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The years following the 9/11/2001 terrorists attacks saw a marked increase in community and hospital emergency preparedness, from communications across community networks, development of policies and procedures, to attainment and training in the use of biological warfare resources. Regular drills ensured emergency and health care personnel were trained and prepared to address the next large-scale crisis, especially from terrorist and bioterrorist attacks. This chapter looks at some of the more familiar global health issues over the past two decades and the lessons learned from hospital responses to inform hospital management in preparation for future incidents.

This study is a narrative review of the literature related to lessons learned from four major events in the time period from 2002 to 2023 – SARS, MERS, Ebola, and COVID-19.

The initial search yielded 25,913 articles; 57 articles were selected for inclusion in the study.

Comparison of key issues and lessons learned among the four major events described in this article – SARS, MERS, Ebola, and COVID-19 – highlight that several lessons are “relearned” with each event. Other key issues, such as supply shortages, staffing availability, and hospital capacity to simultaneously provide care to noninfectious patients came to the forefront during the COVID-19 pandemic. A primary, ongoing concern for hospitals is how to maintain their preparedness given competing priorities, resources, and staff time. This concern remains post-COVID-19.

Values have long guided special education services and supports for students with extensive support needs; over the past four decades, those values have been backed by research evidence demonstrating the critical nature of values related to inclusive education, self-determination, and seeking strengths and assets. In this chapter, we investigate these values and their supporting research, documenting strengths and needs in extant research. We emphasize the need to continue to embrace and maintain these values while pursuing research that addresses research gaps while centering the priorities, perspectives, and preferences of people with extensive support needs.

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.

The COVID-19 pandemic created a broad array of challenges for hospitals. These challenges included restrictions on admissions and procedures, patient surges, rising costs of labor and supplies, and a disparate impact on already disadvantaged populations. Many of these intersecting challenges put pressure on hospitals' finances. There was concern that financial pressure would be particularly acute for hospitals serving vulnerable populations, including safety-net (SN) hospitals and critical access hospitals (CAHs). Using data from hospitals in Washington State, we examined changes in operating margins for SN hospitals, CAHs, and other acute care hospitals in 2020 and 2021. We found that the operating margins for all three categories of hospitals fell from 2019 to 2020, with SNs and CAHs sustaining the largest declines. During 2021, operating margins improved for all three hospital categories but SN operating margins still remained negative. Both changes in revenue and changes in expenses contributed to observed changes in operating margins. Our study is one of the first to describe how the financial effects of COVID-19 differed for SNs, CAHs, and other acute care hospitals over the first two years of the pandemic. Our results highlight the continuing financial vulnerability of SNs and demonstrate how the factors that contribute to profitability can shift over time.

In this chapter, the author critically examines the deeply entrenched practices and theories within counselor education, revealing their roots in historically dominant, Eurocentric, and often racially oppressive assumptions. This study brings to light the pervasive impact of these traditional approaches, illuminating their role in perpetuating racial oppression and disparities in mental health care. The author presents a compelling argument for adopting Critical Race Theory (CRT) as an effective pedagogical and clinical practice framework in the counseling profession, a step toward its much-needed liberation. CRT's tenets are examined as a robust alternative, promoting socially just outcomes in counseling and psychotherapy. The article highlights CRT's capacity to address the well-established relationship between racism, white supremacy, and minority mental health. It proposes a groundbreaking model for praxis, predicated on CRT, which holds potential not only to challenge and disrupt oppressive structures but also to pave the way for the liberation of both the oppressed and the oppressor. This seminal work prompts a re-envisioning of counselor education, asserting a call for a transformative shift toward a liberation-based, social justice pedagogy.

A new High School Equivalency (HSE) policy was developed in the United Arab Emirates (UAE) in response to a shift toward a knowledge-based economy and a transformation toward STEM education. The purpose of this study is to explore and understand the stakeholders' perceptions and experiences in implementing the new HSE policy in a school that follows a US curriculum in the UAE. The study was conducted before the COVID-19 lockdown. The phenomenological approach was used to shed light on the implementation of the HSE policy in an active learning environment and the challenges facing the school's stakeholders. The study results reveal the challenges that stakeholders face in implementing the HSE policy and their experiences in offering students the courses they need. All stakeholders agreed that the transformation toward STEM education requires proper implementation of the high school equivalency policy in an active learning environment that help in developing students' twenty-first-century skills and prepare them to meet the job market needs.