Using the cmist model to develop evidence-based practice: A study from shelters in hurricane sandy
Over many years, disparities and inconsistencies have been reported in identifying and meeting client needs for support in disaster shelters. Systems of intake that rely on self-report of needs, or instruments based on medical need are insufficient to reach the range of the whole community. Initially pilot tested in Hurrican Isaac, and used widely during Hurricane Sandy in shelters in New York, an access and functional needs model called CMIST was utilized to assess shelter populations. Communication, Maintaining health, Independence, Saftey/Support/Self-determination, and Transportation needs were assessed by licensed health care providers( primarily registered nurses)using a job action guide to assure that all areas of functional support were included. Using interview and case study methodolgy, data gathered from eight shelters demonstrated 70% of clients interviewed had needs related to Maintaining Health with the rest of the need scattered amongst the other four categories. Needs included managing chronic medical conditions in order to prevent diminishing health such as replacing medications, as well as support of function such as access to meals, mobility, appropriate sleeping support and emotional health care. Once durable medical equipment, appropriate cots and consumable medical supplies were obtained, the most requested resource was for personal assistance services or certified nursing assistants. The ability of a community to recover from disaster is linked to the post-disaster health of individuals impacted by the disaster. Early identification and support of client needs in shelters can diminish morbidity and contribute to enhanced personal and community recovery. The CMIST model contributes to this process.
Provision of health care to the public
Systems thinking models (conceptual and theoretical models), applications related to public health
Define the five elements in the CMIST model.
Differentiate a functional assessment from a diagnostic label.
Discuss the value of a public health assessment model for disaster sheltering.
Keyword(s): Disasters, Assessments
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: Mary Casey-Lockyer, currently, is the manager for Disaster Health Services at the national headquarters for the American Red Cross. Her responsibilities include: Disaster Health Services program development,supporting and coordinating the Disaster Health Service volunteer response to disasters and fostering partnerships with federal/state/local partners and non-governmental agencies and associations. Mary earned a Masters in Homeland Security for Public Health Preparedness in 2010 from the Pennsylvania State University Hershey School of Medicine.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.