Point of Dispensing 101 - CRCOG€¦ · 24/05/2006 · Session Overview POD basics POD management...

Point of Dispensing Staff Point of Dispensing Staff

OrientationOrientation

Session OverviewSession Overview

�� POD basicsPOD basics

�� POD managementPOD management

�� POD roles and responsibilitiesPOD roles and responsibilities

�� Preparing to work at a PODPreparing to work at a POD

Learning ObjectivesLearning Objectives

After completing this module, you After completing this module, you

will be able to describe:will be able to describe:

�� The purpose of a Point of Dispensing (POD)The purpose of a Point of Dispensing (POD)

�� The general structure and operations of The general structure and operations of

public health PODspublic health PODs

�� How you can prepare yourself and your How you can prepare yourself and your

family for your working in a PODfamily for your working in a POD

POD basicsPOD basics

What Is Mass Dispensing?What Is Mass Dispensing?

�� Dispensing a vaccine, antibiotic or Dispensing a vaccine, antibiotic or

other medication other medication quicklyquickly to a large to a large

group of people. group of people.

�� Community members Community members

�� Hospital staff & patientsHospital staff & patients

�� Point of Dispensing (POD) Point of Dispensing (POD) –– a location a location

where mass dispensing occurs where mass dispensing occurs

Why would a POD be activated?Why would a POD be activated?

�� Usually: To prevent disease in those Usually: To prevent disease in those

exposed to an infection but who are exposed to an infection but who are

not yet sicknot yet sick

�� Possible: To treat an infectious diseasePossible: To treat an infectious disease

�� The treatment offered would be limited to The treatment offered would be limited to

dispensing a specific medication.dispensing a specific medication.

What Kinds of Emergencies Might What Kinds of Emergencies Might

Require a POD?Require a POD?

�� Natural disasterNatural disaster

�� Influenza pandemicInfluenza pandemic

�� Bioterrorism attackBioterrorism attack

What is the Strategic National Stockpile ?What is the Strategic National Stockpile ?

A large CDCA large CDC--managed stockpile of medicine managed stockpile of medicine

and medical supplies to protect the and medical supplies to protect the

American public if there is a public health American public if there is a public health

emergency severe enough to cause local emergency severe enough to cause local

supplies to run out. supplies to run out.

You can learn more about the Strategic National Stockpile at http://www.bt.cdc.gov/stockpile

Strategic National Stockpile Strategic National Stockpile

ComponentsComponents�� Push Pack/12 HoursPush Pack/12 Hours

�� Vendor Managed Inventory/ 24Vendor Managed Inventory/ 24--36 hours36 hours

SNS ResponsibilitiesSNS Responsibilities�� SNSSNS

�� Send medications / vaccinesSend medications / vaccines

�� Provide technical assistanceProvide technical assistance

�� State and Local governmentsState and Local governments

�� Demonstrate need for suppliesDemonstrate need for supplies

�� Receive, stage, store and return suppliesReceive, stage, store and return supplies

