Lack of Quality Management During Hurricane Katrina Research Paper

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Table of Contents

Introduction
Research Questions
Description of Hurricane Katrina
Failures in the Emergency Response
Key Findings and Recommendations
Conclusion
References

Introduction

Given the devastating outcomes that may accompany calamities associated with storms, it is dangerous to downplay the importance of monitoring, evaluation, and quality control which are very critical to ensuring the success of any rescue efforts. Many times, however, organizations tend to forget the aspect of quality management in the planning and sadly, this leads to unpreparedness when the disasters strike (Leitmann, 2007).

A regular update of the disaster preparedness and emergency management will ensure that response teams are able to deliver as expected when the time comes. According to Haddow, Bullock and Coppola (2008), the natural disasters always prompt stakeholders to recreate their response plan and devise new ways of responding to disasters.

The challenges faced during Hurricane Katrina clearly pointed out that better response mechanisms must be developed and followed fully (Brooks & Darling, 1993). Apparently, the need for disaster preparedness has continued to grow as the organizations realize that being caught unaware is quite devastating (Tierney, Lindell & Perry, 2001).

This paper looks at how a lack of quality management interfered with the response mission during Hurricane Katrina. A number of issues that led to poor response have been examined and recommendations have been made for better and organized response in the future.

Research Questions

The questions to be answered by this research include:
How prepared was the response team before the storm happened?
What support mechanisms were put in place to help the response team to achieve its objectives?
How effective were partnership created during the response?

Description of Hurricane Katrina

Hurricane Katrina is one of the strongest storms to ever be experienced in the history of the United States. Among the cities affected, there are New Orleans, Louisiana, Alabama and Mississippi (FOIA, 2006). According to Goldman and Coussens (2007), almost 90,000 square miles suffered from the effects of Hurricane Katrina.

In Louisiana State, for example, nearly 1.7 million people suffered the devastating effects of the storm and required to be evacuated. The rescue task was a daunting one and had to involve people being moved from the affected and heavily populated regions to safe locations both within the affected state as well as to other states around the country.

Even though efforts were made and about 1.5 million people were evacuated from Louisiana before Hurricane Katrina happened, close to 200,000 individuals who remained behind were severely affected by the storm. Some of these people failed to evacuate because of lack of resources while others simply made a choice to stay behind rather than move to safe places.

Before and after the storm, shelters and emergency rooms were prepared to cater for special needs of those affected. Although the state managed to evacuate almost 12,000 caregivers and their patients, the process was generally slow as the strategies employed were not very effective (Goldman & Coussens, 2007).

In certain cases patients had to be evacuated at most two at a time, using a boat. Shah (2005) describes Hurricane Katrina as the most expensive tragedy that has ever been experienced by the global insurance industry (Shah, 2005). The disaster caused by Hurricane Katrina is a very clear indicator of how important it is to make sure that proper recovery mechanisms are put in place.

Failures in the Emergency Response

Despite numerous evacuation pleas, more than 100,000 people were stranded in flooded regions of the city, and as pointed out earlier, some people were unable to leave while some chose not to evacuate. Some evacuation plans used by the responders, such as providing buses, totally failed.

The failure experienced caught officials and the emergency response team completely off guard and this was further worsened by the fact that the police, medical, and other means of assistance were inadequate to cope with the scale of the disaster caused by Hurricane Katrina. Although the rescue efforts went on for over several days, those left in New Orleans suffered increasing deprivation and lack of facilities.

Rescue efforts were later reinforced by issuing a compulsory evacuation order that involved an airlift and major logistical resources. The rescue troops went house to house so as to guarantee a complete evacuation. Much of the media attention was focused towards the lengthy time taken for emergency response and this ultimately led to the resignation of the head of the Federal Emergency Management Agency (FEMA).

While a number of factors were highlighted as being strengths, there were several issues that worked against the ability to provide an orchestrated and efficient response to the disaster.

Evidence showed that mission objectives were not established in response to Hurricane Katrina and some organizations lacked an incident action plan leading to confusion about the mission objectives among responders originating from different organizations.

It is assumed that an emphasis on pre deployment planning in various areas, including the deployment of personnel and coordination with external agencies would have proven quite beneficial during the rescue mission (Goldman & Coussens, 2007).

Apparently, there were also changes that happened in the organizational structure after the response started and these complicated the response operation even further. It impacted lines of authority, reporting, communicating channels, information exchange, and adherence to standard operating procedures.

