EDUCATION IN THE AREA OF POPULATION PROTECTION IN HEALTH CARE

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1 EDUCATION IN THE AREA OF POPULATION PROTECTION IN HEALTH CARE Josef STOREK Abstract The requirements for the education in the area of population protection were transferred from the area of Health Care to the area of the preparedness of human sources in the context of: maintaining and enhancing the achieved level of the preparedness of the workers in Health Care especially regarding the process of basic qualifying (pre-gradual) and lifelong (post-gradual) learning. Human sources can be divided, according to the preparedness of Health Care to existing threats, into independent groups with a different relation to the security tasks including population protection and they belong to the following health care sectors: a) Workers at Health Care administration offices b) Employees of the providers of health care services c) Workers at the bodies of public health protection d) Employees of the suppliers of health care needs Each, this way defined group has its own internal organization of managing and leading positions, guaranteeing the operation of a relevant health care entity both in standard and non standard situations. Key words Education in the area of population protection, preparedness of human sources, qualifying and lifelong learning, key management and leadership positions. INTRODUCTION The development of a national security system, inter alia, has come to the requirement for the conceptual solution of the preparedness of persons in managing bodies and critical infrastructure see Conception of the education in crisis management, approved by the National Security Council on November 16, 2004; regarding Health Care, it is the Conception of crisis preparedness of the CR Health Care approved on April 3, 2007 by the resolution no. 9 especially - in the area of human sources preparedness: it is necessary to maintain and further deepen the achieved level of the capabilities of Health Care workers in the process of qualifying and lifelong learning. - in the area of professional environment: it is necessary to develop the scope of medical science, first of all field of emergency medicine and disaster medicine, including the development of security research and the engagement of universities, support the implementation of research results for the needs of medical management of risks, increase the efficiency of a management process, incident, crisis, and defense planning, improve the procedures of emergency and disaster medicine. The resort conception follows the requirement of the Security Strategy of the Czech Republic for the necessity of the support of the security policy in terms of science, research and education. 1

2 THE SCIENCE FOR POPULATION PROTECTION 1/2014 SECURITY EDUCATION 1 CURRENT STATE The basic principle for the systemic security of the health care capability, health care workers and medical facilities to face the current security threats and risks is derived from the medical field of emergency medicine and the distribution of this issue into purposeful labor division: a) emergency and disaster medicine field, b) branch institutions for education and crisis management schools, c) professional institutions (Czech Medical Chamber, Czech Medical Community of Emergency Medicine and Disaster Medicine, Czech Association of Nurses), d) system of accredited centers, e) system of education programs for selected branches in Health Care, f) system of certified courses and regular professional meetings (Dostal Days, Brno Days of Disaster Medicine, Hradec Kralove Days of Disaster Medicine, CR and SR Days of Disaster Medicine), including the practical part of preparedness (central Rallye and peripheral system of Health Care education and training centers) etc. The system is dimensed according to the significance from the top specialized learning to professional education and specific learning in defined areas of nursing care together with managerial preparation of leading workers of the Health Care critical infrastructure and covering the key levels of the management: tactical and operational. The strategic level of the management is, in terms of the competences and the scope of actions, in the gestion of the Ministry of Health. 2 RESULTS Regarding the quantitative indicators, the situation in the years is expressed in the table no. 1: Table 1 Survey of schooled medical workers a) Number of doctors who acquired specialization in EM... about 430 b) In professional preparation the module of competence for crisis preparedness was attended by a. Doctors about 9,340 b. Pharmacists and Other Specialists... about 2,810 c) Specialists for the organization and management of security policy of a medical facility... about 100 TOTAL < 12,600 Correlated start up of a National Security System is a quantitative indicator of the time interval reflection of the obligation of the Heath Care workers to participate in education activities in the frame of the preparation to perform their specialization in health care; regarding qualitative changes, in the indicators of health care or the descent of some unfavorable indicators of heath conditions, there is therefore the assumption to increase professional competence and in the future we can expect also the shift of long-term indicators of health conditions (see e.g. Nazidla 2003, Vresova 2007, Studenka 2008). 2

