Developing disaster health preparedness in Australia

Disasters have always occu[r]ed and no civilization in history is immune from their effects. This thesis examines the major elements of health system preparedness for disaster response in Australia and the issues that impact on this. The thesis aim is to identify factors that can be targeted to improve preparedness for response.\ud \ud A conceptual model is presented as the framework for the thesis, which incorporates the major variables involved. These are the type of disaster, which influences the nature of response; the scale of the disaster, which influences the size of the response; and the components of surge management – space, supplies, staff and system, which enable the response.\ud \ud The thesis is presented in three parts, consistent with the conceptual model. The literature review (Chapter 2) outlines existing work and the current state of knowledge. Separate chapters (Chapter 3-5) for local, national and international response are mapped against examples of the main disaster types (natural; man-made; mixed). Chapter 6 then collates the findings to form conclusions and identify future directions. In all, 26 publications are submitted as the core of the thesis, comprised of two editorials, three monographs, one textbook chapter and 20 peer reviewed research papers. Novel sources of data are used, including the first published survey of the disaster preparedness of Australian Emergency Departments (ED), the first study looking at the impact of Pandemic H1N1 2009 on Australian EDs and the first survey of Australian health team members deployed internationally.\ud \ud A number of recommendations are presented and mapped against models such as the surge management paradigm, the comprehensive approach to disaster management, Haddon's matrix and the Input, Throughput, Output model for ED care. Three of these are combined to form a novel integrated model that can be used as a tool to help understand, prepare for, and respond to disasters.\ud \ud The thesis has multiple direct links to policy and practice, with a number of findings already translated into practice or used to inform system development. This has occurred across local, state, national and international preparedness. It is hoped that the findings of this thesis, and its associated outputs, will continue to help inform future emergency preparedness and contribute to further improvements in the care provided to the victims of disasters