Hurricanes and Storms: From Preparedness to Recovery,
Strategies for a Brighter Future
Wednesday, August 8, 20184:00pm ET/3:00pm CT
Scott Needle, MD, FAAPDavid Schonfeld, MD, FAAPDisaster Preparedness Advisory Council
WEBINAR SPONSORS
OBJECTIVES
1. Recognize situations that pediatricians as well as families are still facing specific to recovery from the 2017 hurricanes.
2. Identify steps that can be taken to improve preparedness for hurricane recovery (for offices as well as patients/families).
3. Outline the common symptoms of adjustment reactions in children and adolescents that may occur in response to a disaster.
4. Describe the timeline for coping over time and the importance of long-term support.
5. Appreciate the importance of professional self-care and list strategies clinicians can use to promote wellness for themselves and colleagues.
6. Outline 5-10 ways that pediatricians can improve outcomes for children and families during disaster recovery.
7. Identify 3 resources to improve pediatric capabilities in hurricane recovery.
TECHNICAL SUPPORT
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PRA CREDITS STATEMENT
• The American Academy of Pediatrics (AAP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
• The AAP designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
• This activity is acceptable for a maximum of 1.0 AAP credits. These credits can be applied toward the AAP CME/CPD Award available to Fellows and Candidate Members of the American Academy of Pediatrics.
• The American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME. Physician assistants may receive a maximum of 1.0 hours of Category 1 credit for completing this program.
• This program is accredited for 1.0 NAPNAP CE contact hours of which 0 contain pharmacology (Rx) content, (0 related to psychopharmacology) (0 related to controlled substances), per the National Association of Pediatric Nurse Practitioners (NAPNAP) Continuing Education Guidelines.
CME/MOC
• Successful completion of this CME activity, which includes participation in the activity, with individual assessments of the participant and feedback to the participant, enables the participant to earn 1 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABP MOC credit.
FACULTY
David J Schonfeld, MD, FAAPDirector, National Center for School Crisis and Bereavement
Professor of the Practice, Suzanne Dworak-Peck School of Social Work and Department of Pediatrics, USC and CHLA
Member, American Academy of PediatricsDisaster Preparedness Advisory Council
Insert Photo Here
FACULTY
Scott Needle, MD, FAAPCommunity Pediatrician and Medical DirectorHealthcare Network of Southwest Florida
Member, American Academy of PediatricsDisaster Preparedness Advisory Council
DISCLOSURES
• The presenters have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider of commercial services discussed in this activity.
• The presenters do not intend to discuss an unapproved/investigative use of a commercial product/device in this presentation.
2017: HARVEY, IRMA, MARIA
2017: A YEAR OF DISASTERS
137 Major Disaster Declarations• 34 states• Puerto Rico, Virgin Islands
• Hurricanes• Flooding• Wildfires• Mass shootings
THE EFFECTS OF DISASTERS
• Morbidity and mortality
• Economic loss
• Long-term suffering
• Disruption of healthcare
• Economic loss
• Provider stress
GOALS OF RECOVERY
Return to normalcy
Reduce suffering
Promote resiliency
Get back to helping others
RETURN TO OPERATIONS
Space Staff
Stuff Security
Services
COMMUNICATIONS
• Getting the word out
• Services, hours, and locations
• What families can do
VACCINES
• Keep all vials!
• Insurance: spoilage
• Private: return for credit
• VFC: return for exchange
PRACTICE RECOVERY: RESOURCES
• AAP Chapter
• Business insurance
– Material losses
– Loss of income
• Local government, Chamber of Commerce
• Be your own advocate!
