All ETDs from UAB

Advisory Committee Chair

Andrew C Rucks

Advisory Committee Members

Peter Ginter

Charles Katholi

David Becker

Lisa McCormick

Stephen O'Connor

Document Type

Dissertation

Date of Award

2015

Degree Name by School

Doctor of Public Health (DrPH) School of Public Health

Abstract

Natural or man-made disasters overwhelm the resources of a healthcare organization and strain or compromise the provision of medical services to rapidly expanding patient populations. Public and private healthcare organization routinely plan and exercise systems and responses intended to bolster medical care capabilities and increase the capacity of the organization during crisis events. Providers of pediatric emergency medical service are particularly vulnerable to disaster surge, since many pediatric emergency services operate consistently at near capacity. In recent years, policy-makers and medical professionals have begun to look toward healthcare coalitions as a mechanism to rapidly expand resources and capacity for patient care following a crisis event. With the intent to allow flexibility in the formation, structure, and governance of coalition - and thereby encourage participation - grant funding and other public support is not often conditioned upon the adoption of particular policies and practices. This has resulted in profound variation in the form and function of healthcare coalitions, often a result of trial and error methodologies and an operational framework with a strong theoretical foundation. This study reviews and identifies long-standing theoretical models for collaborative efforts with similar objectives, synthesizes a conceptual framework for pediatric preparedness healthcare coalitions and investigates the associated domains of the framework through interviews of experts in the field of pediatric preparedness and survey of the members of identified pediatric preparedness collaboratives. The resulting pediatric preparedness healthcare coalition (PPHC) framework identifies and explains the operational constructs important to coalition-building in the context of pediatric preparedness. Seventeen of 25 proposed measures across seven domains were evaluated by both the expert panel and coalition membership. Measures in four of the seven proposed domains were not sufficiently correlated to support the hypothesized interaction of framework elements. Pilot survey data were useful in establishing differences in perceived or attributed importance of the measures between groups. The study considered organization type, leadership status, and the respondent's level of participation in the coalition. Ultimately, the framework provides a foundation for describing components of pediatric preparedness coalition building, but further research is needed to explain the relationships between the model constructs.

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