Access the recorded webinar here: https://attendee.gotowebinar.com/ recording/3308777215303817986 Highly Pathogenic Infectious Disease Exercise Planning Tools March 7, 2017
ASP R TRACIE: Thr ee Domains •Self-service collectio n o f a udience-tailored materials •Subject-specific, SME-reviewed “Topic Collections” •Unpublishe d a nd SME peer-reviewed materials highlighting real-life t ools a nd e xperiences •Personalize d s upport and responses to r equests f or informatio n a nd technical assistance •Accessible b y toll-fr ee number , email , or web form •Promotes password-protecte d discussio n among vette d users in ne ar r eal-time •Able t o s upport cha ts a nd t he peer-to-peer e xchange of user-develope d templates, pl ans, and other materials ASP R TRACIE website 2
Role of the National Ebola Trainin g and Educatio n Center • Through the 5 year project period and in collaboration with ASPR, CDC, and other stakeholders, the NETEC will: Create readiness metrics and – Conduc t peer revie w readiness assessments of – regional and stat e ETCs and assessment centers as requeste d by state heal th departments. 3
Role of NETEC (continued) – Create, conduct, and maintain a comprehensive suite o f onsite a nd online educatio n courses a nd helpful resources and tools . – Develo p a repository for educatio n resources , announcements, links to key information, and exercise templates available at the NETE C website . – Provide technic al assistance to public health departments and healthcare facilities. – Creat e a research infrastructur e across th e 10 regional ETCs. 4
Richard Hunt, MD Senior Medical Advisor, Division of National Healthcare Preparedness Programs 5
Welco me Messag e a nd Webinar Purpose • T he healthcar e system c an prepar e to manag e patien ts with highly pathogen ic infectiou s diseas e by conducting exercises bas ed o n t he regional, tier ed approac h set fort h by ASP R fo r Ebola. • NETEC develo ped full y customizabl e exercis e materia ls to assis t in conducting d rills and exercises and meeting Ebol a H PP m easures. 6
Learning Objectives • Participants will: – Learn about exercis e templat es to tes t readiness for high ly pathogenic infectious diseas e patients. – Know how exercise templates support guidance. – Understand how exercises support ASPR’s regional, tiered approach and address unique challenges and situations. 7
Nicholas V. Cagliuso, Sr., PhD, MPH Assistant Vice President, Emergency Management New York City Health + Hospitals 8
HSEEP Exercise Methodology 9
HSEEP Exercis e P rogram Ma nagement 10
Syra S. Madad, DHSc, MSc, MCP Director, System-wide Special Pathogens Program New York City Health + Hospitals 11
NETEC Exercis e Resources 6 end-users 2 exerci se types • Frontline Facilities • Discussion-based • Assessment Hospitals • Operations-based • State-Designate d ETCs • Region al Ebo la and Special Pathoge n Treatment 2 exerci se options Centers (RESPTCs) • Healthcare Coalitions • Ebola • Region al Transport Plan • Other Special Pathogens (airborne) 12
NETEC Exercis e Templates • Fully customizable to meet each e nd user’s unique requirements Option t o choose any single • airborne-transmissible pathogen and proceed expeditiously • Directly map to specific measures in the ASPR HPP Ebola Preparedness Measurement Implementation Guidance 13
NETEC Exercis e Templates Special consideratio n sections: • Surg e management – – Laborator y support services – Wast e management Care of a pediatric patient – – Decedent management – Care of a labor/delivery patient – Diagnostic radiological studies – Surgical intervention • Built-i n injects througho ut for further food-for-thought • Contains HSEEP-complaint: – Situation Manual/Exercise Plan – Exercise Schedule – After Actio n Report – Improvement Plan – Participan t Feedbac k Form and more 14
Frontline Facilitie s 15
Frontline Facilities: Exercise Structure 1. Patien t Self-Presen ts a t Frontlin e Facility – 2 Modules: Identificatio n & Isolatio n / Frontline Facility Activation – 4 Spec ial Consideration Sections: Basic Laboratory Services, Surge Capacity, Diagnostic Radiologic al Imaging, Waste Management 2. Patien t Transport – 3 Modules: Coordinatio n & Planning Transportatio n / Gro und Transpor t / Recovery Planning 16
Assessment H ospita ls 17