�� Dispense at community PODs Dispense at community PODs

�� HospitalsHospitals

�� Receive, store and return suppliesReceive, store and return supplies

�� Dispense to at hospital PODsDispense to at hospital PODs

Kent

Sharon

Stafford

Killingly

Norfolk Salisbury

Litchfield

Newtown Lyme

Lebanon

Guilford

Suffield

Goshen Tolland

Granby Woodstock

Haddam

New Milford

Cornwall

Danbury

Pomfret Ashford

Union

Hebron

Montville

Enfield

Oxford Ledyard

Groton

Mansfield

Plainfield

Berlin

Salem

Colchester

Avon

Thompson

Greenwich

Wilton

Glastonbury

Madison

Bristol

Coventry

Griswold

Canaan

Stamford

Shelton

East Haddam

Preston

Easton

Hartland

Torrington

Ellington

Hamden Southbury

Voluntown

Redding

Fairfield

Warren

Windsor

Middletown

Somers

Cheshire

Stonington

Simsbury

Canterbury

Wallingford

Norwich Woodbury

Sterling

Waterford

Eastford

Ridgefield

Canton

Monroe

Willington

Milford

Brooklyn

Washington

North Stonington

Colebrook

Roxbury

Killingworth

Harwinton

Southington

Winchester

Burlington

Morris

Durham

Meriden

Windham

Barkhamsted

Portland

New Hartford

Bozrah

Wolcott Waterbury

Norwalk

Hampton

Watertown

Weston Trumbull

Bethel

Putnam

Old Lyme

Bethany

Chaplin

Vernon

Branford

Farmington

Lisbon

Bloomfield

Franklin

Plymouth

Manchester

Clinton Orange

Bolton

Columbia

Westport

Chester

South Windsor

Essex

Darien

Andover

Bethlehem

Seymour

Sprague

Naugatuck

North Canaan

Cromwell

East Lyme

East Hampton Sherman

Hartford

Stratford

Scotland

Brookfield

East Windsor

New Fairfield

Marlborough

North Branford

New Canaan

Middlebury

North Haven

New Haven

Prospect

West Hartford

Woodbridge

Bridgeport

Westbrook

Bridgewater

East Hartford

East Granby

Rocky Hill

Deep River

Newington

Middlefield

Old Saybrook

New Britain Plainville

East Haven

Thomaston Wethersfield

West Haven

Derby Ansonia

Beacon Falls

Windsor Locks

New London

09 41

38

24

37

40

34

35

08

21

36

14

39

07

20 13 06

33

16

12

04

28

31

10

25

02

29

01

26

03

05 23

15

34

22

32

17

19

30

11

27

18

DEMHS Region1

2 3

4 5

State of Connecticut Mass Dispensing Areas and

MDA Lead Health Number Department/ District

01 Greenwich HD 02 Stamford HD 03 Norwalk HD 04 Westport HD 05 Danbury HD 06 Bethel HD 07 Newtown HD 08 New Milford HD 09 Torrington Area HD 10 Fairfield HD 11 Bridgeport HD 12 Stratford HD 13 Naugatuck Valley HD 14 Pomperaug HD 15 Waterbury HD 16 Chesprocott HD 17 Milford HD 18 West Haven HD 19 New Haven HD 20 Quinnipiack Valley HD 21 Guilford HD 22 Meriden HD 23 Wallingford HD 24 Farmington Valley HD 25 Bristol/ Burlington HD 26 Southington HD 27 New Britain HD 28 Central Connecticut HD 29 WH/ Bloomfield HD 30 Hartford HD 31 Windsor HD 32 East Hartford HD 33 Manchester HD 34 North Central HD 35 Chatham HD 36 Middletown HD 37 Ledge Light HD 38 Uncas HD 39 CT River Area HD 40 Eastern Highlands HD 41 Northeast HD

Department of Emergency Management and

May 24, 2006

40

Homeland Security Planning Regions

Blue Spot Fever ScenarioBlue Spot Fever Scenario•

•••

•••

In January a new infectious disease emerged called “blue spot fever.” At first, the disease seemed to be limited to a few isolated cases. However, as more cases were identified, it became clear that the disease was spreading. By May, the diseaseappeared in several regions of the eastern United States.

Scientists with the US Centers for Disease Control and Prevention (CDC) have determined that blue spot fever spreads easily from person-to-person in respiratory droplets created while coughing or sneezing and is potentially fatal. However, certain medications called “antispotics” seem to provide effective protection if given within a few days of contact with an infected person.

Blue Spot Fever ScenarioBlue Spot Fever Scenario

The CDC has recommended that everyone living within a 50-mile radius of the identified cases receive the antispotics. Antispotics from the Strategic National Stockpile are sent to Connecticut.

Luckily, there is a sufficient quantity of the medication for everyone to receive it. In order to give medications to everyone designated by the CDC, local health departments / districts have to mobilize large numbers of staff and volunteersto set up local PODs and dispense antispotics.

How Will a POD Be Set Up?How Will a POD Be Set Up?

�� The layout of a POD is designed to The layout of a POD is designed to

facilitate accurate and rapid dispensing facilitate accurate and rapid dispensing

of a specific medication/vaccine of a specific medication/vaccine

�� Basic POD floor planBasic POD floor plan

�� VariationVariation

�� SituationSituation

�� Local circumstancesLocal circumstances

POD layoutPOD layout

Where will PODs be located?Where will PODs be located?

PODs locations must be :PODs locations must be :

�� Appropriate size and layout Appropriate size and layout

�� Can be secured Can be secured

�� Accessible Accessible


The POD planners in your Mass Dispensing Areaare concerned that the large number of people expected to come to the POD could cause severe traffic congestion. Therefore, they chose to locate the POD at a school that was right off the highway and away from the center of town. They also made sure that local police officers are available to assist with automobile traffic flow in the surrounding area.

To ensure the safety and security of POD workers and attendees, they chose a site where security officers can controlmovement into the clinic.

