Promoting Disaster Resilience Through Use of Interdisciplinary Teams: A Program Evaluation of the Integrated Care Team Approach

DOIhttp://doi.org/10.1002/wmh3.176
Date01 March 2016
AuthorLavonne M. Adams
Published date01 March 2016
Promoting Disaster Resilience Through Use of
Interdisciplinary Teams: A Program Evaluation
of the Integrated Care Team Approach
Lavonne M. Adams
One approach humanitarian organizations may use to support community resilience following mass
fatality disasters is by integrating services through formation and deployment of interdisciplinary
teams. One such model is the Integrated Care Team (ICT) used by the American Red Cross. This
paper describes a program evaluation conducted on the ICT, in which 120 ICT participants
completed a survey. Although fewer than half of the respondents agreed that ICT members had
suff‌icient ICT-specif‌ic training, the majority of respondents understood their role and that of others
in ICT. The majority agreed that the ICT effectively provided health services, mental health services,
and spiritual care. The majority agreed that ICT effectively used community resources and provided
f‌inancial support. Recommendations stemming from the evaluation include implementation of more
consistent ICT-specif‌ic training within the context of interdisciplinary collaboration, establishment
of clear protocols for use of f‌inancial and other resources, and future research into effectiveness of
the ICT approach.
KEY WORDS: resilience, interdisiciplinary teams, mass fatality disaster
Introduction
The concept of community resilience has become an integral part of
discussions on disaster preparedness and response (The United Nations, 2015).
The United Nations Off‌ice for Disaster Risk Reduction International Strategy for
Disaster Reduction (UNISDR) has def‌ined resilience as “the ability of a system,
community, or society exposed to hazards to resist, absorb, accommodate to and
recover from the effects of a hazard in a timely and eff‌icient manner, including
through the preservation and restoration of its essential basic structures and
functions” (2009, p. 24). The process of community resilience may also be
described as a process linking together a network of adaptive capacities or
resources including economic development, social capital, information and
communication, and community competence (Norris, Stevens, Pfefferbaum,
Wyche, & Pfefferbaum, 2008). No single entity is capable of providing for the
World Medical & Health Policy, Vol. 8, No. 1, 2016
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1948-4682 #2016 Policy Studies Organization
Published by Wiley Periodicals, Inc., 350 Main Street, Malden, MA 02148, USA, and 9600 Garsington Road, Oxford, OX4 2DQ.
totality of community resilience; rather, it is a shared responsibility of multiple
entities and stakeholders (Committee on Increasing National Resilience to
Hazards and Disasters, Committee on Science, Engineering, and Public Policy,
Policy and Global Affairs, & The National Academies, 2012). Resilience empha-
sizes the strengthening of social networks and the role of community members
collaborating and engaging to problem solve how to rebuild the community, and
is now viewed as a crucial component in promoting disaster recovery (Moore,
Chandra, & Feeney, 2013; Uscher-Pines, Chandra, & Acosta, 2013).
Strains on resilience may occur following mass fatality disasters, which are
complex and involve death; physical and psychological injuries; widespread
property destruction; infrastructure and resource damage; and, frequently,
complications including socioeconomic disadvantage (Raphael & Ma, 2011). Such
disasters pose unique challenges, as survivors may be dealing not only with their
own physical and/or psychological trauma, but also the loss of family and
friends. Although considerable literature regarding mass fatality disasters
emphasizes crisis counseling or other mental health interventions (Cohen, 1997;
Jones, Allen, Norris, & Miller, 2009; Leitch & Miller-Karas, 2009; Norris, Hamblen,
& Rosen 2009; Prewitt & Orlando, 2008; Rosen, Greene, Young, & Norris, 2010), it
is crucial to recognize that such efforts occur within the context of a wider
humanitarian effort (Perez, Coady, DeJesus, McGuinness, & Bondan, 2006).
Promoting resilience following a mass fatality disaster is multi-faceted and
requires activation of multiple systems to promote recovery and provision of
varied services ranging from practical, community-based interventions to special-
ized intensive treatment (Cruz-Vega et al., 2001; Perez et al., 2006; Reifels et al.,
2013; Weisaeth, 2004). Health services provided following a disaster are varied,
and may include provision of basic health care, health education, and support to
those affected or referral for those with more severe illness or injury to another
level of care (Bowenkamp, 2000). In the event of disaster-related deaths,
condolence services are provided and may include crisis counseling, f‌inancial
assistance for funeral-related expense (Farag et al., 2013). Additionally, other
disaster-related needs may be addressed, including referral to resources for
disaster-recovery assistance, location of emergency housing, or replacement of
lost health-related items (Farag et al., 2013).
To provide such an array of services and to meet a variety of needs, a
multidisciplinary team approach may be used. The term “multidisciplinary
response team” can be used to indicate a group of individuals representing
various disciplines who are trained to respond to disasters. The makeup of the
team varies based on its role in the disaster response. Small teams may be set up
to provide outreach to survivors following a disaster (Hassmiller, Adams, &
Weeks, 2013). In contrast to service centers, a frequently utilized model in which
survivors go to a central location (Huleatt, LaDue, Leskin, Ruzek, & Gusman,
2002; Weisaeth, 2004), multidisciplinary outreach teams deploy directly into
affected communities. Disciplines represented in such a team may include health-
care professionals such as nurses and physicians, mental health professionals
such as psychologists and social workers, individuals trained to respond to the
Adams: Resilience Through ICT 9

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