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U.S. Department of Health and Human Services

Goal 5: Improve Health Outcomes from Disasters by Strengthening the Ability of our Nation's Health Care System to Effectively Respond and Recover

Health care, including behavioral health, is an essential component of national health security. All private and public sector health care facilities must be able to maintain operations, provide patient care, and anticipate increased demand for service during disasters and public health emergencies. Health care facilities that routinely provide efficient and effective care are better able to support an effective response to and recovery from health incidents. While implementation of the Affordable Care Act will improve access to day-to-day care, an essential source of surge capacity is the ability to develop policies that facilitate the delivery of care at the most efficient, safe, and appropriate level. When incidents happen, adapting to the unanticipated requires an integrated effort from all parts of the health care delivery system, and this integrated effort is strengthened by regular day to day use. The challenges of cost, quality, and access that health systems experience daily are amplified during a disaster. Health care and emergency response systems must work better—and work better together—every day. Similarly, the interdependence of health care, public health, and emergency management systems cannot be overstated and their integration is essential to achieving national health security.
ASPR has several responsibilities that support the goal of prepared health care systems. ASPR provides policy leadership to develop a collective national vision for improving the preparedness and integration of health care delivery systems, including emergency care systems, and also has several programs that help to operationalize and continuously improve this vision. Most notably, the Hospital Preparedness Program plays a fundamental role by providing funding to improve healthcare preparedness capabilities and enhance community, regional, and national healthcare preparedness.   


  • Identify opportunities to integrate preparedness activities with routine health care delivery to meet the demands created by current or future disaster threats. Proposed activities:
    • ASPR will work with HHS partners in CMS, Agency for Healthcare Research and Quality (AHRQ), and Health Resources and Services Administration (HRSA) to better define preparedness and daily delivery of care linkages, including evidence based capabilities and measures [OEM, OPP];
    • ASPR will work with all partners to promote regulations and standards that integrate healthcare emergency preparedness [OEM, OPP];
    • ASPR will work with CMS to promote Conditions of Participation that include emergency preparedness [OEM, OPP].
Outcome: Legislative, departmental, state, and local healthcare policy and regulations include health preparedness concepts and validated measures that foster improved community health response.
  • Develop a resilient national healthcare system that is coordinated to meet state, regional, and national needs in emergencies that are population- and evidence-based, financially sustainable, and outcome driven. Proposed activities:
    • In coordination with the CDC, ASPR will revise HPP’s and PHEP’s technical assistance strategies based on evaluation analysis. Improved technical assistance will allow awardees to better achieve public health and healthcare preparedness capabilities [OEM, OPP];
    • In coordination with the CDC, ASPR will review its data collection methods to collect more accurate data and reduce awardee burden. ASPR will shift some of its data collection methods from qualitative to quantitative data and provide standardized templates to increase precision, better inform baseline data, and track awardee progress over time [OEM, OPP];
    • ASPR and the CDC will better align their program and evaluation branches, which will collaborate on setting targets for capabilities that connect to objectives and outcomes. After establishing program baselines, evaluation and program staff will develop targets. ASPR and CDC staff will work together to integrate the program and evaluation aspects of joint preparedness capabilities [OEM, OPP]; 
    • ASPR and the CDC will consider improvements to their joint Funding Opportunity Announcement that will include concrete goals and tiering of activities that will help awardees create individualized roadmaps towards achieving the desired healthcare and public health preparedness capabilities [OEM, OPP]. 
Outcome: A sustainable, integrated, and scalable healthcare system that is able to provide appropriate care to all patients during and after a disaster. Additionally, ASPR successfully develops and releases evidence-based national guidelines, support tools, and measures; community appropriate technical assistance; and funding to improve healthcare system resilience resulting in improved health outcomes.
  • Support the transformation to a patient- and community-centered emergency care system that is integrated into the broader healthcare system, high quality, and prepared to respond in times of public health emergencies. Proposed activities will take place in three key domains:
    • Domain 1: Patient and Community Centered emergency care:
      • Determine and articulate strategic priorities related to patient centered outcomes in acute care [OPP, OEM];
      • Convene a meeting of stakeholders interested in developing an evidence-based system to understand the acute care capabilities of hospitals so as to improve patient decision making, EMS protocols, and healthcare coalition development [OPP, OEM];
      • Support efforts of emergency care training to bridge hospitals and communities through education initiatives focused on emergency care related public health initiatives (e.g. trauma first aid for teachers and schools) [OPP, OEM].
    • Domain 2: Integration of emergency care into the broader healthcare system:
      • Provide leadership and policy coordination for emergency care activities at HHS (HRSA, CDC, AHRQ, National Institutes of Health (NIH)) [OPP, OEM];
      • Convene a meeting of stakeholders engaged in the delivery and payment of scheduled and unscheduled acute care delivery, to develop a conceptual model for ideal acute care delivery [OPP, OEM].
    • Domain 3: Delivery of high quality emergency care:
      • Develop a report on the relationship between geography and acute care utilization, planning, and outcomes [OPP, OEM]; 
      • Work collaboratively to define how emergency care systems can be measured at the community level [OPP, OEM].
Outcome: A regionalized, coordinated, and accountable emergency care system that is fully integrated into the health care system and able to respond to and recover from disasters and public health emergencies.
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  • This page last reviewed: February 18, 2014