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The 2012 Integrated Training Summit will take place May 21-25 in Nashville, Tennessee.

Wednesday, May 23rd

BB. EMR Best Practices: Pearls of Wisdom to Increase Clinical Efficiency

10:30 - 11:45

Summary

Open to the Public: limited to 60 concurrent users.

This workshop is designed for ESF#8 responders who use EMR in the field. In this workshop, instructors will present lessons learned and best practices derived from deployments, training, and exercises. Discussions will focus on the roles and responsibilities of ESF#8 providers in relation to their responsibilities for administering, monitoring, supervising, or utilizing EMR. Participants will also learn about EMR business practices that increase clinical efficiency. Participants will learn:

Please come prepared with your questions and plan to participate in an interactive question-and-answer session. Bring your team’s best practices to share with others.

Objectives

  1. Discuss EMR best practices with course participants for an understanding of how these practices will increase clinical efficiency.
  2. Cite suggestions of placement of EMR hardware for various types of clinical situations and operations.
  3. Discuss personnel placement and utilization for optimal clinical operation of the EMR application.
  4. Discuss the increased use of the EMR application and how to get the most out of it.
  5. Identify the roles and responsibilities of the various clinical positions in relationship to the use of the EMR application.

Intended Audience

Presenters

CC. Intro to Joint Patient Assessment Tracking (JPATS) System

10:30 - 11:45

Summary

Open Access: limited to 60 participants.

This workshop will provide an overview of JPATS, the HHS web-based application that tracks patients through the Federal patient movement system. Participants will review the Federal patient movement system and learn how JPATS is used to track patients from their entry into the system to their return to origin or final destination. A walk-through of the JPATS software application will include:

Instructors will walk participants through a guided tour of the application. They will also discuss best practices and lessons learned from actual deployments, field exercises, and training. After completing the course, participants may attend the JPATS Basic Application Training course or visit the DMIS Hands-On Lab, where they can gain a better understanding of the JPATS web application through facilitated hands-on practice with patient scenarios.

Objectives

  1. Describe the role of JPATS in the Federal patient movement system.
  2. Describe the procedure for registering patients.
  3. Discuss how changes in patient disposition are captured in JPATS.
  4. List and describe the reports available in the JPATS application.
  5. Describe the data elements found on the JPATS dashboard.

Intended Audience

Presenters

DD. Basic Information Technology (IT) for Electronic Medical Records (EMR): Clinical and IT Users

13:15 - 14:30

Summary

Open to the Public: limited to 30 concurrent users.

This workshop will allow participants to become familiar with the basic IT requirements of the Electronic Medical Records (EMR) system. EMR is the application that ESF #8 responders use to capture patient encounters during a disaster. Attendees will participate in a facilitated walk-through of the basic IT requirements for EMR setup and maintenance. This workshop will also include:

Participants wanting more experience with the system application should consider attending the Electronic Medical Records Overview workshop. Additional hands-on practice may be gained by attending the DMIS Hands-On Lab.

Objectives

  1. Identify and review EMR hardware and networking components.
  2. Describe the integration of the hardware configuration and the supporting software infrastructure.
  3. Describe the goals and performance standards associated with EMR setup in the BoO.
  4. Demonstrate the EMR system and stand-alone setup.
  5. List the resources for obtaining additional IT support in the field.

Intended Audience

Presenters

EE. Joint Patient Assessment Tracking System (JPATS) Basic Application Training

13:15 - 14:30

Summary

Open Access: limited to 30 participants.

This workshop will allow participants to become familiar with the latest version of the JPATS web application. Following a brief review of the application, attendees will participate in instructor-led interactive lessons and exercises. Participants will learn all of the elements necessary to successfully master the JPATS application and track a patient through the Federal patient movement system. This course is geared to the new or inexperienced user. Experienced users may consider attending the JPATS Refresher workshop.

Participants wanting a more extensive review of the application before participating in hands-on training should consider attending the Introduction to JPATS workshop. Additional hands-on practice may be gained by attending the DMIS Hands-On Lab.

Objectives

  1. Describe the role of JPATS in the Federal patient movement system.
  2. Demonstrate the procedure for registering patients.
  3. Demonstrate how changes in patient disposition are captured in JPATS.
  4. Generate each type of report and identify the data contained in the report.
  5. Using the data elements found on the JPATS dashboard, recite a verbal summary report of patient movement activity at a specific location.
  6. List the resources for obtaining additional IT help in the field.

Intended Audience

Presenters

FF. Electronic Medical Records (EMR) Overview

15:15 - 16:45

Summary

Open to the Public: limited to 40 concurrent users.

This workshop will allow participants to become familiar with v.6 of the Electronic Medical Records (EMR) application. EMR is the application that ESF#8 providers use to capture patient encounters and document patient care during a disaster. A facilitated review of the EMR application includes:

Participants in this class will learn how the EMR application is integrated into DMIS to provide the most complete information about the medical care of patients treated during deployments. Following a facilitated walk-through of EMR, participants will have an opportunity for hands-on practice with the application.

