NCDMPH Newsletter Fall/Winter 2010

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Operation Continuing Promise Presents Assessment Opportunity

As part of its core mission of coordinating federal efforts in the areas of education and training for all-hazards disasters, the National Center for Disaster Medicine and Public Health (NCDMPH) recently conducted a knowledge assessment aboard the USS Iwo Jima during Operation Continuing Promise 2010.

Continuing Promise 2010

Operation Continuing Promise, a United States Southern Command mission, is a four-month humanitarian and civic assistance deployment to provide medical, dental, veterinary and engineering support in eight countries in Latin America and the Caribbean. With a medical personnel group of about 175 people delivering assistance, this mission presented a unique opportunity for the NCDMPH to assess the humanitarian/disaster relief knowledge of a large sample of people who would respond to a domestic disaster or public health emergency.

The NCDMPH's Acting Director, Dr. Kenneth Schor, and Strategic Consultant, Becky Zukowski, were participants in the mission for three weeks in July and August of this past summer, during which they conducted an assessment survey of approximately 100 medical personnel, including U.S. armed forces and foreign military officers. The survey, designed by Uniformed Services University Disaster Psychiatry fellow LTC (Dr.) Mike Stanley, aims to identify gaps in knowledge of disaster relief responders.

A follow-up assessment, focusing on post-effort attitudes and acquired knowledge, is being conducted as the medical personnel conclude their portion of the mission in November.

"Our experience as part of Continuing Promise, as well as the initial results we've tabulated from the assessment survey, has really been an eye-opening experience in terms of the work that lays ahead for the NCDMPH," said Dr. Schor. "Our final report of recommendations to the U.S. Navy Southern Command Surgeon will pave the way for all-hazards responders both domestically and internationally to have a greater knowledge and understanding of how to deliver assistance."

While participating in the mission, Dr. Schor and Mrs. Zukowski amassed an impressive amount of photos, observations and thoughts related to humanitarian/disaster relief and life aboard the USS Iwo Jima. In an effort to share that information with its stakeholders, the NCDMPH's website has added a new feature - A Promise Kept, a journal that retroactively chronicles the NCDMPH's involvement, and includes photos, from operation Continuing Promise 2010.

"By sharing these photos and observations that we recorded while actually participating in the mission, we're able to look back and examine our impressions in real-time," said Ms. Zukowski. "We're not looking back on our experience with rose-colored glasses; we're able to truthfully analyze our impressions and use them to identify gaps in knowledge."

Other resources, articles and links to social media communities for Continuing Promise can be found in the academic Joint Program section of the NCDMPH website, which is where the final report of recommendations will also be posted upon its delivery to the U.S. Southern Command Surgeon.

Collaborative Exercise Yields Valuable Experience

This fall, the NCDMPH participated in the National Naval Medical Center (NNMC)'s annual Collaborative Multi-Agency Exercise (CMAX), an exercise that prepares area hospitals for the influx of patients during a mass-casualty event.

The exercise, a Joint Commission Emergency Management requirement for hospital accreditation, is the result of the Bethesda Hospitals' Emergency Preparedness Partnership (BHEPP). CMAX Exercise This union was formed between NNMC, National Institutes of Health Clinical Center, Suburban Hospital and the National Library of Medicine (NLM) out of an identified need for coordinated collaboration during a man-made or natural disaster.

This year's exercise was one of the largest ever and included participation from 28 hospitals in the Washington, DC area. The main objectives were to test patient transfer capabilities, surge capacity, resource sharing and informatics/communications research projects. The scenario being tested involved multiple attacks, including an airplane crashing in the Pentagon parking lot and bombs exploding at a concert at the Dallas Center, a protest on the National Mall, and a National Special Security Event in which the President is in attendance.

The NCDMPH staff was invited to participate in varying capacities; Acting Director Dr. Kenneth Schor was an evaluator of the Hospital Command Center, Joint Program Coordinator Kandra Strauss-Riggs was an evaluator of the Family Reception Center, Strategic Advisor Rebecca Zukowski was an evaluator of the Immediate Care Unit, Administrative Assistant Kristen Brown played the role of the sister of a victim at the Family Reception Center and Communications Associate David Berry was a roaming photographer of the exercise.

"The NCDMPH is truly pleased to have been selected as evaluators of the exercise," said Ms. Zukowski. "Being at the scene of the response work - whether it's from the command center or an emergency room - really gives a perspective that you can't get by analyzing a response on paper."

Immediately following the conclusion of the exercise, evaluators were asked to give feedback on what they saw in a "3 up, 3 down" manner - meaning, they were to discuss three positive and three negative points that they observed during the response.

