424: Ability of Hospitals to Meet Influenza Pandemic Surge Capacity Requirements: Regionalization In Disaster Response

At a major referral hospital in the Southern Hemisphere, the 2009 influenza A (H1N1) pandemic brought increased critical care demand and more unscheduled nursing absences. Because of careful preparedness planning, including rapid expansion and redistribution of the numbers of available beds and staff, hospital surge capacity was not exceeded.

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Medical Students' Participation in the 2009 Novel H1N1 Influenza Vaccination Administration: Policy Alternatives for Effective Student Utilization to Enhance Surge Capacity in Disasters

Disaster Medicine and Public Health Preparedness ◽

10.1001/dmp.2011.33 ◽

2011 ◽

Vol 5 (2) ◽

pp. 150-153 ◽

Cited By ~ 6

Author(s):

Heather E. Kaiser ◽

Daniel J. Barnett ◽

Awori J. Hayanga ◽

Meghan E. Brown ◽

Andrew T. Filak

Keyword(s):

Public Health ◽

Medical Students ◽

Disaster Response ◽

H1n1 Influenza ◽

Policy Dialogue ◽

Surge Capacity ◽

Policy Alternatives ◽

The Status ◽

Response And Recovery ◽

Novel H1n1 Influenza

ABSTRACTAs cases of 2009 novel H1N1 influenza became prevalent in Cincinnati, Ohio, Hamilton County Public Health called upon the University of Cincinnati College of Medicine to enhance its surge capacity in vaccination administration. Although the collaboration was well organized, it became evident that a system should exist for medical students' involvement in disaster response and recovery efforts in advance of a disaster. Therefore, 5 policy alternatives for effective utilization of medical students in disaster-response efforts have been examined: maintaining the status quo, enhancing the Medical Reserve Corps, creating medical school–based disaster-response units, using students within another selected disaster-response organization, or devising an entirely new plan for medical students' utilization. The intent of presenting these policy alternatives is to foster a policy dialogue around creating a more formalized approach for integrating medical students into disaster surge capacity–enhancement strategies. Using medical students to supplement the current and future workforce may help substantially in achieving goals related to workforce requirements. Discussions will be necessary to translate policy into practice.(Disaster Med Public Health Preparedness. 2011;5:150–153)

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Ability of Regional Hospitals to Meet Projected Avian Flu Pandemic Surge Capacity Requirements

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00005707 ◽

2008 ◽

Vol 23 (2) ◽

pp. 103-112 ◽

Cited By ~ 8

Author(s):

Raymond P. Ten Eyck

Keyword(s):

Avian Influenza ◽

Negative Pressure ◽

Disaster Preparedness ◽

Influenza Pandemic ◽

Neuraminidase Inhibitor ◽

Home Healthcare ◽

Surge Capacity ◽

Avian Flu ◽

Preparedness Planning ◽

Complete Set

AbstractIntroduction:Hospital surge capacity is a crucial part of community disaster preparedness planning, which focuses on the requirements for additional beds, equipment, personnel, and special capabilities.The scope and urgency of these requirements must be balanced with a practical approach addressing cost and space concerns. Renewed concerns for infectious disease threats, particularly from a potential avian flu pandemic perspective, have emphasized the need to be prepared for a prolonged surge that could last six to eight weeks.Null Hypothesis:The surge capacity that realistically would be generated by the cumulative Greater Dayton Area Hospital Association (GDAHA) plan is sufficient to meet the demands of an avian influenza pandemic as predicted by the [US] Centers for Disease Control and Prevention (CDC) models.Methods:Using a standardized data form, surge response plans for each hospital in the GDAHA were assessed.The cumulative results were compared to the demand projected for an avian influenza pandemic using the CDC's FluAid and FluSurge models.Results:The cumulative GDAHA capacity is sufficient to meet the projected demand for bed space, intensive care unit beds, ventilators, morgue space, and initial personal protective equipment (PPE) use. There is a shortage of negative pressure rooms, some basic equipment, and neuraminidase inhibitors. Many facilities lack a complete set of written surge policies, including screening plans to segregate contaminated patients and staff prior to entering the hospital. Few hospitals have agreements with nursing homes or home healthcare agencies to provide care for patients discharged in order to clear surge beds. If some of the assumptions in the CDC's models are changed to match the morbidity and mortality rates reported from the 1918 pandemic, the surge capacity of GDAHA facilities would not meet the projected demand.Conclusions:The GDAHA hospitals should test their regional distributors' ability to resupply PPE for multiple facilities simultaneously. Facilities should retrofit current air exchange systems to increase the number of potential negative pressure rooms and include such designs in all future construction. Neuraminidase inhibitor supplies should be increased to provide treatment for healthcare workers exposed in the course of their duties. Each hospital should have a complete set of policies to address the special considerations for a prolonged surge. Additional capacity is required to meet the predicted demands of a threat similar to the 1918 pandemic.