Depending on the area of focus, standard operating procedures did not exist, were in draft form, or were in a conflict with other organization’s standard operating procedures. Another major challenge was the ability to staff and deploy teams effectively as well resource tracking. As a part of the preparation process, a clear definition of the roles assigned to all staff is a critical requirement and must be done fully (Goldman & Coussens, 2007).

A lack of a clear communication protocol also made it difficult for stakeholders to get in touch with the rescue team. Some people felt that better results could be realized by taking an inclusive approach that brings together all the key people who are seen to play a very critical role in the rescue mission. There is also a need for greater awareness of the basic knowledge regarding emergency response operations among staff.

Key Findings and Recommendations

The following sub sections show the issues pointed out and recommendations on how to effectively address them. The tables contain the factors that led to poor results and later corrective actions are listed.

Issue 1: Mission Objectives and Deployment Assignments

Contributing Factors
Poor definition and communication of mission objectives	Clear objectives were not established for effectively responding to Hurricane Katrina. This led to confusion among the responders. Responders simply defaulted to what was seen as the best course of action and no formal action plan was followed. The lack of a clear and publicized action plan greatly affects management’s ability to lead in the most efficient and effective way. Mission clarity can be ensured by having in place an incident action plan.
Staff deployment assignment were made without following the established Action Request Form (ARF) and Mission Assignment (MA) process	Deployment of personnel before the Action Request Form was completed also led to problems. Other personnel were also not deployed according to a specific Mission Assignment. In severe cases, some deployed staff had to be sent home simply because they were not responding effectively to the needs of the states where they had been deployed. The use of the ARF or MA should be made mandatory for all rescue operations if better results are to be realized.
The need to clearly define the role of the Emergency Management Assistant Compact (EMAC)	The use of the Emergency Management Assistant Compact is very instrumental in changing the types of requests for help that the rescue team receives from the states as well as how states interact to provide mutual aid. States using EMAC can request and receive direct assistance from the states without having to contact the rescue team. During the rescue mission, EMAC representatives claimed that they were not made aware of the resources and services provided by the rescue team. It is important to ensure that EMAC representatives are well aware of the resources and services provided by the rescue team.
Better coordination between the rescue team and the Public Health Service Office of Force Readiness and Deployment (OFRD) was required.	Both the rescue team and the Public Health Service Office of Force Readiness and Deployment were selecting staff for deployment from the same pool of Public Health Service Officers. It was reported that in some cases, medical officers deployed through OFRD were filling non-clinical roles while they could have been deployed by the rescue team to provide public health support.

Corrective Action Plan

The corrective action plan for the above concerns includes:

Standardizing the incident action plan process and implementing it during all responses.
Ensure that all key personnel in the division of emergency operations are familiar with the incident action plan process to enable them to support agency leadership during an event.
Ensure a smooth coordination between the OFRD and the rescue team to determine priority needs and availability of public health service personnel during a response so that a balance is maintained between clinical needs and public health requirements.
Work with stakeholders to determine the changes that should be made to ARF and MA processes so as to accelerate response support.
Have a central body that brings the efforts of all the rescue organizations together so as to perform consolidated rescue operations.