Participants wanting more experience with the system setup should consider attending the Basic Information Technology for Electronic Medical Records workshop. Additional hands-on practice may be gained by attending the DMIS Hands-On Lab.

Objectives

  1. Provide a facilitated walk-through of the EMR software application.
  2. Complete an instructor-led, hands-on practice session using targeted practice scenarios.
  3. Identify and describe the hardware in the EMR cache.
  4. Review the roles and responsibilities of ESF#8 responders.
  5. Discuss the relevance and applicability of EMR in the context of the role of the ESF#8 responder.
  6. Describe how the EMR application is integrated into DMIS to provide information during response.

Intended Audience

Presenters

1. Opening/Keynote

08:30 - 09:00

2. Preparedness and Professionalism in Public Health and Disaster Management: Historical Reflections

09:00 - 10:00

Summary

In 1793 the ports of the United States were hit by a terrible yellow fever epidemic, in the new nation's largest city, Philadelphia, this epidemic had many effects that have attracted the attention of historians but one of the most far reaching was the argument, eventually successful, made by Benjamin Rush that members of a profession had a responsibility to the larger community not just their paying customers.

In the centuries which follow, in epidemic and disaster, the health and safety professions have discovered many individual and important tools and techniques to help manage the disasters and some of these will be highlighted. However, the costs of preparedness are real and immediate, as Ibsen noted in “An Enemy of the People,” “the majority never have right on their side”—as a result most preparedness is achieved after the fact of a disaster for which the community was inadequately prepared. As the flu threat and immunization campaign of 1976 demonstrated, preparedness without disaster can lead to significant public criticism.

Perhaps most importantly, as many new environmental threats emerged and independent professional traditions evolved in the twentieth century, it became clear that inter-professional education and cooperation would be crucial to future progress in management of and recovery from disasters and public health emergencies.

Objectives

  1. Outline the development of the professional obligation to the community
  2. Provide three examples of learning preparedness from disasters
  3. Recognize and outline the importance of different skill sets and professions in response to late twentieth century domestic disasters.

Presenters

3. Integrating Resilience into Disaster Medical Care

10:30 - 11:45

Summary

The panel will present a model of disaster medical care that integrates behavioral health into overall physical and emotional health and builds resilience among survivors of disasters. This model drastically changes the often stigmatizing approach of traditional mental health and its application to a disaster response.

Specifically, this model focuses on a whole person wellness approach to behavioral health care delivery in a disaster response. Survivors are solicited for common physical, emotional or behavioral concerns and briefly treated in conjunction with the medical care services. The goal is to augment the medical services being delivered as well as provide behavioral health care that is less stigmatized and addresses the needs of the whole person including adjustment to the disaster, grief, mental illness, or substance abuse.

Lastly, this model will assist the survivors in building resilience through education and encouragement of healthy behaviors. The panel will present an urgent care scenario in which a behavioral health team deployed a Wellness Center to augment medical care. Using self referral and physician referral forms citing common reactions to disaster, ie, eating, sleeping, emotional stress, substance use, and isolation, patients are provided with brief counseling and education. As a result, more than one out of every four sought behavioral health consultation and without disruption or delay to the provision of other health services.

The panel will present a resilience model that is particularly well suited to a disaster response to:

Objectives

  1. Explain the concept of wellness in improving resilience and how it can be implemented in a medical disaster response
  2. Operationalize concepts for implementation in a medical disaster response
  3. Describe clear roles for behavioral health providers in medical settings

Intended Audience

Presenters

4. Palliative Care Considerations in Disaster Situations

10:15 - 11:30

Summary

Palliative care has implications during disasters. While we routinely improve the quality of life and mitigate suffering for people facing serious illness our disaster preparedness planning efforts often fail to account and plan for those patients who will die from illness, injury, or lack of access to life-saving resources during disasters.

In mass casualty events, it is likely there will be more patients who require care than we have resources to treat. Those patients will require palliative care techniques; like pain and symptom management. Secondly, we will need to maintain services for those receiving palliative care services at the time of the disaster. Advanced illness and end-of-life care pose particular challenges during health emergences, given complex care needs and the often competing demands for trained providers, materiel and space.

This session will present and compare existing national guidelines for health emergency response, focusing on issues related to palliative and end-of-life care. Special attention will be given to the surge capacity planning needs of hospice and palliative care providers and to providing tools for leveraging their expertise to maximize care for patients with serious, advanced illness.

Objectives

  1. Discuss Health and Human Services (HHS) templates for states, emergency medical services (EMS) systems, hospitals and individual clinicians to guide decision making when implementing crisis standards of care that can be easily read, understood and executed during an incident.
  2. Explain existing guidelines for scarce resource allocation and crisis standards of care, and their implications for surge capacity planning factors for hospice and palliative care providers.
  3. Identify potential disaster scenarios that might be faced at the local and state level, requiring palliative care services.

