The state of emergency management 2000: The process of emergency management professionalization in the United States and Florida

This dissertation analyzes the current status of emergency management professionalization in the United States and Florida using a qualitative case study. I investigate the efforts of various organizations at the national and state levels in the private and public sectors to organize emergency management as a profession. I conceptualize emergency management professionalization as occurring in two phases: the indirect institutionalization of the occupation of emergency management and the formal advancement toward an emergency management profession. The legislative, organizational, and procedural developments that occurred between approximately 1900 and the late 1970s became the indirect institutionalization of the occupation of emergency management. Over time, as our society developed and became increasingly complex, more disasters affect the security of the population. In order to adapt to increasing risks and vulnerabilities the emergency management system emerged and with it the necessary elements upon which a future profession could be established providing the basis for the formal advancement toward an emergency management profession. ^ During approximately the last twenty years, the formal advancement toward an emergency management profession has encompassed two primary strategies—certification and accreditation—motivated by the objective to organize a profession. Certification applies to individual emergency managers and includes all training and education. Accreditation of state and local emergency management agencies is reached by complying to a minimum level of proficiency with established standards of performance. Certification and accreditation are the mechanisms used to create an emergency management profession and thus act as axes around which the field of emergency management is organizing. ^ The purpose of this research is to provide a frame of reference for whether or not the field of emergency management is a profession. Based on sociology of professions literature, emergency management can be considered to be professionalizing. The current emergency management professionalization efforts may or may not be sufficient to achieve the ultimate goal of becoming a legitimate profession based on legal and public support for the exclusive right to perform emergency management tasks (monopoly) as well as self-regulation of those tasks (autonomy). ^

Effective knowledge integration in emergency response organizations

Natural and man-made disasters have gained attention at all levels of policy-making in recent years. Emergency management tasks are inherently complex and unpredictable, and often require coordination among multiple organizations across different levels and locations. Effectively managing various knowledge areas and the organizations involved has become a critical emergency management success factor. However, there is a general lack of understanding about how to describe and assess the complex nature of emergency management tasks and how knowledge integration can help managers improve emergency management task performance. ^ The purpose of this exploratory research was first, to understand how emergency management operations are impacted by tasks that are complex and inter-organizational and second, to investigate how knowledge integration as a particular knowledge management strategy can improve the efficiency and effectiveness of the emergency tasks. Three types of specific knowledge were considered: context-specific, technology-specific, and context-and-technology-specific. ^ The research setting was the Miami-Dade Emergency Operations Center (EOC) and the study was based on the survey responses from the participants in past EOC activations related to their emergency tasks and knowledge areas. The data included task attributes related to complexity, knowledge area, knowledge integration, specificity of knowledge, and task performance. The data was analyzed using multiple linear regressions and path analyses, to (1) examine the relationships between task complexity, knowledge integration, and performance, (2) the moderating effects of each type of specific knowledge on the relationship between task complexity and performance, and (3) the mediating role of knowledge integration. ^ As per theory-based propositions, the results indicated that overall component complexity and interactive complexity tend to have a negative effect on task performance. But surprisingly, procedural rigidity tended to have a positive effect on performance in emergency management tasks. Also as per our expectation, knowledge integration had a positive relationship with task performance. Interestingly, the moderating effects of each type of specific knowledge on the relationship between task complexity and performance were varied and the extent of mediation of knowledge integration depended on the dimension of task complexity. ^

Effective Knowledge Integration in Emergency Response Organizations

Natural and man-made disasters have gained attention at all levels of policy-making in recent years. Emergency management tasks are inherently complex and unpredictable, and often require coordination among multiple organizations across different levels and locations. Effectively managing various knowledge areas and the organizations involved has become a critical emergency management success factor. However, there is a general lack of understanding about how to describe and assess the complex nature of emergency management tasks and how knowledge integration can help managers improve emergency management task performance. The purpose of this exploratory research was first, to understand how emergency management operations are impacted by tasks that are complex and inter-organizational and second, to investigate how knowledge integration as a particular knowledge management strategy can improve the efficiency and effectiveness of the emergency tasks. Three types of specific knowledge were considered: context-specific, technology-specific, and context-and-technology-specific. The research setting was the Miami-Dade Emergency Operations Center (EOC) and the study was based on the survey responses from the participants in past EOC activations related to their emergency tasks and knowledge areas. The data included task attributes related to complexity, knowledge area, knowledge integration, specificity of knowledge, and task performance. The data was analyzed using multiple linear regressions and path analyses, to (1) examine the relationships between task complexity, knowledge integration, and performance, (2) the moderating effects of each type of specific knowledge on the relationship between task complexity and performance, and (3) the mediating role of knowledge integration. As per theory-based propositions, the results indicated that overall component complexity and interactive complexity tend to have a negative effect on task performance. But surprisingly, procedural rigidity tended to have a positive effect on performance in emergency management tasks. Also as per our expectation, knowledge integration had a positive relationship with task performance. Interestingly, the moderating effects of each type of specific knowledge on the relationship between task complexity and performance were varied and the extent of mediation of knowledge integration depended on the dimension of task complexity.

