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Development of a Proof-of-Concept Multi-Method Computer Simulation to Support rural healthcare Disaster Preparedness Planning

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International Journal of Disaster Risk Science 2024年第3期15卷 346-358页

作者： Thomas A.Berg Kristina W.Kintziger Julie Suzuki Crumly Scott A.Lawson Carole R.Myers Tracey T.Stansberry College of Nursing University of Tennessee Knoxville Department of Environmental Agricultural and Occupational Health University of Nebraska Medical Center Public Health and healthcare Oak Ridge Associated Universities

Due to a lack of resources, rural communities often face challenges when planning catastrophic events. This project involved applying systems thinking and model-based systems engineering to develop a proof-of-concept, multi-method computer simulation and then determining whether the simulation could be used to assess the efficacy of disaster planning approaches on health outcomes in rural communities, as a function of primary healthcare. The project focus was a rural or non-urban healthcare system experiencing a natural hazard. Both system dynamics and discrete event models were incorporated to represent subsystem operations, crucial disaster responses, as well as three key response systems: public health, emergency management, and healthcare. The subsystem models included several components: policies/procedures, communications,resources, exercises/drills/training, healthcare space and staff, and the flow of affected people into and through the *** combined simulation can serve as a first step to a more comprehensive approach to helping rural communities achieve more efficient and effective healthcare planning for disaster responses.

关键词： Computer simulation Disaster preparedness Model-based systems engineering rural healthcare System dynamics model Systems thinking

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The Application of Model-Based Systems Engineering to rural healthcare System Disaster Planning:A Scoping Review

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International Journal of Disaster Risk Science 2023年第3期14卷 357-368页

作者： Thomas A.Berg Kelsi N.Marino Kristina W.Kintziger College of Nursing University of Tennessee-KnoxvilleKnoxvilleTN37966USA College of Public Health University of Nebraska Medical CenterOmahaNE68198USA

Disasters and other emergency events have complex effects on human systems,particularly if the events are severe or *** these types of events happen in rural communities,the resources of the local public health,healthcare,and emergency response organizations can be quickly depleted or *** for emergencies can help to mitigate their ***-based systems engineering(MBSE)methods,including computer simulations,can provide insight on how best to prepare for these events and to explore the effects of varying approaches and resource *** best apply these methods for improving disaster management in rural settings,a synthesis of the current body of evidence in this field is *** objective of this scoping review was to provide a descriptive overview of the application of computer simulation based on MBSE approaches to disaster preparedness and response for rural healthcare *** studies met inclusion criteria,and varied in terms of MBSE method used,healthcare setting,and disaster type and context *** identified a gap in the research regarding the application of MBSE approaches to support rural healthcare disaster preparedness planning ***-based systems engineering and systems thinking,therefore,represent novel methods for developing tools and computational simulations that could assist rural communities better prepare for disasters.

关键词： Computer simulation Disaster preparedness Model-based systems engineering rural healthcare Systems thinking

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Integrated primary care-behavioral health program development and implementation in a rural context

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Family Medicine and Community Health 2018年第3期6卷 131-141页

作者： Kendra Campbell Loren McKnight Angel R.Vasquez Department of Psychology University of Alaska FairbanksFairbanksAKUSA

Objective:Despite the known benefits of integrated primary care and behavioral health services,integrated behavioral health services have not been readily used in medical clinics in interior *** minimal resources,we recently developed an integrated primary care-behavioral health program in a medical clinic in interior Alaska to meet clinic and community *** objective of this study was to explore initial program outcomes and determine the feasibility of program development and ***:We initially conducted a needs assessment for integrating behavioral health services into primary *** development was informed by specific clinic *** program implementation,initial program outcomes were tracked with use of data from the electronic health record and patient and provider use and satisfaction *** level of integration of primary care and behavioral health services was evaluated with the Practice Integration ***:A total of 188 patients were seen by behavioral health consultants during the initial pilot phase,including 44.0%referred for mental health symptoms,33.1%referred for physical health issues,and 22.3%referred for both mental and physical health *** initial program outcomes indicate modest clinical improvement(measured by the nine-item Patient Health Questionnaire)as well as patient and provider satisfaction with the model,and a moderate level of practice ***:On the basis of the initial findings,it appears that our integrated primary care-behavioral health program has the potential to serve an important role in addressing the behavioral health needs of the local *** implementation procedure and initial program outcomes suggest that such models are feasible in rural and small-scale settings with minimal overhead costs.

关键词： Integrated healthcare primary care behavioral health program development rural healthcare

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