Issue 2: Organizational Structure and Incident Command System

Contributing Factors
The change to the incident command system organizational structure during the incident led to confusion and response inefficiencies	The incident command system organizational structure within the Director’s Emergency Operations Center (DEOC) changed a few days after the response started. This impacted the lines of authority, reporting, communication channels, and information exchange. Changes made were not incompliance with the existing operational procedures. Individuals involved in the response were confused as to their mission and tasks as the organizational structure changed. The change in the incident command system led to a breakdown in communication with the DEOC and among the field teams contributing to the deployed personnel either reverting to previously known patterns for communications and the mass dissemination of information to individuals. This greatly affected the speed at which decisions could be made.
There was a lack of awareness of the incident command structure (ICS) and emergency response processes	Staff reported a lack of awareness of the overall ICS structure and the national response plan (NRP) as well as emergency response processes. This led to the rescue team being unaware of the existing emergency response standard operating procedures, chain of command, information flow and the organization structure while in response mode.
Detailed standards of operating procedures (SOPs) should be developed and disseminated to all individuals identified as potential emergency responders	SOPs were found to be in various states of availability: non existent, not complete, in draft form, complete but not current or in conflict with similar SOPs. Reviews showed that SOPs did not provide procedural guidance for DEOC or deployment teams. Some individuals were simply not aware that SOPs existed. Furthermore, new teams that were formed did not have SOPs for procedural guidance. Since some SOPs were either outdated or in draft form, they were not executed. Individuals who were unfamiliar with prior response operations were not given the operating procedures or briefed on the overall emergency response process.
The Role of Senior Management Official (SMO) needs to be clearly defined and articulated	The senior management official works directly with state health commissioners, local health authorities, and others to implement the portfolio management project within each state. The role of the SMO in an emergency situation is very critical and must therefore be clearly articulated in the rescue plan. The SMO needs to be tightly integrated with the incident management structure.
DEOC needs to improve its capacity to rapidly and accurately and accurately identify personnel for deployments and to track personnel deployed to the field	The current resource tracking system (RTS) does not provide detailed information that is required by the deployment team. Personnel would often be deployed to fill roles that were completely outside their area of expertise. Manual spreadsheets were used to track deployed staff and reconciling these were time consuming. Be establishing a centralized and detailed resource tracking tool that lists all deployable personnel, their updated qualifications, and contact information, the availability of deployment personnel can be more effectively managed. The system should also provide functionality to track deployed personnel.
Conditions leading to the change in alert status from response to recovery were not clearly understood	There were no clearly defined activities or events that determined when the DEOC moved from response to recovery alert status. In addition, current SOPs do not address the recovery phase of a response. In the final stages of the Katrina response, responders reported that CDC’s level of involvement was not clearly communicated to personnel and as a result, deployed individuals felt that focus was diverted from the response and they did not feel that they received full mission support.
Responder resilience was a concern	Resilience is a continuous process and needs to be addressed before, during and after a response. Changes in incident management command structure are needed to enable full situational awareness, feedback and guidance in matters pertaining to agency response and resilience. There were also concerns for better screening of deployable staff to ensure that only those suitable for disaster work were deployed. There was also a need for the agency to more consistently recognize the contributions of employees at whatever level after response operations.

Corrective Action Plan

The corrective action plan for the above concerns identified above includes;

Make every effort to finalize CDC SOPs for emergence response. SOPs should offer procedural guidance for all individual teams involved in an emergency response. It is also important to ensure that SOPs are in some way, linked to operational procedures of cooperating partners.
It is also necessary to develop SOP addressing contingency planning for emerging secondary or tertiary events which should be well integrated within the CDC drills and exercises.
Create a clear role of the SMO in emergency preparedness and response activities.
Identify organizational processes for response coordination in those states that do not have an assigned SMO.
Develop a criterion to determine activation and deactivation of the DEOC and at what point response coordination is handed over to the lead CIO for recovery activities.

Issue 3: Information Flow and Management

Contributing Factors
The internal information flow and management processes were not clearly defined and daily task lists and supporting action items were not effectively managed	Individuals involved in the response were unable to clearly define to whom or how information should be transferred internally (Pavignan, 2006). Document clearance and version control became difficult because there were no specifications for the process within the SOPs. This deficiency resulted in mass emailing, incomplete communication loops, and loss of information. It was generally difficult for members of the response team to know which tasks were being actively pursued, by whom, and when these tasks had been completed.
Preparing briefings for CDC leadership diverted time and resources from critical response activities	The opinion of the respondents was that so much time was devoted to developing reports in order to brief senior officials about the progress (Logue, 1996). Activities in the DEOC appeared to be driven by daily briefing schedule.
A process for information and data sharing to internal and external partners should be established	There was some confusion regarding what information could be shared with partners and this destabilized the response operations to some degree.
Communication with the field needs to be addressed	Personnel in the field experienced difficulty communication with voice, email and data transmission among themselves, with local and state officials and with the DEOC.
Partnerships with the private sector need to be strengthened	The private sector which includes non-governmental organizations, faith based organizations, as well as profit or not for profit organizations play a very critical role in disaster response (Maiden, Paul & Thompson, 2007). . Improving the collaboration with these organizations will strengthen response operations and better results will be realized from the collaborative efforts (Morgan, Ahern & Cairncross, 2005). .