Common positive takeaways from the exercise included good communication among BHEPP members, patient tracking, patient surge response and the transferring of patients from NNMC and Suburban Hospital to the National Institutes of Health Clinical Center. Areas of improvement included the need for more security, less chatter on radio devices and the implementation of BHEPP informatics tools without assistance from the NLM.

"The opportunity to give immediate feedback was an appealing feature of the exercise," said Ms. Strauss-Riggs. "The hope is that by continually improving this exercise every year via the feedback, the area hospitals will be significantly more prepared to handle an influx of patients in the event of an actual disaster."

Latest Workshop Produces Capabilities and Competencies Framework

The series of six workshops on emergency preparedness and response being co-sponsored by the NCDMPH continued on September 22, with the latest session resulting in a framework of capabilities and competencies for the disaster health workforce.

The NCDMPH was joined by its co-sponsors of the workshop, the Yale New Haven Center for Emergency Preparedness and Response, U.S. Northern Command, and the FETIG, the National Center's advisory board.

The workshop was structured so three breakout sessions could focus on different areas of disaster response, including planning, communication, evacuation, responder safety and CMAX Discussion patient care. Each breakout group was tasked with developing a draft of capabilities and competencies to present to the rest of the workshop attendees later in the session.

Breakout session leaders presented the capability and competency drafts to the larger crowd, and suggestions, edits and final decisions were agreed upon in a lively, yet respectful manner. The final draft of the framework is currently being compiled.

After the framework had been finalized, the afternoon concluded with the NCDMPH's Acting Director, Dr. Kenneth Schor, giving closing remarks to the attendees. During his speech, Dr. Schor applauded the workshop attendees for coming to agreement on a number of difficult decisions regarding the framework, but cautioned them that establishing this framework is just the beginning of the intense work to come at the remaining three workshops.

Additional photos from the "Building a Framework for the Development of Core Capabilities and Competencies for Medical Disaster Preparedness and Response" can be found on the NCDMPH website.

NCDMPH to Shine Light on Kids and Disasters

A report issued to the President and Congress by the National Commission on Children and Disasters (NCCD) in October contained a recommendation for the NNCDMPH to establish pediatric disaster competencies.

NCCD Report 2010 Cover Image

Formed in 2007 due to concerns about the safety of children during disasters, the NCCD has the ear of President Obama on all matters concerning children's needs as they relate to preparation for, response to, and recovery from all hazards. The report contains findings and recommendations for improvement in 11 areas, including child physical health and trauma, elementary and secondary education, sheltering and evacuation.

The NCDMPH is specifically named in Recommendation 3.3 of the child physical health and trauma section by way of its advisory board, the Federal Education and Training Interagency Group for Public Health and Medical Disaster Preparedness and Response (FETIG). The recommendation calls for the FETIG, working through the NCDMPH, to "prioritize the development of pediatric core competencies, core curricula, training and research."

This recommendation perfectly aligns with one of the stated goals of the NCDMPH work plan, which aims to identify and integrate national disaster health core competencies in pediatrics.

To begin answering this charge, the NCDMPH is hosting a pediatric workshop in March that will gather experts in the fields of pediatric disaster preparedness to develop core pediatric disaster health competencies. The workshop will feature discussion panels led by leaders in the field with the goal of developing initial recommendations.

"Children are an extremely vulnerable population during a disaster, so it's truly on the shoulders of us, as a National Center, to lead the way in developing the competencies that can better prepare the disaster workforce to protect children," said the NCDMPH's Joint Program Coordinator, Kandra Strauss-Riggs. "The results of this workshop can serve as the foundation for improvement in the education and training of those protecting children in a disaster."

For those interested in attending or learning about the workshop, please e-mail

Highlights From National Preparedness Month

National Preparedness Month

With September being designated National Preparedness Month (NPM) by the Federal Emergency Management Agency's site, the NCDMPH took action to promote preparedness for all types of disasters. With "Preparation" and "Collaboration" being two of the NCDMPH's Core Four principles (along with Knowledge and Excellence), it's no surprise to see the National Center's level of commitment to NPM.

The goal of NPM is to encourage everyone to "take simple steps to prepare for emergencies in their homes, businesses, and communities." The NCDMPH took this message to heart by conducting an evacuation drill at the National Center's offices in Rockville, MD.

By physically going through the steps needed to have a safe evacuation and identifying a local "safe spot" to meet, everyone was able to familiarize themselves with his or her role, and allowed for suggestions and improvements to be made in the Center's evacuation plan.

Just because September is over doesn't mean your home or office can't take steps to be a safer place. Please visit for tips on preparedness and information on building an emergency kit.

Previous Newsletters and Publications

Spring 2010 Newsletter or PDF version
Fall 2009 Newsletter or PDF version