How will a POD be staffed?How will a POD be staffed?

�� It takes many people to run a PODIt takes many people to run a POD

�� Number and mix of skills on depends on situationNumber and mix of skills on depends on situation

�� Source of staffSource of staff

�� Public health and hospital staff membersPublic health and hospital staff members

�� Other first respondersOther first responders

�� VolunteersVolunteers

�� Representing many professions, disciplines, Representing many professions, disciplines,

agencies, and backgrounds.agencies, and backgrounds.

POD managementPOD management

How will POD operations How will POD operations

be managed?be managed?

�� Using the Incident Command System Using the Incident Command System

which is part of the National Incident which is part of the National Incident

Management System (NIMS). Management System (NIMS).

�� In compliance with:In compliance with:

�� with good emergency response practicewith good emergency response practice

�� federal requirementsfederal requirements

� Time and crisis tested

ICS Mass Dispensing POD Org ChartICS Mass Dispensing POD Org Chart


Successful dispensing of antispotics to the population within a short period of time requires clear command, control and coordination of human resources and materials.

Therefore, all PODs, including the ones in your Mass Dispensing area, are being managed using the Incident Command System.


At the beginning of the Blue Spot POD operation the scene seems a little chaotic.

However, as people settle into their emergency response functional roles and follow the chain of command a smooth rhythm ensues.

POD roles and POD roles and

responsibilitiesresponsibilities

How Will You Know When and How Will You Know When and

Where to Respond?Where to Respond?

�� If you are needed, you will be:If you are needed, you will be:

�� contacted by a designated person in health contacted by a designated person in health

department or hospitaldepartment or hospital

�� given specific information about where and given specific information about where and

when to report when to report

�� On site, you will report to the staff signOn site, you will report to the staff sign--in in area where you will be given an assignment area where you will be given an assignment

How Long Will You Be How Long Will You Be

Working in the POD?Working in the POD?

�� Shifts are usually 8Shifts are usually 8--12 hours12 hours

�� The POD will be in operation until The POD will be in operation until

the mission has been achievedthe mission has been achieved

What Should You Bring ?

��Bring as little as possibleBring as little as possible

��BringBring

�� Photo identification Photo identification –– requiredrequired

�� POD Go PakPOD Go Pak

�� Specific equipment, as requested Specific equipment, as requested –– e.g. e.g.

stethoscopestethoscope

�� Food will be provided to you while you work Food will be provided to you while you work

at the POD. at the POD.


At the time of this epidemic, you are called on to work at a POD. Given the large number of people who need prophylaxis you are asked to serve several shifts over a 48 hour period. You commit to serving at the POD. You are told to report to a designated site near the selected POD location at 8:00am. You are told to bring your driver’s license for identification.

When you arrive at the designated site you sign-in and receive an ID badge. Once everyone is signed-in a bus takes you, and the other POD workers, to the POD site.

How Will You Know What to Do How Will You Know What to Do

When You Arrive at the POD?When You Arrive at the POD?

�� Job Action SheetJob Action Sheet

�� JustJust--inin--time trainingtime training

Job Action SheetJob Action Sheet

�� Job titleJob title

�� Job missionJob mission

�� To whom you report To whom you report

�� Tasks to performTasks to perform

JustJust--inin--time Trainingtime Training

�� The training delivered at the time of The training delivered at the time of

an incident an incident

�� Focused on providing the knowledge Focused on providing the knowledge

and skills you need to fill your role and skills you need to fill your role

JITT for short

How Will You be How Will You be

Assigned a Role ?Assigned a Role ?�� Incident Commander or designee will assign Incident Commander or designee will assign

a role based on a role based on

�� Your skillsYour skills

�� Needs of the operationNeeds of the operation

�� You may be reYou may be re--assigned as the needs of the assigned as the needs of the

operation changeoperation change

POD roles

Blue Spot Fever Scenario

When you and the other POD workers arrive at the POD site you are given just-in-time training as a group. The training includes information on Blue Spot Fever and the set up and organization of the POD including arrangements for security, food and breaks.

You are a registered nurse. You have received training on being a smallpox vaccinator. However, at this POD medication, not vaccine, is being dispensed. You are assigned to work as a Triage Officer and given a job action sheet for the role. Your supervisor is the Triage Unit Leader.

After the group training session, you go to the Triage Unit. Your supervisor gives you and the other Triage Officers just-in-time training on your role as described in your job action sheet.

