Survey
Purpose
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To
gather information from health care coalitions (HCCs) about the
state of health care system preparedness and response today versus
before 2012 in order to illustrate the impact HPP has had on
health care system preparedness. In 2012, the Hospital
Preparedness Program (HPP) shifted to a coordinated health care
coalition approach. This survey will also collect data on HCC’s
technical assistance (TA) needs. The survey will be sent to the
main point of contact from each of HPP’s 380+ HCCs. No more
than one survey will be completed per HCC.
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Guiding
Question
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As
a result of HPP, how is health care system preparedness different
today than it was in 2012 and before?
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Section
1: Consent Form and Demographic Information
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Consent
Form Language
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You
are invited to participate in an online survey by ASPR. This
survey is intended for health care coalitions (HCCs) funded by
ASPR’s Hospital Preparedness Program (HPP) with the purpose
of gathering information from HCCs about the impact of HPP on the
state of health care system preparedness and response.
HPP
appreciates your time and effort in completing this short survey.
Your input is important, and we encourage candid responses. The
survey will take approximately 15 minutes to complete online;
there are no known risks or discomforts associated with this
survey. Your participation in this assessment is completely
voluntary, and you may stop the assessment at any time.
The
survey is being provided to all HPP-funded HCCs. We ask that the
person with the most knowledge of your health care coalition
submit
the completed assessment by Friday, November 3, 2017.
We request only one response per HCC.
If
you have any questions, please contact Kati Miller at
[email protected].
Again,
thank you for your time and feedback.
Clicking
on the “Agree” button indicates that you have read the
above information, are 18 years of age or older, and consent to
participate in this survey.
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Demographic
Information Questions
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Question
Type
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Response
Options/ Description
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State/Jurisdiction
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Yes/No
and Fill In
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Health
Care Coalition Name
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Yes/No
and Fill In
|
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Name
|
Fill
In
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Role/Title
|
Fill
In
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Organization
Name (e.g., John Smith Medical Center)
|
Fill
In
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Organization
Type
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Drop
Down
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Section
2: Impact Questions
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When
answering the following questions, please consider that HPP
shifted its emphasis to coordinated health care system
preparedness and response through health care coalitions (HCCs) in
2012 at the start of the 2012-2017 project period.
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Theme
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Question
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Relationships
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How
strongly do you agree with the following statements?
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Strongly
Disagree
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Disagree
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Agree
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Strongly
Agree
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I
am confident that the health care organizations within my HCC
would have been able to coordinate local and regional health
care, government, and public health entities to respond
effectively to an emergency or disaster
that occurred prior
to 2012.
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Today,
I am confident that our HCC can coordinate across local and
regional health care, government, and public health entities
to respond effectively to an emergency or disaster.
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Capability
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Please
indicate your level of agreement with the following statements:
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Strongly
Disagree
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Disagree
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Agree
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Strongly
Agree
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I
believe that regional
health care system preparedness efforts,
such as health care coalitions and local/regional exercises,
are critical to national preparedness.
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|
|
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I
believe that HPP
funding
is critical to developing and maintaining national health
care system preparedness.
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I
believe that HPP
guidance
is critical to developing and maintaining national health
care system preparedness.
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I
believe that HPP
technical support through ASPR
TRACIE
is critical to developing and maintaining national health
care system preparedness.
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HPP
funding, guidance, and technical support have improved my
HCC’s ability to decrease morbidity and mortality
during emergencies and disasters.
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Outcomes
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Please
indicate your level of agreement with the following:
Because
of HPP's emphasis on health care system coordination beginning in
2012, my HCC is now more capable of____________.
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Strongly
Disagree
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Disagree
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Agree
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Strongly
Agree
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Providing
care to a surge of patients that exceeds my HCC’s
member organizations’ day-to-day patient volume
baseline
|
|
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Earliest
possible communication of situational awareness and risk
information to other health care organizations
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|
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Maintaining
operations
throughout
the surge of patients during an emergency
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|
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Appropriately
coordinating and supporting response activities with other
health care organizations
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Please
indicate your level of agreement with the following:
Today,
my health care coalition is more capable of incorporating and
building upon lessons learned from an emergency, incident, or
exercise than it was before 2012.
Strongly
Disagree
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Disagree
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Agree
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Strongly
Agree
|
|
|
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For
the 2017-2022 project period, there are four
capabilities that describe what the health care delivery
system, including HCCs, hospitals, and emergency medical services,
has to do to prepare for and respond effectively to emergencies
that impact the public’s health. These capabilities include
18 objectives in total, which are referenced in questions 5
through 7 below. When responding to these questions, please
remember that we
are interested specifically in your individual HCC’s
priorities.