Intended Audience

Presenters

5. Passing the Torch: Succession Planning Done Right?

10:30 - 11:45

Summary

One of the primary tasks of any quality Leader is the continual and progressive work around succession planning. There are those that say a great Leader may not be replaceable; and then there are those that say a great Leader should have prepared for such a transition. The successful Leader's role is to literally plan to be replaced! The welfare of any great organization depends upon this premise.

The primary acts that a great Leader performs to prepare for successful transitions are casting vision, planting and guarding the organizational culture, and fostering an environment where subordinate Leaders can perform in a "fail safe"manner, free to make mistakes and learn without sinking the organization as a whole. This presentation will center on these three primary acts and if done correctly and proactively, will lay the framework for a successful transition in any organization.

Finally, the great Leader must learn firsthand that the success or failure of such a transition lies completly within. Ego management, over or lack of confidence, and personal motives and behaviors are all critical in any Leadership transition. If you are in a Leadership position, you have a job to do; plan to leave the day you are hired, because you will leave whether you want to or not!

Objectives

  1. Describe the intrinsic value of performing the three acts of Succession Planning offered in this course and how to do them.
  2. Discuss the importance of "looking within" in order to successfully pass the torch. Ironically, what's inside you will come out when you leave, like it or not.
  3. Demonstrate the process of Passing the Torch!

Intended Audience

Presenters

6. Chaplaincy Support for Disaster Deployment Responses

10:30 - 11:45

Summary

As stated by George Everly, "It has been commonly observed that in times of crisis and disaster, many individuals seek out religious or spiritual leaders…" but it it has only been within the last 10 to 15 years that spiritual care has been formally integrated into many types of disaster response missions.

The provision of spiritual and emotional support to those impacted by disasters in a timely and appropriate manner has the benefit of mitigating short and longer term distress (emotionally, spiritually and physically) for individual survivors, communities, first responders and others involved in providing disaster relief. Chaplains with specialized training typically provide spiritual care services in disaster response but there exist various methods and approaches used in providing these services and examples of these will be discussed.

As with other components within disaster response, spiritual care is a field that is growing and adapting to most effectively meet the needs and challenges of diverse communities. Encouraging collaborative partnerships in providing spiritual care within communities and across agencies serving those in need will be essential for the success of the overall disaster response mission.

Objectives

  1. Discuss a history and overview of spiritual care services as a formal component in disaster response.
  2. Define the role and function of chaplains and others providing spiritual care within the incident command and disaster response operation.
  3. Describe planning, methods, and execution of spiritual care services as an integrated component of USPHS and other agency disaster response missions.

Intended Audience

Presenters

7. DRAT! (Disaster Readiness Actions for Teens) and North Minneapolis Tornado Recovery

10:30 - 11:45

Summary

On May 22, 2011, the worst tornado to hit Minneapolis in 30 years pummeled the north side of Minneapolis in an high-poverty area with a high percentage of rental property, multi-family homes, and subsidized (more than 80% in some areas). A Behavioral Health Recovery Committee was developed consisting of Hennepin County, City of Minneapolis, Health and Family Support, North Point Center for Health & Wellness, and MN Department of Health(MDH) through grant funding by the MN Department of Human Services. Our focus was on youth recovery knowing that in working with the children we would also help tornado impacted families and communities to recover.

The MDH DRAT! Disaster Readiness Actions for Teens program, was chosen as our vehicle for post-emergency preparedness education. DRAT! is a youth emergency preparedness training program specifically geared for tweens (ages 10-12) and teens with the goal of engaging, educating and empowering youth to respond safely during critical incidents such as natural disasters, man-made incidents, public health emergencies and school threats. The DRAT! program name and logo were determined by surveying MN youth aged 10 -18 via word of mouth and with an online twitter and Facebook survey.

A youth focus group was utilized to review content and ensure that it connected with our population and meet the program goal of engaging, educating and empowering youth to respond safely during crisis and disasters. It contains 6 modules

  1. Why prepare
  2. Stay Safe
  3. Make a plan
  4. Make a Kit
  5. Stay Calm
  6. Celebration of Knowledge

Our initial goal consisted of training approximately 100 youth by providing five 1.5-hour trainings to youth groups consisting of 25 tweens/teens. We determined that due to the potentially traumatized and disaster impacted nature of our audience we would focus mainly on the modules discussing making plans, staying safe, and staying calm. Our trainers consisted of a licensed mental health profession to teach the youth PFA module teamed with a peer trainer for the preparedness content.

This presentation will discuss the need for a youth focus in disaster recovery and review: the DRAT! training modules; emergency preparedness kit; Youth Psychological First Aid training and Youth PFA card; our training plan, and how we adapted and implemented the program; effectiveness based on trainer debriefing and participant evaluations; and next steps in youth and community recovery and resilience building.