WHAT TO EXPECT (WHEN YOU’RE PRACTICING AFTER DISASTER)
• Food
• Water
• Shelter
• Children’s needs
Basic needs
• Medicines
• Equipment
• Functioning
• Flares
Chronic conditions
• Derm
• Respiratory
• Injury
• Exposure
• GI
Acute concerns
THE MEDICAL HOME AND TRANSITIONING FROM RESPONSE TO
RECOVERY
• Normalcy
• Familiarity
• Best healthcare setting
• Coordination of services
• Address the chronic needs of recovery
HOW TO HELP
• Assist and support families
– Individually
– Across the practice
• Anticipate needs and concerns
• Monitor for developments
• Advocate for children
HOW TO HELP
• Care for yourself
• Learn, revise, and prepare
– Preparedness Checklist for Pediatric Practices
– Ensuring the Health of Children in Disasters
Supporting the recovery of
children, families and yourself
David J Schonfeld, MD, FAAPSuzanne Dworak-Peck
School of Social Work and PediatricsUniversity of Southern California and
Children’s Hospital Los [email protected]
Director, National Center for School Crisis and Bereavementwww.schoolcrisiscenter.org
1-877-536-NCSCB (1-877-536-2722)www.grievingstudents.org
National Center for School Crisis and Bereavement
• I have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider of commercial products or services discussed in this CME activity
• I do not intend to discuss unapproved/investigative use of commercial product(s)/device(s) in my presentation
National Center for School Crisis and Bereavement
• Cascade of secondary losses and stressors– Relocation– Loss of peer network– Academic failure– New social network – Financial stresses– Parental stress, mental health problems– Marital conflict or domestic violence
• Don’t focus solely on post-traumatic symptoms from the events immediately surrounding the crisis
• Explore how they are coping now in light of current stressors
Range of Reactions to Crisis
National Center for School Crisis and Bereavement
• Sleep problems
• Separation anxiety and school avoidance
• Anxiety and trauma-related fears
• Difficulties with concentration
• Deterioration in academic performance
• Regression
• Depression
• Substance abuse
• Somatization
• Trauma symptoms/post-traumatic stress disorder
Potential Symptoms of Adjustment Reactions
National Center for School Crisis and Bereavement
National Center for School Crisis and Bereavement
A B
C
D E
FG
H
I
A = baseline functioningB = eventC = vulnerable stateD = usual coping mechanisms failE = helplessness, hopelessnessF = improved functioning
G = continued impairmentH = return to baselineI = post-traumatic growth
Adjustment Over Time in Crisis
National Center for School Crisis and Bereavement
Importance of Professional Self-Care
• It is distressing to be with children who are in distress
• It’s critical health care providers find ways to have their own personal needs met and appreciate and address impact of supporting children who are grieving or traumatized
National Center for School Crisis and Bereavement
Supporting Those Most in Need can be Gratifying
• Realistic objectives of purpose of interactions
• Health care providers have skills and resources to provide meaningful assistance
• Health care providers are aware of and have sufficient support to deal with personal impact of work
• Especially difficult in austere environment and when you have other challenges
National Center for School Crisis and Bereavement
Support for Staff
• Organizational support
– Additional support staff
– Modify workload, expectations, schedule
– Supportive supervision
– Professional development
– Employee Assistance Program
• Family and peer support
– Inclusion of spouses/significant others in meetings
– Bring staff together for social reasons – preserve cohesion
– Celebrate successes
National Center for School Crisis and Bereavement
Challenges to Self-Care
• Making time when there is so much to do and everyone needs your help
• Feeling shame or guilt for attending to your own needs
• Assuming others are having less trouble adjusting
• Lack of modeling of professional self-care
National Center for School Crisis and Bereavement
National Center for School Crisis and Bereavementwww.schoolcrisiscenter.org
Coalition to Support Grieving Studentswww.grievingstudents.org
AAP Children and Disasters – www.aap.org/disasters
– Coping and adjustment: www.aap.org/disasters/adjustment
Website Resources
National Center for School Crisis and Bereavement
www.schoolcrisiscenter.org
National Center for School Crisis and Bereavement
www.grievingstudents.org
National Center for School Crisis and Bereavement
For further information about NCSCB
visit us, call us, like us, share us:
facebook.com/schoolcrisisorg
@schoolcrisisorg
National Center for School Crisis and Bereavement
www.SchoolCrisisCenter.org | [email protected]
1-888-53-NCSCB (1-888-536-2722)
RESOURCES
• AAP Children & Disasters Web Site (www.aap.org/disasters)
• AAP Hurricane Preparedness Web Page (www.aap.org/disasters/hurricane)
• AAP Hurricane Response and Recovery Web Page (www.aap.org/disastersrecovery)
CME/MOC CREDIT
• Complete the post activity survey.
• Only physicians can claim MOC Part 2 credit. A quiz for MOC Part 2 credit will be included in the post activity survey.
• Physicians must identify their ABP ID number.
AAP staff will email each person claiming CME/MOC 2 credit with their certificate of completion. Email [email protected] with any questions.
QUESTIONS?
Please e-mail [email protected] to receive info on future events, or follow-up as needed.