the connectivity of all these elements as they are related on one another in actual practice.  It has been said that ‘no man is an island.’  In the same way, in a crisis no responder is an island – and disaster planners must consider this in the next iteration of healthcare emergency plans.  


Rarely are personnel from the myriad of government and health response agencies brought together to discuss essential interorganizational cooperation and collaboration. The CHI symposium brought this concern to the forefront by highlighting the degree to which healthcare disaster teams, agencies and businesses are inextricably and forever reliant upon one another. With all the constructive and beneficial information presented by the distinguished speakers, that was perhaps the most valuable lesson of all.