Objectives

  1. Describe how to use a youth emergency preparedness program can be utilized as a community disaster recovery tool.
  2. Discuss how to implement Psychological First Aid training for youth as a means to reduce disaster stress symptoms and encourage on-going daily stress reduction and healthy self-care behavior.
  3. Assess the effectiveness of youth emergency preparedness planning in youth disaster behavioral health recovery and overall community resilience building.

Intended Audience

Presenters

8. Medication Needs of Survivors with Chronic Conditions to Prevent Deterioration during Sheltering

10:30 - 11:45

Summary

The recent Japanese Earthquake and subsequent tsunami, Hurricanes Katrina, Ike and Gustav, and the Indian Ocean Tsunami, have focused our attention on the need for disaster preparedness and mitigation. Large cities, such as Tokyo, New York, San Francisco, or St. Louis, remain at high risk for catastrophic loss of life from weather, earthquake or man-made disaster. Such large-scale disasters affect every segment of society, though it is clear that some segments are more vulnerable than others.

Treatment of the patient who is injured in a disaster is a well-considered part of the overall plans by the emergency manager and the medical community at large. Other populations, such as children, nursing home residents, prisoners, pregnant woman, respirator dependent patients, those on dialysis, the frail elderly and chronically disabled individuals have been identified in other venues. There has been extensive research published on disasters, health care disparities, and medically underserved populations but little attention has been paid to those with chronic diseases who will decompensate without their medications or treatments.

A major category of vulnerable children and adults includes those with chronic treatable illnesses such as diabetes, COPD, seizures, hypertension, heart disease, or even chronic pain syndromes. This population may normally lead productive lives with little or no external signs of disability. Given a few days without their supportive medication, however, they may require intensive care and consume precious medical resources. Displaced abruptly from their home or workplace, their medications may be left behind or destroyed in the disaster.

We attempted to compile a list of medications that should be considered for those planning shelters or non-emergent care facilities in the wake of a disaster. What medications will urgent care providers (in shelter or similar situations) need to provide these patients to prevent deterioration of their condition? The authors reviewed literature from 2000-2011 using key words of chronic, disaster, disease management, planning, and preparedness. Searches were performed using Google, Google Scholar, and PubMed for medication required in the first week of sheltering in disasters to create a meta-analysis.

Objectives

  1. Identify those chronic diseases which will require additional attention to prevent decompensation during sheltering operations.
  2. Explain why prompt intervention in chronic disease care in sheltered patients will decrease the burden on overtaxed medical resources.
  3. List chronic disease medications that emergency planners should consider in arranging stockpiles, caches, and deployment packages.

Intended Audience

Presenters

9. Triage in the Field: Taking it to The Next Level

10:30 - 11:45

Summary

Triage is a process for prioritizing the treatment and movement of casualties in order to provide the greatest care to the greatest number, achieving the best possible outcomes. Effective triage and appropriate patient classification, (Minimal=Green, Delayed=Yellow, Immediate=Red, and Expectant=Black), will help maximize life-and limb-saving capabilities of medical personnel, equipment, and facilities.

Providing hands-on case based scenarios with the use of a human patient simulator will facilitate in a comprehensive training environment meeting the needs of all skill levels. The human patient simulator is a computer driven, multi-discipline tool which will demonstrate a variety of human physiologic conditions related to injuries sustained from mass casualty events.

Attendees will be given instant and post-simulation feedback during their demonstration of triage classification and medical interventions based upon the patient's initial assessment and mechanism of injury. Due to the fact that real-world emergency situations provide no room for error, this particular virtual learning environment will promote improved “real-world” triage care and increase confidence within our medical responders.

Objectives

  1. List and define the four categories and colors of triage.
  2. Verbalize and demonstrate the ability to properly triage and explain mechanism of injury with appropriate lifesaving intervention.
  3. Recite appropriate physiologic theoretical data on virtual human patient simulator casualties and place them in their respective categories.

Intended Audience

Presenters

10. ESF #8 Patient Tracking Force Multiplier

10:30 - 11:45

Summary

Monitoring interstate and multijurisdictional patient movement during emergencies has historically presented great challenges. Over the past two years the Department of Homeland Security, Department of Health and Human Services, and their partners have worked collaboratively to identify and develop holistic solutions that address tracking of patients while improving the overall situational awareness.

This truly interactive session will monitor the movement of the session attendees in real time as they are tagged (banded), registered and moved among "locations" in the room representing four disparate systems. Attendees will be able to see themselves being simultaneously transferred between systems and locations as "emergency patients”.