A Markov chain location-allocation meta-model for hurricane relief

An emergency is a deviation from a planned course of events that endangers people, properties, or the environment. It can be described as an unexpected event that causes economic damage, destruction, and human suffering. When a disaster happens, Emergency Managers are expected to have a response plan to most likely disaster scenarios. Unlike earthquakes and terrorist attacks, a hurricane response plan can be activated ahead of time, since a hurricane is predicted at least five days before it makes landfall. This research looked into the logistics aspects of the problem, in an attempt to develop a hurricane relief distribution network model. We addressed the problem of how to efficiently and effectively deliver basic relief goods to victims of a hurricane disaster. Specifically, where to preposition State Staging Areas (SSA), which Points of Distributions (PODs) to activate, and the allocation of commodities to each POD. Previous research has addressed several of these issues, but not with the incorporation of the random behavior of the hurricane's intensity and path. This research presents a stochastic meta-model that deals with the location of SSAs and the allocation of commodities. The novelty of the model is that it treats the strength and path of the hurricane as stochastic processes, and models them as Discrete Markov Chains. The demand is also treated as stochastic parameter because it depends on the stochastic behavior of the hurricane. However, for the meta-model, the demand is an input that is determined using Hazards United States (HAZUS), a software developed by the Federal Emergency Management Agency (FEMA) that estimates losses due to hurricanes and floods. A solution heuristic has been developed based on simulated annealing. Since the meta-model is a multi-objective problem, the heuristic is a multi-objective simulated annealing (MOSA), in which the initial solution and the cooling rate were determined via a Design of Experiments. The experiment showed that the initial temperature (T0) is irrelevant, but temperature reduction (δ) must be very gradual. Assessment of the meta-model indicates that the Markov Chains performed as well or better than forecasts made by the National Hurricane Center (NHC). Tests of the MOSA showed that it provides solutions in an efficient manner. Thus, an illustrative example shows that the meta-model is practical.

Development of local homeland security networks in the state of Florida: A social network analysis approach

How do local homeland security organizations respond to catastrophic events such as hurricanes and acts of terrorism? Among the most important aspects of this response are these organizations ability to adapt to the uncertain nature of these "focusing events" (Birkland 1997). They are often behind the curve, seeing response as a linear process, when in fact it is a complex, multifaceted process that requires understanding the interactions between the fiscal pressures facing local governments, the institutional pressures of working within a new regulatory framework and the political pressures of bringing together different levels of government with different perspectives and agendas. ^ This dissertation has focused on tracing the factors affecting the individuals and institutions planning, preparing, responding and recovering from natural and man-made disasters. Using social network analysis, my study analyzes the interactions between the individuals and institutions that respond to these "focusing events." In practice, it is the combination of budgetary, institutional, and political pressures or constraints interacting with each other which resembles a Complex Adaptive System (CAS). ^ To investigate this system, my study evaluates the evolution of two separate sets of organizations composed of first responders (Fire Chiefs, Emergency Management Coordinators) and community volunteers organized in the state of Florida over the last fifteen years. Using a social network analysis approach, my dissertation analyzes the interactions between Citizen Corps Councils (CCCs) and Community Emergency Response Teams (CERTs) in the state of Florida from 1996–2011. It is the pattern of interconnections that occur over time that are the focus of this study. ^ The social network analysis revealed an increase in the amount and density of connections between these organizations over the last fifteen years. The analysis also exposed the underlying patterns in these connections; that as the networks became more complex they also became more decentralized though not in any uniform manner. The present study brings to light a story of how communities have adapted to the ever changing circumstances that are sine qua non of natural and man-made disasters.^

A State and Territorial Survey Regarding Utilization of Environmental Health Shelter Assessments during Disasters, and a Secondary Analysis of Available Shelter Assessment Data

