Purpose Almost no data exist on how best to respond to the medical needs of civilians displaced by natural disasters. After Hurricane Katrina destroyed the Gulf Coast and seriously damaged the infrastructure of Jackson, Mississippi, in August of 2005, the University of Mississippi Medical Center (UMMC) was challenged with serving a large group of evacuees at a major Red Cross evacuation shelter near our campus. As a part of this experience, we developed a shelter clinic organizational structure that may be useful in future disasters.
Methods Retrospective review of administrative and clinical records for patients served by a medical clinic established emergently after Hurricane Katrina.
Results Faced with numerous evacuees seeking medical assistance, UMMC established an ambulatory clinic at the fairgrounds, where a large American Red Cross shelter was located in Jackson, Mississippi. To facilitate the operation of this clinic, policies and procedures were developed. These include a functional clinic floor plan, medical record data system, job descriptions, and operational agreements for medical, psychiatric, pharmacy, and related services. These policies and procedures facilitated care for almost 2,500 evacuees during 17 days of clinic operation. For instance, the simple floor plan developed allowed triage of patients with referral for adult and pediatric medical and psychiatric care and specialty services, including asthma treatment, within 3,447 square feet. The medical data form allowed rapid accumulation of clinical information necessary for documentation of care and planning of subsequent health care services. An organizational chart with job descriptions was essential.
Conclusion Although medical facilities have emergency response plans for epidemics and mass trauma, little attention has focused on plans for care of evacuated populations. Academic health centers and other medical facilities along evacuation routes should be prepared to provide medical services to evacuees in time of disaster as the American Red Cross provides only first aid to sheltered populations. Our experience has allowed us to develop policies and procedures that should be useful to other caregivers who might be called on in future disasters.
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