This session will include solutions for tracking both National Disaster Medical System (NDMS) and non-NDMS patients. Tracking systems discussed and utilized will include those from Louisiana, Maryland, Tennessee, and the NDMS' Joint Patient Assessment and Tracking System (JPATS). Overviews will include Federal, state and local system roles and relationships across the patient tracking continuum, including the Transcom Regulating and Command & Control Evacuation System (TRAC2ES) and others.

This session will demonstrate how easily crucial information concerning the care and tracking of patients can now occur to provide 360 degree situational awareness during an emergency. Longitudinal patient tracking information can be maintained. The ability to electronically receive data-rich manifests allows responders to lean forward and assist in ways never possible before in mass patient evacuation emergencies. With the aggregate data from these combined tracking systems HHS/ASPR can be fully aware of the locations and conditions of people to enable a more directed response while improving locating missing persons.

Participants will be introduced to emerging data exchange standards, methods to seamlessly track patients in emergencies, bar coding technology, use of triage tagging systems, and mobile software applications. The session will also delineate for participants implementation options available to their organization, step-by-step instructions, identify organizational and technology impediments to successful implementation. The session will also introduce participants to the use of the National Health Information Network (NHIN) and FEMA Integrated Public Alert and Warning System (IPAWS).

Objectives

  1. Describe the emerging data exchange architecture that is being established to provide patient tracking in a timely and meaningful fashion for future emergencies.
  2. Explain how patient tracking systems and secure message routing can be used for critical situational awareness during emergencies involving multiple jurisdictions and states.
  3. Assess the ability of their current organization, infrastructure, and communications capability to support effective patient tracking during emergencies.

Intended Audience

Presenters

11. Zombie Emergency: All-Hazard Emergency Preparedness Instruction

10:30 - 11:45

Summary

In May 2011, the Centers for Disease Control (CDC) Health Matters Blog posted one of the most highly commented and viewed posts on all-hazards preparedness, Preparedness 101: Zombie Apocalypse. In the spring of 2012, the University of Rhode Island College of Pharmacy organized an elective class, "Public Health Consequences of Infectious Diseases," on emerging infectious diseases including a practical component on all-hazard emergency preparedness and response.

While the didactic portions of the class involved student groups researching and presenting past responses to actual emerging infectious disease outbreaks, the response practical involved students planning and testing a new College of Pharmacy building as a primary point of dispensing (POD) during an outbreak of a hypothetical infection that creates zombies, thus mimicking an outbreak of an unknown, yet highly communicable and terrifying infectious disease.

Using borrowed signage and materials from the state health department's Center for Emergency Preparedness and Response (CEPR) municipal POD Go-Kit, the students set up a POD in real-time, recruited faculty, staff, and students as volunteers to attend the POD, serve in the POD, and attack the POD as zombies. Evaluators from other universities, cities and towns, and the state were able to view the POD flow and activities through the glassed-in rooms used in the POD.

This activity was also combined with a student pharmacist-run re-packaging exercise in association with CEPR, providing "Zombycycline" for dispensing in the POD. Evaluators also observed the activity. Finally, four groups of student pharmacists in the elective class produced public service announcements outlining the mitigation, preparedness, response, and recovery from the zombie apocalypse, with guidance from the CDC Public Health Preparedness and Response Zombie Task Force.

It is hoped that the POD location will be used for future actual and exercise responses, potentially including pharmacist-administered influenza immunizations to the staff, faculty, and students at the University as a pandemic influenza exercise.

Objectives

  1. Define the value of collaboration of university health professional schools, CDC, and state health departments in emergency response training activities.
  2. Evaluate the effectiveness and pitfalls of using a technologically advanced university building as a POD site staffed by student volunteers.
  3. Develop a plan to enhance higher education and public health collaboration for all-hazard preparedness and response.

Intended Audience

Presenters

12. Operational Medicine: Past, Present & Future

10:30 - 11:45

Summary

What is Operational Medicine?

Operational Medicine (OPMED) is defined as care provided in an unconventional setting where access to traditional resources may be significantly limited. This can include working with limited supplies, staffing or time as well as under extremes of climate, location or environment. OPMED includes components of disaster, military, wilderness, frontier, emergency, prehospital, tactical, and international medicine.

The concept of OPMED, perhaps best defined by the military experience, resonates with the emergency preparedness and response community. “Good medicine under challenging conditions” is an appropriate phrase from Afghanistan to Joplin. Whether from war or disaster, the practice of medicine in an affected community will be significantly different compared to one that is intact. Poor environmental conditions, limited supplies, long hours and high patient volumes are common variables regardless of the setting. However, fundamental differences exist between the military and civilian practice of OPMED. These differences will shape the delivery of care in the civilian disaster environment.

The speakers will introduce examples of OPMED missions, discuss how OPMED principles may differ from the typical care delivered in the United States, and will emphasize the opportunities for ESF8 responders to benefit from the lessons learned across the other disciplines of OPMED from around the globe. This session will serve as a "kickoff" lecture to presentingframe the other presentations in the new OPMED track at the 2012 Integrated Training Summit.