Disasters are complex events characterized by damage to key infrastructure and population displacements into disaster shelters. Assessing the living environment in shelters during disasters is a crucial health security concern. Until now, jurisdictional knowledge and preparedness on those assessment methods, or deficiencies found in shelters is limited. A cross-sectional survey (STUSA survey) ascertained knowledge and preparedness for those assessments in all 50 states, DC, and 5 US territories. Descriptive analysis of overall knowledge and preparedness was performed. Fisher’s exact statistics analyzed differences between two groups: jurisdiction type and population size. Two logistic regression models analyzed earthquakes and hurricane risks as predictors of knowledge and preparedness. A convenience sample of state shelter assessments records (n=116) was analyzed to describe environmental health deficiencies found during selected events. Overall, 55 (98%) of jurisdictions responded (states and territories) and appeared to be knowledgeable of these assessments (states 92%, territories 100%, p = 1.000), and engaged in disaster planning with shelter partners (states 96%, territories 83%, p = 0.564). Few had shelter assessment procedures (states 53%, territories 50%, p = 1.000); or training in disaster shelter assessments (states 41%, 60% territories, p = 0.638). Knowledge or preparedness was not predicted by disaster risks, population size, and jurisdiction type in neither model. Knowledge: hurricane (Adjusted OR 0.69, 95% C.I. 0.06-7.88); earthquake (OR 0.82, 95% C.I. 0.17-4.06); and both risks (OR 1.44, 95% C.I. 0.24-8.63); preparedness model: hurricane (OR 1.91, 95% C.I. 0.06-20.69); earthquake (OR 0.47, 95% C.I. 0.7-3.17); and both risks (OR 0.50, 95% C.I. 0.06-3.94). Environmental health deficiencies documented in shelter assessments occurred mostly in: sanitation (30%); facility (17%); food (15%); and sleeping areas (12%); and during ice storms and tornadoes. More research is needed in the area of environmental health assessments of disaster shelters, particularly, in those areas that may provide better insight into the living environment of all shelter occupants and potential effects in disaster morbidity and mortality. Also, to evaluate the effectiveness and usefulness of these assessments methods and the data available on environmental health deficiencies in risk management to protect those at greater risk in shelter facilities during disasters.

Factors affecting emergency department length of stay of patients admitted to telemetry and critical care units

The purpose of this study was to determine the emergency department (ED) length of stay (LOS) of patients admitted to inpatient telemetry and critical care units and to identify the factors that contribute to a prolonged ED LOS. It also examined whether there was a difference in ED LOS between clients evaluated by an ED physician, an Advanced Registered Nurse Practitioner (ARNP) or a Physician's Assistant (PA).^ A data collection tool was devised and used to record data obtained by retrospectively reviewing 110 charts of patients from this sample. The mean ED LOS was 286.75 minutes. Multiple factors were recorded as affecting the ED LOS of this sample, including: age, diagnosis, consultations, multiple radiographs, pending admission orders, nurse unable to call report/busy, relatives at bedside, observation or stabilization necessary, bed not ready and infusion in progress. No significant difference in ED LOS was noted between subjects initially evaluated by a physician, an ARNP or a PA. ^

Fever, methods of fever management, and caretakers' perceptions of pediatric after-hour telephone triage and advice services for children between the ages of twelve months and three years with fever

Despite the frequency with which fevers occur in children ages 1–3 years, lack of knowledge and understanding about the implications of fever and methods of fever management often results in anxiety among caretakers, sometimes prompting them to seek help at nearby emergency departments. Caretakers often look to health care professionals for advice and guidance over the telephone. The purpose of this study was to investigate caretakers' knowledge of the implications of fever, methods of fever management, perceptions of pediatric telephone triage and advice services regarding fever, and the effectiveness of after hour telephone triage directed toward improving the caretakers' ability to manage their child's fever at home. Pre-triage questionnaires were completed by 72 caretakers over the telephone before the triage encounter. Twenty-two of those same caretakers whose children were triaged using the fever guideline completed and returned the mailed post-triage questionnaire. Descriptive statistics were used to analyze responses for the larger pre-intervention group and describe comparisons for the pre and post-triage responses in the smaller sample subset (n = 22). ^

A study on uncertain dynamic disaster management tasks, knowledge sharing, and task performance

Each disaster presents itself with a unique set of characteristics that are hard to determine a priori. Thus disaster management tasks are inherently uncertain, requiring knowledge sharing and quick decision making that involves coordination across different levels and collaborators. While there has been an increasing interest among both researchers and practitioners in utilizing knowledge management to improve disaster management, little research has been reported about how to assess the dynamic nature of disaster management tasks, and what kinds of knowledge sharing are appropriate for different dimensions of task uncertainty characteristics. ^ Using combinations of qualitative and quantitative methods, this research study developed the dimensions and their corresponding measures of the uncertain dynamic characteristics of disaster management tasks and tested the relationships between the various dimensions of uncertain dynamic disaster management tasks and task performance through the moderating and mediating effects of knowledge sharing. ^ Furthermore, this research work conceptualized and assessed task uncertainty along three dimensions: novelty, unanalyzability, and significance; knowledge sharing along two dimensions: knowledge sharing purposes and knowledge sharing mechanisms; and task performance along two dimensions: task effectiveness and task efficiency. Analysis results of survey data collected from Miami-Dade County emergency managers suggested that knowledge sharing purposes and knowledge sharing mechanisms moderate and mediate uncertain dynamic disaster management task and task performance. Implications for research and practice as well directions for future research are discussed.^