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The road less taken: Modularization and waterways as a domestic disaster response mechanism

Journal of Emergency Management ◽

10.5055/jem.2013.0140 ◽

2017 ◽

Vol 11 (3) ◽

pp. 225

Author(s):

Donald A. Donahue Jr, DHEd, MBA, FACHE ◽

Stephen O. Cunnion, MD, PhD, MPH ◽

Evelyn A. Godwin, MS, RN

Keyword(s):

Disaster Response ◽

Single Point ◽

American Population ◽

Response Mechanism ◽

Surge Capacity ◽

The Road ◽

Deployment Cycle ◽

Capacity Current ◽

Mode Of Transportation ◽

The Military

Preparedness scenarios project the need for significant healthcare surge capacity. Current planning draws heavily from the military model, leveraging deployable infrastructure to augment or replace extant capabilities. This approach would likely prove inadequate in a catastrophic disaster, as the military model relies on forewarning and an extended deployment cycle. Local equipping for surge capacity is prohibitively costly while movement of equipment can be subject to a single point of failure. Translational application of maritime logistical techniques and an ancient mode of transportation can provide a robust and customizable approach to disaster relief for greater than 90 percent of the American population.

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A tabletop school bus rollover: Connecticut-wide drills to build pediatric disaster preparedness and promote a novel hospital disaster readiness checklist

American Journal of Disaster Medicine ◽

10.5055/ajdm.2019.0318 ◽

2019 ◽

Vol 14 (2) ◽

pp. 75-87

Author(s):

Mark X. Cicero, MD ◽

Klevi Golloshi, BS ◽

Marcie Gawel, MSN ◽

James Parker, MD ◽

Marc Auerbach, MD, MSci ◽

...

Keyword(s):

Disaster Preparedness ◽

Disaster Response ◽

Coalition Building ◽

National Guidelines ◽

School Bus ◽

Surge Capacity ◽

Preparedness Plan ◽

Public Health Officials ◽

Complete Survey ◽

Survey Responses

Objective: To assess emergency medical services (EMS) and hospital disaster plans and communication and promote an integrated pediatric disaster response in the state of Connecticut, using tabletop exercises to promote education, collaboration, and planning among healthcare entities.Design: Using hospital-specific and national guidelines, a disaster preparedness plan consisting of pediatric guidelines and a hospital checklist was created by The Connecticut Coalition for Pediatric Disaster Preparedness.Setting: Five school bus rollover tabletop exercises were conducted, one in each of Connecticut’s five EMS regions. Action figures and playsets were used to depict patients, healthcare workers, vehicles, the school, and the hospital.Participants: EMS personnel, nurses, physicians and hospital administrators.Intervention: Participants had a facilitated debriefing of the EMS and prehospital response to disasters, communication among prehospital organizations, public health officials, hospitals, and schools, and surge capacity, capability, and alternate care sites. A checklist was completed for each exercise and was used with the facilitated debriefing to generate an after-action report. Additionally, each participant completed a postexercise survey.Main Outcome Measures: Each after-action report and postexercise survey was compared to established guidelines to address gaps in hospital specific pediatric readiness.Results: Exercises occurred at five hospitals, with inpatient capacity ranging 77-1,592 beds, and between 0 and 221 pediatric beds. There were 27 participants in the tabletop exercises, and 20 complete survey responses for analysis (74 percent). After the exercises, pediatric disaster preparedness aligned with coalition guidelines. However, methods of expanding surge capacity and methods of generating surge capacity and capability varied (p 0.031).Conclusion: Statewide tabletop exercises promoted coalition building and revealed gaps between actual and ideal practice. Generation of surge capacity and capability should be addressed in future disaster education.

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Self-Adaptation in Dynamic Disaster Environments: Response to the 2006 Avian Influenza Crisis in Turkey

Journal of Asian and African Studies ◽

10.1177/0021909614558954 ◽

2016 ◽

Vol 51 (6) ◽

pp. 742-759 ◽

Cited By ~ 1

Author(s):

Sitki Corbacioglu ◽

Suleyman Celik ◽

Ulvi Saran

Keyword(s):

Avian Influenza ◽

Disaster Management ◽

Complex Adaptive Systems ◽

Disaster Response ◽

Adaptive Systems ◽

Influenza Pandemic ◽

Sufficient Information ◽

Complex Adaptive ◽

Research Findings ◽

Self Adaptation

This paper examines the response to the 2006 avian influenza crisis in Turkey. Using complex adaptive systems as the theoretical framework, the paper discusses the extent to which the Turkish disaster management system showed self-adaptation during the crisis. Self-adaptation requires organizational flexibility that facilitates sufficient information flow through technical and cultural infrastructures. This study uses qualitative methods to analyze the data. The research findings indicate that during the crisis, Turkish disaster management was faced with critical difficulties related to organizational, technical and cultural capacities that undermined its capacity to adapt to changing conditions. The system was able to manage these difficulties in seven to ten days; however, Turkey’s contemporary disaster response services still require a transformation to effectively respond to any influenza pandemic.