This session will explore many of the issues faced by civilian practitioners in the disaster environment, and will address how they may be able to adapt some of the principles of OPMED to help them carry out their mission. In particular, the panel will discuss how the concepts of OPMED have been and will be incorporated into the ESF-8 response to disasters and public health emergencies. The presenters have experience in civilian and military medicine under a wide range of environments, and the intended audience is physicians, nurses, EMS personnel, emergency officials, disaster responders, and others that work in non-traditional situations where health care is delivered.

Objectives

  1. Define what the specialty of Operational Medicine is and the role of operational medicine in ESF-#8.
  2. Explain common conceptual approaches to operational medicine patients, and then define how the environment of care requires variations.
  3. Provide examples of how the priorities of delivering care in a resource-challenged environment may differ from the delivery of care under non-challenged envirionments.
  4. Describe how physiology rather than resources defines healthcare, and identify two approaches that differ from traditional care.
  5. Describe an example of lessons learned from military medicine that would benefit civilian ESF-#8 medical personnel operating in a resource-challenged environment.

Intended Audience

Presenters

13. Advancements in HPP Regional Healthcare Coalitions: Utah's Experiences

13:15 - 14:30

Summary

The ASPR Hospital Preparedness Program provides a framework and minimal set of objectives for the development of Regional Healthcare Coalitions, while appropriately leaving important Coalition structural and functional decisions to states. The State of Utah, through partnerships between the Department of Health and its local health districts, have developed a successful Coalition model that utilizes local health districts as hosting agencies for Coalitions. Through this partnership, critical community linkages have been sustained, new collaborative partners have been identified, and preemptive preparations for the alignment of CDC PHEP and ASPR HPP have been completed.

This presentation will provide an overview of the strategies, methods, and challenges related to partnering with local health departments for Regional Healthcare Coalition hosting. The presentation will address the processes utilized to develop project objectives, time-lines, and funding allocations. Structural topics will be reviewed, including the identification, recruitment, and retention of Coalition partners, the development of core program documents including MOU/A, Coalition charters, and regional response plans. The target audience for this presentation will be local, district, and state level staff involved in the implementation and development of Regional Healthcare Coalitions.

Objectives

  1. Design a plan to determine the Regional Healthcare Coalition structure that will be successful in their state, and identify local partners that will contribute to successful outcomes.
  2. Compare the benefits and challenges of utilizing local health districts as hosting agencies for Coalitions.
  3. Analyze the process of Coalition objective development, and determine how these objectives could be implemented in other states.

Intended Audience

Presenters

14. Healthcare Partnership: A Low Cost & High Impact Strategy

13:15 - 14:30

Summary

As a part of the Florida Department of Health efforts to continue to expand & improve partnerships and joint efforts with health care system partners, the Medical Surge Program has explored a number of approaches to engage partners. In August 2011, a short survey was sent to hospital and hospital system partners.

The purpose of the survey was to determine the level of interest in short, scheduled, virtual meetings for the exchange of information. The distribution lists included approximately 175 unduplicated email addresses. Ninety-nine responses were received with only one negative response. As a result of this initial response a number of short programs will be offered. The program content is based on an assessment and prioritization by the target audience, our hospital partners at the direct service level.

The role of the department is to facilitate and promote participation. To make the sessions more attractive to participants, continuing education credit is offered as appropriate. The presenters come from the disciplines that have the highest level of expertise for the subject area. For example some sessions, such as safety and security or active shooter, include a law enforcement component.

Use of virtual meeting technology allows us to have statewide participation. Participants receive announcements, registration information, and program materials electronically. Much of the material and samples shared can be downloaded and customized for site specific use. The initial plan was to limit participation to approximately 50 sites or participants. The first program offered was "Using Disaster Core Competencies for Hospital Personal."

The presenters included a nurse from a small critical access hospital with 25 beds in a rural area of Florida, a representative from a medium hospital with 250 beds, and a physician from a 700 + facility in a large urban area. We were also fortunate to have a hospital health care system rep who addressed how he was able to use the competencies in his system. The exchange of information connected providers that had not previously had contact as well as a commitment to share sample materials such as memorandums of agreement.

The final count for the webinar was 64 participants. The number may be higher as more than one person could view and participate in the program once a site is logged in. The evaluations have been very favorable and a number of topics have been suggested for future programs.

Objectives

  1. Provide an overview of using short JIT information sharing & training programs to address emerging preparedness issues for health care system providers
  2. Demonstrate improved & increased sharing of information & best practicse among & between hospitals & health care system partners.
  3. Describe examples of increased engagement of hosptials and strengthened partnershipe between the department and hosptials

Intended Audience

Presenters

15. Engaging Youth: A Key Component of Succession Planning

13:15 - 14:30

Summary

The next generation of medical, public health, preparedness and response leaders will emerge from today's youth. It is essential that programs exist to effectively engage, mentor and develop youth now, so when the time comes, they are ready to strengthen the local public health system, improve response capabilities and build community resiliency.