You review the form you will be using to perform triage. You don’t understand one of the questions. You ask your supervisor and she explains the question to you.


How Will You be Protected?How Will You be Protected?

�� Vaccination or medication being dispensed Vaccination or medication being dispensed

before the POD opensbefore the POD opens

�� Supply and training on appropriate personal Supply and training on appropriate personal

protective equipmentprotective equipment

�� Safety officer always presentSafety officer always present

�� Facilities for food & restFacilities for food & rest

All appropriate precautions will be All appropriate precautions will be All appropriate precautions will be All appropriate precautions will be

taken to protect POD workers.taken to protect POD workers.taken to protect POD workers.taken to protect POD workers.

Dealing with stress

Working at a POD may be a stressful Working at a POD may be a stressful

�� Monitor self and others for signs of stress Monitor self and others for signs of stress

and fatigueand fatigue

�� POD attendees and coPOD attendees and co--workers may vent workers may vent

anger. Donanger. Don’’t take it too personally. t take it too personally.

�� Mental health workers will be available on Mental health workers will be available on

site.site.

Report any serious problems to supervisorReport any serious problems to supervisor

What are signs of stress What are signs of stress

and fatigue?and fatigue?

�� Lack of concentrationLack of concentration

�� Increased number of nonIncreased number of non--critical errorscritical errors

�� Critical errorsCritical errors

�� IrritabilityIrritability

�� Worry Worry

�� Feeling illFeeling ill


Before the clinic is open you, and the other POD workers, are given antispotics.

It appears that the organism that causes Blue Spot Fever can be spread by respiratory droplets from coughs or sneezes. POD workers who interact closely with members of the public have been told to wear masks.


You notice that some of the triage officers are wearing their masks on the top of their heads rather than over their nose and mouth. You suggest that they wear it properly but they continue to wear them on their heads. You tell your unit leader. The Safety Officer is informed about the situation and stops the movement of patients to Triage until the Triage Officers put on their masks. Later on you notice that a fellow Triage Officer is making critical errors and appears to be experiencing extreme anxiety. You tell your Unit Leader who arranges for that Triage Officer to have a break and meet with a Mental/Behavioral Health Specialist.

What Are Ethical Guidelines for What Are Ethical Guidelines for

Working in a POD?Working in a POD?

�� Treat members of the public with fairness Treat members of the public with fairness

and respectand respect

�� CourtesyCourtesy

�� ConfidentialityConfidentiality

�� No favoritism or discriminationNo favoritism or discrimination

�� DonDon’’t spread rumors t spread rumors

�� Honor your commitment to work at a POD Honor your commitment to work at a POD until the mission is complete. until the mission is complete. Your fellow staff members and the public are relying on you.

What Do You Do When It's What Do You Do When It's

Time to Leave?Time to Leave?

� Your supervisor will tell you

when your shift is complete

�� When leaving yWhen leaving your supervisor our supervisor

may ask you tomay ask you to::

�� brief him/herbrief him/her

�� turn in a report or equipmentturn in a report or equipment

�� Always cAlways check out at the staff deskheck out at the staff desk any time any time

you leave a PODyou leave a POD

What Do You Do When It's What Do You Do When It's

Time to Leave?Time to Leave?

�� Your supervisor will also tell you when Your supervisor will also tell you when

the mission is complete and your the mission is complete and your

service is no longer neededservice is no longer needed

�� You will be asked to participate in a You will be asked to participate in a

debriefing called a debriefing called a ‘‘hot washhot wash’’

After 4 days you are told that the POD is shutting down. It has achieved its mission of providing antispotics to the members of your community and therefore saving lives.

You participate in a hotwash so that lessons can be learned from the strengths and weaknesses of the operation. You are thanked for your service to your community.


Preparing to work Preparing to work

at a PODat a POD

How Can I Be Ready to Serve?How Can I Be Ready to Serve?