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Do Shared Barriers When Reporting to Work During an Influenza Pandemic Influence Hospital Workers’ Willingness to Work? A Multilevel Framework

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2015.4 ◽

2015 ◽

Vol 9 (2) ◽

pp. 175-185 ◽

Cited By ~ 1

Author(s):

Yoon Soo Park ◽

Laudan Behrouz-Ghayebi ◽

Jonathan J. Sury

Keyword(s):

Disaster Response ◽

Influenza Pandemic ◽

Hospital Workers ◽

Hospital Administrators ◽

Clinical Support ◽

Care Workers ◽

Region Of Residence ◽

Response Capacity ◽

Willingness To Report ◽

Job Role

ABSTRACTObjectiveCharacteristics associated with interventions and barriers that influence health care workers’ willingness to report for duty during an influenza pandemic were identified. Additionally, this study examined whether workers who live in proximal geographic regions shared the same barriers and would respond to the same interventions.MethodsHospital employees (n=2965) recorded changes in willingness to work during an influenza pandemic on the basis of interventions aimed at mitigating barriers. Distance from work, hospital type, job role, and family composition were examined by clustering the effects of barriers from reporting for duty and region of residence.ResultsAcross all workers, providing protection for the family was the greatest motivator for willingness to work during a pandemic. Respondents who expressed the same barriers and lived nearby shared common responses in their willingness to work. Younger employees and clinical support staff were more receptive to interventions. Increasing distance from home to work was significantly associated with a greater likelihood to report to work for employees who received time off.ConclusionsHospital administrators should consider the implications of barriers and areas of residence on the disaster response capacity of their workforce. Our findings underscore communication and development of preparedness plans to improve the resilience of hospital workers to mitigate absenteeism (Disaster Med Public Health Preparedness. 2015;9:175-185).

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(A50) The Nurse as Incident Commander

Prehospital and Disaster Medicine ◽

10.1017/s1049023x11000628 ◽

2011 ◽

Vol 26 (S1) ◽

pp. s15-s15

Author(s):

D.J. Persell

Keyword(s):

Public Health ◽

Homeland Security ◽

Disaster Response ◽

Public Awareness ◽

Influenza Pandemic ◽

World Health ◽

Student Health ◽

Public Health Response ◽

Incident Command ◽

The University

The year 2010 brought an unprecedented public health response to the novel H1N1 influenza pandemic. Included in that response were colleges and universities across the globe. At universities not associated with medical centers, medical directors of student health looked to nursing faculty or nurse practitioner directors of student health for leadership. From the day novel H1N1 was formally declared a public health emergency, Arkansas State University utilized a nurse faculty member with expertise in homeland security as its Incident Commander. A portion of the nurse's time was dedicated to managing the incident. The nurse was positioned to provide guidance and lead the response with an understanding of university structures as well as business and academic continuity. From the beginning, the nurse utilized the Incident Command System to manage the response. Portions of the University's Incident Command structure were activated and Incident Command meetings were held no less than every two weeks. A tabletop exercise was developed specifically for a university setting and to give University officials practice at pandemic management. The nurse's clinical focus and pre-established relationships with disaster response and public health officials allowed critical access to important resources that the University would have otherwise gone without. She guided the University through redefining their pandemic plan, including assisting residence life in establishing alternative housing for sick students. An on-line reporting system was developed that was utilized by faculty, students, staff, and other concerned constituents. A public awareness campaign on the campus was instituted and 1,000 posters were posted around campus encouraging sick students to stay home and/or seek medical care. The World Health Organization, (US) Centers for Disease Control and Prevention, and Department of Education guidelines were monitored and implemented. Two mass-immunization clinics were held on the campus with > 7,000 immunizations provided.

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The Psychosocial Impact of Compounding Humanitarian Crises Caused by War and COVID-19 Informing Future Disaster Response

Prehospital and Disaster Medicine ◽

10.1017/s1049023x21000844 ◽

2021 ◽

pp. 1-5

Author(s):

Hakob Harutyunyan ◽

Artak Mukhaelyan ◽

Attila J. Hertelendy ◽

Amalia Voskanyan ◽

Todd Benham ◽

...

Keyword(s):

Health Care ◽

Health Care Workers ◽

Disaster Response ◽

Large Scale ◽

Health Care Systems ◽

Influenza Pandemic ◽

Care Workers ◽

Care Systems ◽

The Republic ◽

1918 Influenza

Abstract The coronavirus disease 2019 (COVID-19) pandemic has caused the greatest global loss of life and economic impact due to a respiratory virus since the 1918 influenza pandemic. While health care systems around the world faced the enormous challenges of managing COVID-19 patients, health care workers in the Republic of Armenia were further tasked with caring for the surge of casualties from a concurrent, large-scale war. These compounding events put a much greater strain on the health care system, creating a complex humanitarian crisis that resulted in significant psychosocial consequences for health care workers in Armenia.

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