Youth engagement is a key component of succession planning. The Division of the Civilian Volunteer Medical Reserve Corps (DCVMRC), the US Public Health Service (PHS) and HOSA-Future Health Professionals have established a close working relationship in order to further youth engagement and to foster mentoring and youth development opportunities.

HOSA is a national organization that provides a unique program of leadership development, motivation, and recognition for health science education students, and serves as a model of how students can engage in public health and preparedness volunteer activities. Recent research for a doctoral thesis was conducted to explore the challenges and benefits that an MRC unit may experience when engaging high-school aged youth.

The investigator, along with leaders from HOSA, PHS and DCVMRC, will highlight the importance of youth engagement, identify some challenges regarding the youth involvement, and lead discussion about ways to overcome the barriers. ”Real-life” examples of how HOSA, PHS and the MRC have partnered to provide opportunities for students will be presented.

Objectives

  1. Describe the importance of youth engagement as a component of succession planning.
  2. Discuss potential barriers to youth engagement and involvement, and identify ways to overcome the barriers.
  3. Explain opportunities to engage youth in public health, preparedness and response activities.

Intended Audience

Presenters

17. 36 hour Exercise Ventura's Story: Operation Medical Shelter 2011

13:15 - 14:30

Summary

This session will provide concepts from the national health security strategy practically applied in a field setting. The logistics related to medical surge are evaluated by integrating hospitals into the field environment. This ongoing annual exercise requires significant coordination with numerous operational area partners, which ultimately results in increased community resilience. Previous after-action reports identified the need for increased coordination amongst emergency response groups.

The presenters developed an interdisciplinary response exercise with the goal of integrating professional responders as mentors to volunteers in ICS positions to manage the exercise. This served to demonstrate the resourcefulness of our operational area, healthcare system.

The session will examine the practical components of a robust 36-hour sustained exercise that demonstrated the involvement of multiple response partners (“silos” - aka. “Cylinders of excellence!”) some of which include: Public Health, fire, EMS, hospitals, military, law enforcement, medical reserve corps units, American Red Cross, and animal control. The execution of this type of exercise requires the Public Health responder to work in a “boots on the ground” scenario with volunteers and professional responders in a field setting.

Objectives

  1. Apply ideas and concepts in creating HSEEP compliant exercises to build resiliency in their community.
  2. Describe the practical components and specialized features of an integrated 36-hour sustained exercise as a force multiplier.
  3. Analyze methods utilized to integrate professional responders as mentors to staff and MRC volunteers in ICS positions to manage the exercise.

Intended Audience

Presenters

18. Heat Emergency Response Plans and Implementation

13:15 - 14:30

Summary

The Importance of Planning for Heat-related Morbidity and Mortality: Despite Extreme Heat Events (EHE) resulting in more mortality and morbidity than from all other natural hazards combined including catastrophic flooding, tornadoes and hurricanes.

A snapshot review of Maryland local health departments plans and protocols revealed that there is little consensus on who should be responsible for heat planning and whether or not heat planning efforts are even necessary. The review prompted the Maryland Department of Health and Mental Hygiene (DHMH) to develop the State Heat Emergency Plan in 2011 to provide planning guidance on possible steps at the state and local level to prevent heat-related morbidity and mortality.

The Maryland State Heat Emergency Plan guides DHMH's actions during an extreme heat event. An extreme heat event is defined in the plan as a day where the heat index is expected to reach 105ºF or the ambient temperature is expected to exceed 100ºF. During these events, DHMH would issue a Heat Advisory to notify state and local partners of the potential dangers associated with extreme heat events.

The plan provides guidance for Local Health Departments (LHDs) by providing suggested actions and public messaging resources. Weekly reports with information on temperature, emergency department visits, deaths and demographics were issued to provide locals with data to refine their planning efforts. Included in the planning efforts was a State Heat-related Illness website, which provided public messaging with basic information on how individuals can be protected from the heat, links to additional materials, contact information for local health departments and weekly surveillance reports.

This presentation is designed to share DHMH's best practices in developing a statewide plan and providing the necessary guidance to a diverse mix of jurisdictions with different needs. We will explore the various heat planning efforts at the local level, ranging from public education campaigns to jurisdictional heat emergency declarations and sheltering programs. In addition, the issues presented will be highlighted with a case study of a field trip that resulted in heat-related morbidity during an extreme heat event.

The presentation will conclude with the lessons learned, best practices and issues raised during the 2011 Extreme Heat Season.

