A recent study conducted by the Agency for Healthcare Research and Quality (AHRQ) reviewed over 8,500 citations, 500 websites and 1,000 government reports from four primary literature sources—medical, emergency management, supply chain management and government—to provide hard evidence in support of regionalizing resources in the case of a mass casualty incident due to biological attack.
Researchers compiled data describing the country’s existing infrastructure (national, regional, state and local) for a bioterrorism response; actual responses to terrorist attacks, natural disasters and outbreaks; and existing models of regionalization of trauma care and surveillance for bioterrorism (collection and assessment of disease data). “Given the complexity and cost of training, staffing, equipping and mobilizing an adequate bioterrorism response infrastructure,” concludes the study, “no single community can be expected to develop and maintain the necessary capacity for a large-scale bioterrorism response. Instead, regionalization may benefit preparedness and response capabilities.”
Specific benefits include meeting surge capacity in providing services and pharmaceuticals, having trained personnel and resources available to meet demands, and creating pre-existing agreements and pre-event protocols that spell out roles, payment, and agreed-upon chain of command structures.
Researchers also found that while there are ample examples of regional agencies and organizational structures in place, most have been developed for purposes other than bioterrorism response and there is work to be done in coordinating them into a workable system. Key components for development include uniform and interactive information technologies and communications systems to enhance the coordination and transport of personnel, resources and citizens; mutual aid agreements; supply-chain transportation infrastructure; training for personal safety, triage, diagnosis and outbreak management; and an organizational commitment to a “lessons learned” approach to ensure that knowledge gained remains in institutional memory.
AHRQ. Regionalization of Bioterrorism Preparedness and Response. AHRQ Publication No. 04-E016-1, April, 2004. www.ahrq.gov/clinic/epcsums/bioregsum.htm.