Assessment Hospitals: Exercise Structure 1. Accept PUI Transfer 3 Modules: Activation/Gro und Transport/Patien t Hand-off • 2. Patien t Self-Presen ts to ED 3 Modules : Identification & Isolation/Activation/Patient Care & • Labs 3. Patient Admission from Active Monitoring 2 Modules: Activation/Gro und Transport • 4. Patient Transport due to Positive Lab Results 2 Modules: Coordinatio n & Planning Transport/Recovery Planning • 5. Specia l Considerations 5 Modules : Surge Capacity, Diagnostic Radiological Imaging, • Pediatric Patient, Wast e Management, Decedent Management 18
State-Designated Ebola Treatment Centers 19
State-Designat ed Ebola Treatmen t Centers: Exercis e Structure 1. Accept PUI Transfer • 3 Modules: Activation/Gro und Transport & Patient Hand- off/Patien t Care 2. Patien t Self-Presen ts to ED • 3 Modules: Identification & Isolation/Uni t Activation 3. Specia l Considerations • 7 Modules: Surge Capacity, Laborator y Support Services, Diagnostic Radiological Imaging, Pediatric Patient, Waste Management, Decedent Management, Labor/Delivery Patient (transpor t t o RESPTC) 20
Regional Ebola a nd Other Special Pathog en Treatmen t Centers 21
Region al Ebo la and Other Spec ial Pathogen Treatment Centers : Exercise Structure 1. Accept PUI Transfer • 4 Modules: Activation/Air & Gro und Transport/Patient Hand- off/Patien t Care 2. Patien t Self-Presen ts to ED • 3 Modules: Identification & Isolation/Uni t Activation 3. Specia l Considerations • 8 Modules: Surge Capacity, Laborator y Support Services, Diagnostic Radiological Imaging, Pediatric Patient, Waste Management, Surgical Intervention, Decedent Management, Labor/Delivery Patient 22
Heal th Car e Coalitions 23
Healthcar e Coalitions: Exercis e Structure 1. Patien t Arrives a t a HCC Member Facility • 4 Modules: E D Arrival/Ongoi ng Operations/Decisio n to Transfer/Returni ng to Normalcy 2. Multiple Patients Arrive in HCC • 3 Modules: Transportation Planning & Coordination/Transport of Patients/ HCC Surge Capacity 24
Regional Transpor t Pla n 25
Regional Transpor t Plan : Exercise Structure 1. Regiona l Transport Activation, Coordination and Transport • 4 Modules: Pla n Activation/Gro und Transport/Air Transport/Decontamination • Includes 3 special consideratio n sections: Patient decompensatio n e n route/pediatri c patient transfer/multiple patients transfer 26
H ow To Acc ess Templates 27
Exercis e Desig n a nd Executio n Tips • Building block approac h (TTX FSE) • Healthcare facility a nd public health partners hip participation • Clea r roles a nd responsibilities of all participants • Document throug h afte r actio n report • Follow up wit h improvement plan 28
Building Bloc k Approac h In Actio n Hotwash Drill Play (notice) Drill Play (no- notice) Actor Briefing Tabletop Exercise 29
Wra p Up a nd Wha t Comes Next? • NETE C offer s a 4-hour interactive Emergency Managemen t Workshop: – Introduction t o All-Hazards Emergency Managemen t and Healthcare Inciden t Command System (HICS) – Developi ng a nd Implementi ng System, State, a nd Regional Concepts of Operations (CONOPs) (publi c health partnerships: air and gro und transport c onsiderations, succe ss models) – Introductio n to Homela nd Securit y E xercise a nd Evaluation Program (H SEEP ) a nd Applicatio n via N ETEC Exercise Resources – Exercise Worksho p (Participants Groupe d b y HH S Region) 30
Ted Cieslak, MD University of Nebraska Medical Center 31
Exercising a nd the Clinician • Clinicians have fu ll time jobs elsewhere ; thus: – Clinicians ar e generally unprepared for: • Disasters • Other infrequen t or unpredictable events – Som e issues requir e frequent reinforcement: • Safety, Infection Control – Exercises ar e par ticularly important f or: • Lo w probability/hig h consequence events • Clinicians are at ver y high risk 32
T he “Pathogens of Concern:” Whic h Migh t Warran t Exercising? • Ebola & other VHFs – Marburg, Lassa, several others • High Consequence Airborne Pathogens – SARS, MERS – HPAI, novel flu, pandemic flu – XDR-TB, Smallpox • High Consequence Droplet Pathogens – Nipah, Hendra, Plague, Monkeypox 33
Special Populations & Needs • Pediatrics – Com e i n al l s izes and stages of de velopment • Neonate, Infant, Toddler, Child, Adolescent – Many ar e c onfus ed or an xious – Many ar e combativ e or flailing – Many ar e incontinent – All toddlers hav e alter ed reality testing • Obstetrics • Psychiatric Patients • Patients with Physica l Disabilities 34
Thorny Issues i n Pediatrics • Parental presenc e & tele-parenting • Neonates born to infected mothers • Cohorting – I n isolatio n and i n quarantine – Parent/Child, Child/Siblings • Breastfeeding • Sedation in behaviora l management • Pla y (toys in the unit) 35
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