ALE Spotlight: Improving Pediatric, Neonatal, and Obstetric Emergency Preparedness at Tufts Medical Center

By Nina Leifer, MPH’18, Health Services Management & Policy 

For BA/MPH dual degree students, the process for finding an Applied Learning Experience (ALE) begins right after we graduate from college and during the first few weeks of graduate school. The summer following my undergraduate graduation, I started looking into potential careers one could have with an MPH degree. During my search, I stumbled upon a job for disaster and emergency preparedness planning and my interest was immediately piqued. I soon discovered that there is an entire field dedicated to emergency management. Emergency managers at the state and local level are responsible for preparing, responding, and recovering from any public health emergency or disaster that affects the community. Meanwhile, within hospitals there are individuals who train and educate staff to be prepared for different emergencies, develop hospital emergency plans and procedures, conduct drills and exercises, and respond to any emergency that threatens to disrupt normal hospital operations. After gathering as much information as I could, I decided to see if I could find an ALE either in public health emergency preparedness or hospital emergency management.

I quickly learned that many people within the public health community are unaware that this field exists. Nonetheless, I became determined to reach out to anyone I could find who worked in this field in Boston. The process of finding a person and their contact information, and then getting them to respond in a timely fashion was challenging. I was fortunate that one of the people I met with connected me with other individuals who they thought could help. Throughout this search process, I became increasingly comfortable speaking and meeting with strangers and saying yes to any potential opportunity that would expand my knowledge or introduce me to more people in the field. Ultimately, through the help of Career Services I was able to find not one but two project opportunities. I felt extremely grateful to have the ability to choose between two great projects. I was able to ask some of the people I met during the search for their input about which placement I should choose. In the end, I determined that working with Nick Duncan, Director of Emergency Management at Tufts Medical Center, was the best fit for me. The project allowed me to combine my new interest in emergency preparedness and my long-standing penchant for maternal and child health priorities. 

The purpose of my ALE project was to improve Tufts Medical Center’s readiness for emergencies and disasters that affect children, critically ill and preterm babies, and laboring women by identifying gaps in the current emergency management program and developing recommendations to address those identified gaps. In order to meet the aims and objectives of this project, I employed a combination of research methodologies: a literature review, an anonymous online survey, two focus group discussions, and eight key stakeholder interviews. 

The results I gathered provided a detailed picture of pediatric, neonatal, and obstetric emergency preparedness at the medical center. I found that these populations have unique characteristics that make them particularly vulnerable during disasters and require attention in hospital planning and preparation for various emergencies. The result of the survey, which tested the emergency preparedness knowledge of a sample of frontline staff, highlighted a lack of procedural and general emergency knowledge. The focus group discussions and one-on-one interviews suggested that hospital emergency plans need to be more inclusive of these populations and that greater emphasis be placed on educating hospital staff on procedures and information specific to the population with whom they work. Based on my findings from the literature review and responses from the other three project components, I identified several specific gaps in the current emergency management programs. The biggest gaps were related to staff training and education and hospital drills and exercises. I also compiled a list of recommendations to address those gaps based on best practices I found during the literature review. During this project it became evident that more research is needed in this field specifically related to pediatric, neonatal, and obstetric hospital emergency preparedness. 

My ALE project was the highlight of my graduate experience as I dove head first into a new field and a new environment. I learned to be independent and advocate for myself. My preceptor gave me the power to shape my experience and project. He allowed me to gain exposure to other aspects of hospital emergency management outside of my project and take on more responsibilities as work on my project slowed. This experience reinforced my interest in health care delivery and illustrated the numerous opportunities available for public health professionals in a hospital setting. Most importantly, this project led me to my first job. I will have the privilege of implementing more of the recommendations I made in my new role as an emergency management specialist at Tufts Medical Center.