Presentation: World Conference on Disaster Management, June 2010

8/9/2019 Presentation: World Conference on Disaster Management, June 2010

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Excellent Healthcare in Every Neighborhood.

All rights reserved. PCDC 2009

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Diamonds in the RoughHow Emergency Managers & Public Health Officials Can Use

Community Partners to Deliver Low-Cost & Effective

Emergency Management & Business Continuity Services

Presentation to the

World Conference on Disaster Management

Joan Thomas, MPA, ABCP, MEP, Senior Program Manager

Brian Silva, EMT, MPA, Program ManagerPrimary Care Development Corporation

June 7, 2010 Session 306


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Welcome!

Photo Credit: https://reader010.{domain}/reader010/html5/0531/5b0f196655ba4/5b0f19682b273.jpg

hola * * hallo *bonjour * * ciao *


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Objectives

Overview of the modified distribution model and

critical aspects that make it successful

Learn specific experiences using the modified

distribution model as a cost-effective and efficient

means to deliver services

Understand how you can modify the system to fit

your needs


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About Primary Care Development

Corporation (PCDC)


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Primary Care Development Corporation (PCDC)

Public Private Partnership formed in 1993 tostrengthen primary care in underservedcommunities

Helped dozens of providers serving hundreds ofthousands of low-income patients

Capital Access

Performance Improvement Health Information Technology (HIT)

Emergency Preparedness

Operations Improvement

Policy Leadership


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Emergency Preparedness Programs (Partial)

Primary Care Emergency Preparedness Program (PCEPP) Basic

Comprehensive Emergency Operations Planning

Advanced Staff Training

Drills & Exercises

Community Integration

Adult Care Emergency Preparedness Program (ACEPP)

Mass Vaccination / Distribution Operations

Business Continuity Planning


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Community Based POD

Project Overview


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Definitions

Primary Care Comprehensive first contact and continuing

coordinated care provided by physicians

Community Healthcare Center(CHC)

Community-based and patient-directed organizationsproviding health services to populations with limited

access to health care (i.e. low income, the uninsured,

limited English)

Point of Dispensing (POD) A place to dispense items (medical and non) to large

numbers of people as rapidly as possible

Technical Assistance Assistance such as coaching and mentoring designed

to impart knowledge, create sustainability and build

internal capacity


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Background

New York City as the USA epicenter of H1N1 in the spring

of 2009

Large influx at hospital emergency rooms requesting care, notes forwork/school and information

47 confirmed deaths

996 hospitalizations, confirmed and probable (preliminary data)

Almost 16% of New York City residents reported influenza-like

symptoms in a5

0-day period

Department of Health reached out to PCDC to help design a

community based POD program


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POD Process Overview

Project Design

Technical Assistance

POD Execution

After Action & Improvement Planning


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PCDC H1N1 POD Sites


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Statistics & Demographics

19 primary care sites

Located in all five New York City boroughs

Targeted CDC defined at-risk categories of residents

470 POD staff trained (including volunteers)

Average 6 dispensers per POD


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Statistics & Demographics

Total of 90 hours spent vaccinating

7500 patients seen

7000 received H1N1 vaccine

231 received seasonal flu vaccine

Busiest POD vaccinated 950 patients in 4 hours

Project ran August 2009 through January 2010

All PODs executed within a 30-day window (October

November)


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Summary of Benefits

Use existing resources

Lower cost

Trust already established with community

Community integration

Positive impact on local economy


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Summary of Benefits

Decrease the dependence on large numbers of volunteers

Good PR / local support for health centers

Vaccinate lots of people

Prevent ER visits both for treatment or vaccinations

Prevent spread of H1N1


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Questions?