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Funding
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Understanding
that your HCC may focus on multiple objectives, which of the
following are the top three objectives that your HCC plans to
prioritize with your FY2017 HPP funding? (Select 3)
Establishing
and operationalizing an HCC (Capability 1)
Identifying
risk and needs (Capability 1)
Developing
an HCC preparedness plan (Capability 1)
Training
and preparing the health care and medical workforce (Capability
1)
Ensuring
preparedness is sustainable (Capability 1)
Developing
and coordinating health care organization and HCC response plans
(Capability 2)
Utilizing
information sharing procedures and platforms (Capability 2)
Coordinating
response strategy, resources, and communications (Capability 2)
Identifying
essential functions for health care delivery (Capability 3)
Planning
for continuity of operations (Capability 3)
Maintaining
access to non-personnel resources during an emergency (Capability
3)
Developing
strategies to protect health care information systems and
networks (Capability 3)
Protecting
responders’ safety and health (Capability 3)
Planning
for and coordinating health care evacuation and relocation
(Capability 3)
Coordinating
health care delivery system recovery (Capability 3)
Planning
for a medical surge (Capability 4)
Responding
to a medical surge (Capability 4)
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Funding
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If
your HCC were to have received additional funding in FY2017,
which three additional objectives would you prioritize? (Select
3)
Establishing
and operationalizing an HCC (Capability 1)
Identifying
risk and needs (Capability 1)
Developing
an HCC preparedness plan (Capability 1)
Training
and preparing the health care and medical workforce (Capability
1)
Ensuring
preparedness is sustainable (Capability 1)
Developing
and coordinating health care organization and HCC response plans
(Capability 2)
Utilizing
information sharing procedures and platforms (Capability 2)
Coordinating
response strategy, resources, and communications (Capability 2)
Identifying
essential functions for health care delivery (Capability 3)
Planning
for continuity of operations (Capability 3)
Maintaining
access to non-personnel resources during an emergency (Capability
3)
Developing
strategies to protect health care information systems and
networks (Capability 3)
Protecting
responders’ safety and health (Capability 3)
Planning
for and coordinating health care evacuation and relocation
(Capability 3)
Coordinating
health care delivery system recovery (Capability 3)
Planning
for a medical surge (Capability 4)
Responding
to a medical surge (Capability 4)
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Funding
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Which
one or more of the following capability objectives is your HCC
likely unable
to fully
address with your current level of FY2017 HPP funding? (Select
all that apply)
Establishing
and operationalizing an HCC (Capability 1)
Identifying
risk and needs (Capability 1)
Developing
an HCC preparedness plan (Capability 1)
Training
and preparing the health care and medical workforce (Capability
1)
Ensuring
preparedness is sustainable (Capability 1)
Developing
and coordinating health care organization and HCC response plans
(Capability 2)
Utilizing
information sharing procedures and platforms (Capability 2)
Coordinating
response strategy, resources, and communications (Capability 2)
Identifying
essential functions for health care delivery (Capability 3)
Planning
for continuity of operations (Capability 3)
Maintaining
access to non-personnel resources during an emergency (Capability
3)
Developing
strategies to protect health care information systems and
networks (Capability 3)
Protecting
responders’ safety and health (Capability 3)
Planning
for and coordinating health care evacuation and relocation
(Capability 3)
Coordinating
health care delivery system recovery (Capability 3)
Planning
for a medical surge (Capability 4)
Responding
to a medical surge (Capability 4)
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Section
3: Technical Assistance Questions
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Theme
|
Question
|
Technical
Assistance
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From
whom is your HCC most likely to request or seek technical
assistance? (Order from most likely (1) to least likely (8))
Awardee
(state, U.S. territory, freely associated state, Washington D.C.,
Chicago, Los Angeles County, or New York City)
ASPR
Technical Resources Assistance Center and Information Exchange
(TRACIE)
HPP
Field Project Officer
Peers
Trade
Association (e.g., American Hospital Association, Association
of State and Territorial Health Officials, National Emergency
Management Association, National Association of County and City
Health Officials, etc.)
Centers
for Disease Control and Prevention (CDC)
Federal
Emergency Management Agency (FEMA)
HPP
Headquarters Staff
|
What
are your coalition’s three priority areas for technical
assistance? (Please list 3)
-
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According
to the Paperwork Reduction Act of 1995, no persons are required to
respond to a collection of information unless it displays a valid
OMB control number. The valid OMB control number for this
information collection is 0990-0391. The time required to complete
this information collection is estimated to average 15 minutes per
response, including the time to review instructions, search existing
data resources, gather the data needed, and complete and review the
information collection. If you have comments concerning the accuracy
of the time estimate(s) or suggestions for improving this form,
please write to: U.S. Department of Health & Human Services,
OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington
D.C. 20201, Attention: PRA Reports Clearance Office
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