Disaster Risk Management Disparity in the Caribbean: Evidence from Barbados, Dominican Republic, Jamaica and Trinidad and Tobago

This study on risk and disaster management capacities of four Caribbean countries: Barbados, the Dominican Republic, Jamaica, and Trinidad and Tobago, examines three main dimensions: 1) the impact of natural disasters from 1900 to 2010 (number of events, number of people killed, total number affected, and damage in US$); 2) institutional assessments of disaster risk management disparity; and 3) the 2010 Inter-American Bank for Development (IADB) Disaster Risk and Risk Management indicators for the countries under study. The results show high consistency among the different sources examined, pointing out the need to extend the IADB measurements to the rest of the Caribbean countries. Indexes and indicators constitute a comparison measure vis-à-vis existing benchmarks in order to anticipate a capacity to deal with adverse events and their consequences; however, the indexes and indicators could only be tested against the occurrence of a real event. Therefore, the need exists to establish a sustainable and comprehensive evaluation system after important disasters to assess a country‘s performance, verify the indicators, and gain feedback on measurement systems and methodologies. There is diversity in emergency and preparedness for disasters in the four countries under study. The nature of the event (hurricanes, earthquakes, floods, and seismic activity), especially its frequency and the intensity of the damage experienced, is related to how each has designed its risk and disaster management policies and programs to face natural disasters. Vulnerabilities to disaster risks have been increasing, among other factors, because of uncontrolled urbanization, demographic density and poverty increase, social and economic marginalization, and lack of building code enforcement. The four countries under study have shown improvements in risk management capabilities, yet they are far from being completed prepared. Barbados‘ risk management performance is superior, in comparison, to the majority of the countries of the region. However, is still far in achieving high performance levels and sustainability in risk management, primarily when it has the highest gap between potential macroeconomic and financial losses and the ability to face them. The Dominican Republic has shown steady risk performance up to 2008, but two remaining areas for improvement are hazard monitoring and early warning systems. Jamaica has made uneven advances between 1990 and 2008, requiring significant improvements to achieve high performance levels and sustainability in risk management, as well as macroeconomic mitigation infrastructure. Trinidad and Tobago has the lowest risk management score of the 15 countries in the Latin American and Caribbean region as assessed by the IADB study in 2010, yet it has experienced an important vulnerability reduction. In sum, the results confirmed the high disaster risk management disparity in the Caribbean region.

Disater Risk Management Disparity in the Caribbean: Evidence from Barbados, Dominican Republic, Jamaica and Trinidad and Tobago

This study on risk and disaster management capacities of four Caribbean countries: Barbados, the Dominican Republic, Jamaica, and Trinidad and Tobago, examines three main dimensions: 1) the impact of natural disasters from 1900 to 2010 (number of events, number of people killed, total number affected, and damage in US$); 2) institutional assessments of disaster risk management disparity; and 3) the 2010 Inter-American Bank for Development (IADB) Disaster Risk and Risk Management indicators for the countries under study. The results show high consistency among the different sources examined, pointing out the need to extend the IADB measurements to the rest of the Caribbean countries. Indexes and indicators constitute a comparison measure vis-à-vis existing benchmarks in order to anticipate a capacity to deal with adverse events and their consequences; however, the indexes and indicators could only be tested against the occurrence of a real event. Therefore, the need exists to establish a sustainable and comprehensive evaluation system after important disasters to assess a country’s performance, verify the indicators, and gain feedback on measurement systems and methodologies. There is diversity in emergency and preparedness for disasters in the four countries under study. The nature of the event (hurricanes, earthquakes, floods, and seismic activity), especially its frequency and the intensity of the damage experienced, is related to how each has designed its risk and disaster management policies and programs to face natural disasters. Vulnerabilities to disaster risks have been increasing, among other factors, because of uncontrolled urbanization, demographic density and poverty increase, social and economic marginalization, and lack of building code enforcement. The four countries under study have shown improvements in risk management capabilities, yet they are far from being completed prepared. Barbados’ risk management performance is superior, in comparison, to the majority of the countries of the region. However, is still far in achieving high performance levels and sustainability in risk management, primarily when it has the highest gap between potential macroeconomic and financial losses and the ability to face them. The Dominican Republic has shown steady risk performance up to 2008, but two remaining areas for improvement are hazard monitoring and early warning systems. Jamaica has made uneven advances between 1990 and 2008, requiring significant improvements to achieve high performance levels and sustainability in risk management, as well as macroeconomic mitigation infrastructure. Trinidad and Tobago has the lowest risk management score of the 15 countries in the Latin American and Caribbean region as assessed by the IADB study in 2010, yet it has experienced an important vulnerability reduction. In sum, the results confirmed the high disaster risk management disparity in the Caribbean region.