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Community Based POD

Project Details


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POD Process Overview Project Design & Recruitment

Learning Session

Technical Assistance Staff Training

Drills

POD Execution

After Action Report / Improvement Plan (AAR/IP)


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Project Design & Recruitment Work with local department of health

Provide technical assistance and resources Stipends POD Guidance Document

PCDC coaching

Ability to reach high-risk populations

Graduates of the PCDC PCEPP program

Timeline


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Learning Session

One day session 20+ sites; 100+ people

Agenda H1N1 Overview

PODs Overview

Panel Discussion: POD First Hand Experiences Technical Assistance

POD Planning Sessions

Staff Training & After Action Reporting


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Learning Session Resources

Community Based POD Guidance Document

POD Operations

Job Action Sheets

POD Planning Document

NYC H1N1 Materials

Other Resources


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What is a POD? Point of Dispensing (POD)

It is a place to dispense antibiotics or vaccine tolarge numbers of people as rapidly as possible to

prevent them from becoming ill or dying

This dispensing is called mass prophylaxis

PODs are NOT for treating sick people


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How to Create Community Based PODs

1. Organize a POD Planning Team

2. Review the POD Guidance Document

3. Customize the POD plan for their PCC including a flow

chart

4. Choose a date and time for their POD

5. Acquire POD resources (staff & supplies)


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How to Create Community Based PODs

6. Do a POD walk through with the Planning Team and adjust

the plan

7. Train & Drill staff on the final POD plan

8. Complete POD including evaluation & hot wash

9. Complete AAR / IP

10.Using AAR / IP update POD plan and retrain and drill staff


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POD Operations1. Waiting Line / Area Station

2. Screening Station

3. Medical Evaluation Station

4. Dispensing Station

5. Command & Control Station


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Registration /

Screening

Entrance Exit

Dispensing

Evaluation Needed

No Evaluation Needed Medical Evaluation

How is a POD Set Up?


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POD Planning Team

The ideal team:

Senior Management

Clinical RN

MD

Facilities

Front Desk Staff Other staff as necessary


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Technical Assistance

Each site assigned a PCDC coach

3-4 meetings over45-90 days

Provide coaching to sites:

Project Management Support POD Design

Staff Training & Drills

Troubleshooting


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POD Execution Crowds arrived up to two hours before the advertised

opening time

Patients lined up orderly and given forms to fill out prior toentering the POD (checked by staff)

POD staff would check forms and screen patients

Patients directed to medical evaluator or dispenser forvaccination

Patients out of dispensers often in under 2 minutes


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Command & Waiting Screening Medical Dispensing

Control Room Evaluation


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AAR / IP Each site conducted a hotwash after the POD

Information gathered was used in writing the AAR/IP

PCDC provided an AAR/IP template as well as training

Primary Care Emergency Preparedness Program Basic

POD Learning Session

Site self-training

All AAR/IPs aggregated to improve POD resources for

future events and trainings


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Conclusions


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Summary of Benefits Use existing resources

Lower cost

Trust already established with community

Community integration

Positive impact on local economy


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Summary of Benefits Decrease the dependence on large numbers of volunteers

Good PR / local support for health centers

Vaccinate lots of people

Prevent ER visits both for treatment or vaccinations

Prevent spread of H1N1


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Lessons Learned Areas of Success Walk through, staff training and drills before the POD are key

Provided a venue to provide additional health information and services topatients after the POD

Staff reaction extraordinarily positive

On average, cycle time through the POD was short

Health centers able to play a major role in an emergency event; hospitals andhealth departments view them as critical partners

Overall positive patient response to community based PODs

Health centers were able to continue regular operations while executing thePOD


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Lessons Learned Areas of Improvement Encourage partnering for POD sites & teams

Provide clear information to accessing volunteers

Increase scope and intensity of marketing / outreach

All POD forms in the languages of the community being served

Prepare for crowds to arrive early

Staff enthusiasm needs to be balanced with appropriate breaks, snacks,water, etc.


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Questions?


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All i ht d PCDC 2009

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Thank You!

Brian Silva, MPA, EMT

Program Manager

212.437.3937

[email protected]

Joan Thomas, MPA, ABCP, MEP

Senior Program Manager

212.437.3924

[email protected]

Presentation: World Conference on Disaster Management, June 2010

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