3 Similar situation is monitored from available data to achieve a comparable level of preparedness of medical facilities to face anticipated threats and gradually increasing number of graduates of education programs of crisis preparedness. This way we create the assumption of qualitative changes in the documents of medical facilities that are included in critical infrastructure (see. e.g. the level of traumatology planning and planning of crisis preparedness of individual medical facilities). 3 THE OUTLOOK The urgent requirement of a current level of risks and accomplished level of the preparedness of the system is the accelerated setting of the efficient mandatory tool of the continuous education of Health Care workers in critical infrastructure and inside it the critical infrastructure of a sector who are on leadership positions responsible for rapid and efficient response of a given medical facility to current threats including protection of human sources. Especially due to the fact that the preparedness of the sector for the solution of nonstandard situations (i.e. extraordinary events and crisis situations) is ensured besides the structural condition which is so called crisis infrastructure by permanent preparation of persons first of all on key leadership positions regarding the necessary professional competence of a worker in health care and also in the area of security and crisis management together with indispensable skills in the area of the leadership of executive elements of crisis and critical infrastructures; namely synchronously with the activities of relevant bodies of crisis management (figure no. 1). PROGRAM IN EDUCATION IN THE AREA OF HEALTH CARE CRISIS PREPAREDNESS Conception requirements were transferred into the Health Care sector specifically into the area of preparedness of human sources in the context of the need to maintain and further improve the level of the preparedness of Health Care workers especially in the qualification process (pre-gradual professional competence) and other professional learning (post-gradual specialized competence, special professional competence...lifelong learning ) acts no. 95 and 96/2004 Coll. From a comprehensive viewpoint of the health care, the human sources can be divided into independent groups with a different relation and professional position in order to accomplish security tasks in individual Health Care sectors: Workers at the Health Care administration offices Employees of the providers of health care services Workers at the bodies of public health protection Employees of the suppliers of Health Care needs Fig. 1 Education Program 3

4 THE SCIENCE FOR POPULATION PROTECTION 1/2014 SECURITY EDUCATION The frame of the education in the Health Care sector is determined by basic documents: Conception of education in the area of crisis management, approved by the National Security Council no. 14 of November 16, 2004 incorporated into Conception of Health Care Crisis Preparedness of the Czech Republic of March 2007, approved by the National Security Council no. 9 of April 3, 2007, supplemented by the education of professionals in the area of security policy approved by the Resolution of the National Security Council no. 156 of November 16, 2006 and evaluated by the Report on the fulfillment process of the conception of education in the area of crisis management and the determination of the following procedures approved by the Resolution of the National Security Council no. 50 of November 6, 2007 supplemented by the common minimum for the needs of education of professionals in the area of security, approved by the resolution of the NSC no. 32 of July 3, 2007, strengthened by The Green Book on workers in health care in Europe (KOM(2008) 725 Brussels) where among the basic functions of the health care belong the activities such as planning and response to health threats caused by the centers of infectious diseases, pandemics, natural and man-made disasters including catastrophes connected with the change of climate... The modular concept of education in the area of crisis management together with the content according to the enclosure no. 2 Conception of Education in the Area of Crisis Management (the amendment of 2004) enables the sector during the elaboration of education programs flexibly respond also to the requirements of the Conception of Population Protection till 2020 with a view to 2030 in individual forms of professional education: 1. Specializing education in the branch Urgent Medicine Medicine of Catastrophes 2. Mandatory education in other branches Medical First Aid and Emergency First Aid (for non-medical university branches) 3. Preparation of target groups in the a. Course of crisis management in a sector b. Course of crisis management of a sector c. Course of crisis preparedness in health care sector The core of the education process in Health Care sector follows the target state demonstrated in figure 2. The construction of a sector system of education in the area of crisis management has been accomplished according to the rules for education in Health Care by means of the extrapolation of basic documents of National Security Council into the conditions of the sector; in the frame of crisis preparedness and in the scope of the sector educational facilities. The requirements for the content of educational programs express the current degree of professional demand, defined by the volume of the knowledge of relevant scientific branches in Health Care (medicine and outside the medicine). The application of results into practical medicine by means of the educational system is ensured by defined subjects: the academic community (represented by medical faculties, expert community (represented by the medical association), professional community (represented by the professional chamber) and the administration office (represented by the sector ministry). 4