Corrective Action Plan

The corrective action plan for the above concerns identified above includes but is in no way limited to;

Update information flow procedures to include information flow plan for DEOC teams, field teams, and external partners.
Update and utilize standard data collection forms
Ensure the availability of a clear and consistent communication plan that incorporates all existing communications
Establish an accelerated clearance flow for emergency information and documents needed during an emergency event
Use standardized report forms to address briefings
Ensure that information shared with anyone, internally or externally, is consistent between the programs and DEOC
Establish, maintain and enhance linkages with the private sector

Issue 4: Public Health Practice Issues

Contributing Factor

Displaced populations had chronic medical conditions

As the response team carried on with its operations, there did not seem to be an equivalent government effort focused on providing health care services, meeting medical needs and access to care by vulnerable populations (O’Leary, 2004). The established shelters lacked the necessary medicine for dealing with chronic and this was a real health hazard. Proper coordination will ensure the right treatment for vulnerable populations.

Corrective Action Plan

The corrective action plan for the above concerns identified above includes;

Develop standardized assessment tools and recommendations for shelters, their staff and residents
Identify methods to track shelter locations
Establish a workgroup to address chronic and communicable diseases that require routine therapy care for displaced populations

Issue 5: Training and Exercises

Contributing Factors
Evaluate exercise needs and participation	Respondents felt that it is necessary to regularly conduct emergency response readiness exercises with the government, state and local partners as well as other public and private partner organizations. As exercises are planned and conducted, evaluation procedures and corrective action planning should be included within the overall planning process.
Evaluate training needs	It is important to conduct regularly scheduled emergency response readiness training with all appropriate parties. Functional roles in the response plan should be identified and personnel that could be called upon to fill such roles should be trained accordingly.

Corrective Action Plan

The corrective action plan for the above concerns identified above includes;

Conduct training on ARF and MA processes so as to facilitate request for help.
Offer extensive training to all those in leadership roles within the response teams.
Develop and deliver a mandatory training course for all personnel to ensure that they are all well equipped for emergency response role during an event.
Identify functional roles required in a response and offer a thorough training for personnel to fill the roles.

Conclusion

According to Leitmann (2007), it is generally agreed that three elements exist for effective disaster prevention and preparedness. There needs to be an accurate analysis of hazards and vulnerable populations, responders must formulate disaster preparedness and response plans and lastly, being able to communicate prevention and preparedness to the public and key decision makers.

As has been discussed in this paper, it is important to put in place a clear plan that can be followed to respond to emergencies and when the disaster strikes, this plan must be implemented fully. Many times, rescue missions fail because the responders decided to follow their own ways of dealing with the calamity rather strictly adhering to the set procedures. Where responders from different organizations are involved in the response, it is important to ensure that they all read from the same script.

Given that all sorts of disasters will continue to be experienced, recommendations made in this paper are quite relevant and should be adhered to by response teams.

References

Brooks, C. & Darling, P. W. (1993). Disaster Preparedness. Boston, MA: Association of Research Libr.

Freedom of Information Act (FOIA). (2006). Hurricane Katrina after Action Review. Atlanta, GA: Freedom of Information Act. Web.

Goldman, L. & Coussens, C. (2007). Environmental Public Health Impacts of Disasters: Hurricane Katrina. Washington, D.C: The National Academies Press. Web.

Haddow, G. D., Bullock, J. A. & Coppola, D. P. (2008). Introduction to Emergency Management. Burlington, MA: Elsevier, Inc.

Leitmann, J. (2007). Cities and Calamities: Learning from Post-Disaster Response in Indonesia. Journal of Urban Health, Volume 84, Supplement 1, 144-153.

Logue, J. (1996). Disasters, the Environment and Public Health: Improving Our Response. Am. J. Public Health, 86(9):1207–1210.

Maiden, P., Paul, R. & Thompson, C. (2007). Workplace Disaster Preparedness, Response, and Management. London, UK: Routledge.

Morgan O., Ahern M. & Cairncross S. (2005). Revisiting the Tsunami: Health Consequences of Flooding. PLoS Med, 2(6):491–493.

O’Leary, M. R. (2004). Measuring Disaster Preparedness. USA: iUniverse.

Pavignan, E. (2006). Formulating Strategies for the Recovery of a Disrupted Health Sector. Geneva: WHO.

Shah, H. (2005). Hurricane Katrina: Profile of a Super Cat – Lessons and Implications for Catastrophe Risk Management. Newark, C A: Risk Management Solutions. Web.

Tierney, K. J., Lindell, M. K. & Perry, R. W. (2001). Facing the Unexpected: Disaster Preparedness and Response in the United States. Boston, MA: Joseph Henry Press.

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