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Using Exercises to Identify Veterans Health Administration Priorities for Disaster Response: Findings From the New Madrid Earthquake Training Exercise

Gin, June L. PhD; Chan, Edward W. PhD; Brewster, Pete BS; Mitchell, Michael N. PhD; Ricci, Karen A. MPH, RN; Afable, Melissa K. BS; Dobalian, Aram PhD, JD

Journal of Public Health Management and Practice: March/April 2013 - Volume 19 - Issue 2 - p 126–132
doi: 10.1097/PHH.0b013e318256142a
Original Articles

Emergency managers are often charged with prioritizing the relative importance of key issues and tasks associated with disaster response. However, little work has been done to identify specific ways that the decision-making process can be improved. This exercise was conducted with 220 employees of the US Department of Veterans Affairs, who were asked to assign priority rankings to a list of possible options of the most important issues to address after a hypothetical disaster scenario impacting a Veterans Affairs Medical Center. We found that groups that were assigned to represent perspectives farther from the impacted site had less agreement in their identification of the top priorities than those assigned to the impacted facility. These findings suggest that greater geographic and administrative proximity to the impacted site may generate greater clarity and certainty about priority setting. Given the complex structure of many organizations, and the multiple levels of group decision making and coordination likely to be needed during disasters, research to better understand training needs with respect to decision making is essential to improve preparedness. Relatively simple modifications to exercises, as outlined here, could provide valuable information to better understand emergency management decision making across multiple organizational levels.

This study endeavors to identify specific ways by which the decision-making process can be improved among emergency managers using a hypothetical disaster scenario.

Veterans Emergency Management Evaluation Center, North Hills, California (Drs Gin, Chan, Mitchell, and Dobalian and Mses Ricci and Afable); RAND Corporation, Santa Monica, California (Dr Chan); Veterans Health Administration, Office of Emergency Management, Washington, District of Columbia (Mr Brewster); and Department of Health Services, School of Public Health, University of California at Los Angeles (Dr Dobalian).

Correspondence: June L. Gin, PhD, Veterans Emergency Management Evaluation Center, 16111 Plummer St. MS-152, North Hills, CA 91343 (

This material is based on work supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Public Health, and Office of Emergency Management.

The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the US government.

The authors report no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.