5 HEALTH CARE CRISIS MANAGEMENT Security strategy of the Czech Republic CRISIS MANAGEMENT OF HC FACILITY Director of HC facility KS HC Facility Crisis Infrastructure of HC Facility ICM HC secretariat KS HC Facility Typology of massive infliction of persons 1. Mechanical infliction 2. Thermal infliction 3. Intoxication and chemical infliction 4. Radiation infliction 5. Infections infliction 6. Mix infliction 7. Psychical infliction 8. War infliction 9. NUCR (Lx) infliction Crisis legislation of the Czech Republic Dokuments of NSC and planning committees Conception of health care sector crisis management Needs and requirements of locally relevant administration offices Purposeful restructuring of Health Care through HC TRAUMA PLAN for needs of INCIDENT PLAN of administrative unit and PLAN of HEALTH CARE CRISIS PREPAREDNESS of administrative unit Fig. 2 Management of Health Care Crisis Preparedness CONCLUSION The requirement of the Population Protection Conception till 2020 with a view to 2030 pursuing the institutionalization of population protection as a constant part of a national security system is supported by the existence and optimization of the system of the preparation of professionals and also by the joining the area of security and protection of health at work by means of the emphasis on the responsibility of each subject for the security of the operation and for the security of persons protection, first of all, in the field of its activities. Not only, because of the above mentioned, it is necessary to carry out the branch revision of critical infrastructure and larger participation of the academic ground in the adaptability of the security system together with the flexible modification of a sector system of education of workers in Health Care. 5

6 THE SCIENCE FOR POPULATION PROTECTION 1/2014 SECURITY EDUCATION References [1] Conception of education in the area of crisis management approved by the National Security Council no. 14 of November 16, [2] Education of professionals in the area of security policy, approved by the NSC Resolution no. 156 of November 16, [3] Common minimum for the needs of education of professionals in the area of security approved by the NSC Resolution no. 2 of July 3, [4] Report on the fulfillment process of the Conception of education in the area of crisis management and determination of the further procedure, approved by the NSC Resolution no. 50 of November 6, [5] Conception of Health Care Crisis Preparedness of the Czech Republic of March 2007 approved by the NSC Resolution no. 9 of April 3, [6] Green Book on workers in health care in Europe (KOM(2008) 725 Brussels). Available at: [7] CZECH. Act No. 95/2004 Coll., on conditions to acquire competences and specialized competence for the performance of a medical doctor, dentist, pharmacologist as amended. In: Collection of Acts Czech Republic. 2004, part 30, pp ISSN Available at: =zakon&what=cislo_castky [8] CZECH. Act No. 96/2004 Coll., on conditions to acquire competences for the performance of paramedics and for the performance of activities connected with health care as amended. In: Collection of Acts Czech Republic. 2004, part 30, pp ISSN Available at: aspx?q=30&typelaw=zakon&what=cislo_castky [9] CZECH. Decree No. 55/2011 Coll., on activities of health care workers and other professionals. In: Collection of Acts Czech Republic. 2011, part 20, pp ISSN Available at: &typeLaw=zakon&what=Rok&stranka=15 [10] CZECH. MINISTRY OF FOREIGN AFFAIRS. Security Strategy o the Czech Republic, approved by the Government Resolution no. 665 of September 8, ISBN Available at: [11] CZECH. MINISTRY OF INTERIOR. Conception of Population Protection till 2020 with a view to 2030, approved by the Government Resolution no. 805 of October 23, Available at: [12] STOREK, J. Program of education in the area of health care crisis management. In: University Department Concept UMaMK IPVZ Prague since January 1, Prague Information about the author Josef Storek (1950) is a head of the Department of Emergency Medicine and Disaster Medicine within the Institute of Postgraduate Medical Education and an Assistant Professor at the Department of Radiobiology, Toxicology and Population Protection of the Faculty of Health and Social Studies within the University of South Bohemia. 6

7 He is a graduate of the Faculty of Medicine of Charles University in Prague (MD., 1975) and doctoral studies there (Ph.D., 2004). He is the President of the Company of Crisis Preparedness of Healthcare within the Czech Medical Association of J. E. Purkyně and a member of series of expert committees and other bodies. Author of more than 70 articles in professional journals and an author and co-author of 27 publications and more than 100 presentations at national and international conferences. 7