1.1. Have a family preparedness planHave a family preparedness plan

2.2. Participate in available training & exercisesParticipate in available training & exercises

3.3. Be prepared to work under the Incident Be prepared to work under the Incident Command SystemCommand System

4.4. Be sure your employer has your current Be sure your employer has your current contact informationcontact information

5.5. Prepare a POD go packPrepare a POD go pack

�� Communication with Communication with

household membershousehold members

�� Care for dependent Care for dependent

elders, children and elders, children and

petspets

�� Home securityHome security

�� Household Household

medication needsmedication needs

�� Transportation needsTransportation needs

The Connecticut Guide to Emergency Preparedness is available to help you prepare a family preparedness plan

www.dph.state.ct.us/bt/ready/preparedness12pg.pdf

�� Photo identification Photo identification

�� List of Contact number for your familyList of Contact number for your family

�� MedicationsMedications

�� Personal hygiene items (hand sanitizer, Personal hygiene items (hand sanitizer,

toothbrush, toothpaste toothbrush, toothpaste

�� If deployed away from homeIf deployed away from home

�� Pillows / blanketsPillows / blankets

�� ClothingClothing

�� First aid suppliesFirst aid supplies

�� Cell phone chargerCell phone charger

POD Go Pack POD Go Pack

Where Can You Get

Additional Training?

�� Consult your POD trainerConsult your POD trainer

�� TRAINConnecticutTRAINConnecticut�� Online library of coursesOnline library of courses

�� http://ct.train.orghttp://ct.train.org

CT training plan for POD workersCT training plan for POD workers

ConclusionConclusion

1.1. A POD is established to dispense a A POD is established to dispense a

vaccine, antibiotic or other vaccine, antibiotic or other

medication quickly to a large group of medication quickly to a large group of

people usually to prevent diseasepeople usually to prevent disease

2.2. The clinic flow is intended to maximize The clinic flow is intended to maximize

movement through the PODmovement through the POD

3.3. PODs are managed using the Incident PODs are managed using the Incident

Command SystemCommand System

Conclusions

4.4. Each POD worker will be assigned a Each POD worker will be assigned a

specific role which will be described specific role which will be described

in a Job Action Sheetin a Job Action Sheet

5.5. Safety of POD workers is paramountSafety of POD workers is paramount

6.6. Plan and train Plan and train nownow to be an effective to be an effective

POD workerPOD worker

AcknowledgementsAcknowledgements

Materials derived from course entitled Materials derived from course entitled ““Working in a Working in a PODPOD”” developed by the New York Consortium for developed by the New York Consortium for Emergency Preparedness Continuing Education Emergency Preparedness Continuing Education (NYCEPCE). (NYCEPCE).

The CT DPH and Yale CPHP are grateful to those who The CT DPH and Yale CPHP are grateful to those who provided material for the course, especially the provided material for the course, especially the NYCEPCE for sharing their course content. NYCEPCE for sharing their course content.

The development of this course was supported by The development of this course was supported by CDC Cooperative Agreements No. U90/CCU124251CDC Cooperative Agreements No. U90/CCU124251--01 and01 and No. U90/CCU116996No. U90/CCU116996

Acknowledgements (cont.)Additional material included in the course Additional material included in the course came from:came from:

�� Connecticut Association of Health Directors. Orientation to Connecticut Association of Health Directors. Orientation to Connecticut Mass Dispensing Clinics Parts 1 & 2.Connecticut Mass Dispensing Clinics Parts 1 & 2.

�� Centers for Disease Control and Prevention. Strategic National Centers for Disease Control and Prevention. Strategic National Stockpile web site. Stockpile web site. http://www.bt.cdc.gov/stockpile/http://www.bt.cdc.gov/stockpile/

�� FEMA IS Course Material Download: FEMA IS Course Material Download: ISIS--100 Introduction to Incident Command System, I100 Introduction to Incident Command System, I--100. 100.

�� FEMA IS Course Material Download: FEMA IS Course Material Download: ISIS--100 Introduction to Incident Command System, I100 Introduction to Incident Command System, I--100. 100. http://www.training.fema.gov/EMIWeb/IS/is100lst.asphttp://www.training.fema.gov/EMIWeb/IS/is100lst.asp

�� POD training materials from the Connecticut Health POD training materials from the Connecticut Health Departments/Districts of Manchester, Ledge Light and Eastern Departments/Districts of Manchester, Ledge Light and Eastern Highlands.Highlands.

�� Virginia Department of Health, Emergency Preparedness and Virginia Department of Health, Emergency Preparedness and Response Programs. Unit 1 Response Programs. Unit 1 –– Dispensing / Vaccination Site TrainingDispensing / Vaccination Site Training

�� University of Minnesota Center for Public Health Preparedness. MUniversity of Minnesota Center for Public Health Preparedness. Mass ass Dispensing Sites: A Primer for Volunteers. Dispensing Sites: A Primer for Volunteers. http://www.sph.umn.edu/umncphp/massdisp/home.htmlhttp://www.sph.umn.edu/umncphp/massdisp/home.html

QuestionsQuestions

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