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Deriving an Evidence Base for Emergency Management in U.S. Hospitals: Toward Resilience in the Midst of COVID-19

Award Number: R01HS028240
ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY
OPDIV: AHRQ
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 12/01/2020
PERIOD OF PERFORMANCE END DATE: 11/30/2024

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Deriving an Evidence Base for Emergency Management in U.S. Hospitals: Toward Resilience in the Midst of COVID-19 - As U.S. hospitals moved quickly to make plans and respond to the COVID-19 pandemic, many struggled with significant challenges in managing the crisis simultaneously with maintaining the health and safety of patients and hospital staff. This event has demonstrated the need for hospitals to develop effective emergency management (EM) programs to deal with the current crisis and future disaster events. Federal agencies and others have published guidelines on hospital EM, but these guidelines frequently change, are sometimes inconsistent, and do not describe the process for effectively managing emergencies and expected outcomes. Consequently, hospitals have invoked a variety of EM practices in dealing with COVID-19, with varying impact. The variation in EM is especially salient when comparing rural and urban hospitals, which not only differ in terms of resources and the surge in COVID-19 cases, but rural hospitals are typically located in areas with a larger high-risk population of patients with underlying conditions who can have greater complications if COVID- 19 is contracted. Therefore, it is critical to understand hospital EM in response to COVID-19 across both urban and rural settings. Building on prior research, we hypothesize that successful EM programs have distinguishing attributes. First, effective EM practices demonstrate elements of resilience, or capabilities to respond to disruptive events with minimal negative impact to performance. Second, effective EM includes a mixture of formal mechanisms such as standardized protocols and reporting structures, as well as informal mechanisms, such as adaptive routines and flexible roles. Our research examines the EM practices of 12 urban and rural hospitals to identify effective techniques and processes that enabled these organizations to provide quality care and move toward resilience during and after COVID-19. We will use qualitative and quantitative approaches to examine how the combination of EM practices employed by hospitals contributed to resilience, improved health outcomes, and stronger hospital performance overall. We first plan to conduct interviews with hospital executives and clinical leaders directly involved in EM during COVID-19 so we can identify and compare EM practices across each of the study hospitals using thematic analysis (Aim 1). Next, we will use the interview data in Aim 1 to design surveys which we will administer to key personnel at each hospital. Using factor analysis, we will develop a validated scale to assess the saliency of different EM practices, formal and informal mechanisms, and resilience (Aim 2). Last, we will conduct complementary quantitative analyses to examine patient outcomes and hospital performance in relation to the EM scales we developed in Aim 2, so that we can determine which practices and mechanisms of implementing EM were most effective. From these findings we will identify core elements and benchmarks of successful EM programs for broad dissemination (Aim 3). Through our research, we aim to provide hospitals with evidence-based EM practices that will better equip them for the current crisis and future disasters.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2022	HARVARD COLLEGE PRESIDENT & FELLOWS OF	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Research on Healthcare Costs, Quality and Outcomes	000	2	1/7/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2022	HARVARD COLLEGE PRESIDENT & FELLOWS OF	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Research on Healthcare Costs, Quality and Outcomes	000	2	11/2/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $390,981 )
2022	2022	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Research on Healthcare Costs, Quality and Outcomes	000	2	12/8/2021	NON-COMPETING CONTINUATION	$390,981
														Subtotal = $390,981

Issue Date FY: 2021 ( Subtotal = $416,298 )
2021	2021	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Research on Healthcare Costs, Quality and Outcomes	001	1	9/21/2021	NEW	$0
2021	2021	PRESIDENT AND FELLOWS OF HARVARD COLLEGE	677 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	12/1/2020	NEW	$416,298
														Subtotal = $416,298

Grand Total All Awards = $807,279

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Deriving an Evidence Base for Emergency Management in U.S. Hospitals: Toward Resilience in the Midst of COVID-19

Award Number: R01HS028240

ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY

OPDIV: AHRQ

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 12/01/2020

PERIOD OF PERFORMANCE END DATE: 11/30/2024

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