Objectives

  1. State an understanding of the role of public health in a heat emergency.
  2. Explain development and the composition of extreme heat event response plans.
  3. Identify partners for heat planning to help them address outreach, provide cool environments and supply water to at-risk populations.
  4. Describe Urban Heat Island factors and how they affect Extreme Heat Events.
  5. Discuss the types of communities that are most vulnerable to Extrme Heat Events, and how to mitigate the resulitng mortality and morbidity.

Intended Audience

Presenters

19. Veterinary Resources: First Aid for Non-Vets and Disaster Animal Health

13:15 - 14:30

Summary

Working dogs are likely to respond early in a disaster setting prior to deployment and arrival of veterinary personnel. This talk will provide a review of basic first aid and medical care for working dogs utilizing supplies from a basic human medical cache or first aid kit, and discuss aspects of the handler-dog relationship. Target audience for this presentation will be EMT/ paramedics, physicians, nurses, and other allied healthcare responders.

FEMA Urban Search and Rescue Canines: Canine resources have been used to search for missing people in various types of search and rescue responses. This presentation will describe the capabilities, skills, certification credentials of the Federal Emergency Management Agency (FEMA) Urban Search and Rescue (USAR) team, canine search specialist and their canines, and explain how to best utilize this specialized canine resource on a search mission. A description of case studies of actual searches, and lessons learned will be included.

Objectives

  1. Describe similarities and differences in human and veterinary first aid.
  2. Explain the Federal Emergency Management Agency (FEMA) Urban Search and Rescue (USAR) canines.
  3. Identify early-onset medical conditions and environmental injuries for which field care can be initiated.
  4. Describe FEMA USAR canine abilities and appropriate use of FEMA USAR canines in a disaster situation.
  5. Recognize partnerships which can be formed with the handlers, dog owners, medical personnel, and veterinary responders.

Intended Audience

Presenters

20. Hurricanes, Earthquakes and Patients… OH MY! A Peek Behind the USATRANSCOM Curtain

13:15 - 14:30

Summary

The United States Transportation Command (USTRANSCOM), a combatant command of the Department of Defense, is the sole provider of patient movement in support of Defense Support of Civil Authorities (DSCA). This session will outline the Joint Patient Movement Team (JMPT) and Joint Patient Reporting Team (JPRT), who facilitate patient movement during DSCA response efforts.

Unlike a no-notice event, pre-hurricane patient movement requires a certain lead-time for success. The use of Pre-Scripted Mission Assignments (PSMAs) and the critical timeline for DOD involvement will be delineated. Throughout this session, success stories and lessons learned from exercises and real-world events such as Operation Unified Response (Haiti) will be discussed. As planning has evolved over the past 3 years for events such as those described in the National Response Plan, two critical elements have been identified; the increased reliance on a strong DOD/DHHS partnership and the need for compatible information systems.

The DOD/DHHS partnership of the Disaster Aeromedical Staging Facility (DASF) with the Mobile Acute Care Strike Team (MAC-ST) will be highlighted. Technological advances in data capture and transfer could benefit patient movement in the DSCA environment. An example of this would be the expanding use of Joint Patient Assessment and Tracking System (JPATS). The new disaster patient movement request forms will be demonstrated and feedback requested. Annual interagency training opportunities are being projected and standardized training plans are being developed.

Objectives

  1. Describe the timelines required, and capabilities for, a DOD DSCA response.
  2. Analyze the cooperative DASF/MAC-ST initiative between DOD and HHS.
  3. Compare the DoD and DHHS patient tracking systems used during patient movement.
  4. Illustrate required training needed for DSCA patient staging and evacuation.

Intended Audience

Presenters

21. A Military and Public Health Joint Training Model that Cares

13:15 - 14:30

Summary

The United States Public Health Service Commissioned Corps (USPHS) participated in Operation Lone Star, a joint services exercise to provide medical care to the underserved community in South Texas. The experience required integration of three USPHS response teams with the Texas State Guard (TXSG), members of the Texas National Guard (TXNG), and the Texas Department of State Health Services (DSHS).

The results of this fully integrated, local, state, and Federal mission for patient care and disaster preparedness will be the focus of this session to include potential future deployments. This exercise provided a unique opportunity to implement a new deployment model for PHS, which involved dividing assets into multiple operational sites, coordinating efforts with state and local responders, integrating mental health and social services and looking at new ways of collecting and analyzing data.

Clinical teams developed a framework and tools where clients could become empowered to become active in the management of their own health care. Services include immunizations, pre-school physical exams and screening, treatment, and education for general medical conditions plus hearing, vision, behavioral health and dental care. A navigator based system was implemented to provide permission, education and tools so that people left the site with an understanding of their health status in several dimensions including physical, mental, emotional, dietary and safety.

Teams provided attention and focus on the individual and family to plan for health improvement USPHS and Texas epidemiologists and preventive medicine professionals teamed together to collect unique data from Operation Lone Star. One arm of the epidemiological data collection included a household survey, designed specifically for the OLS clinic, addressing client characteristics, evacuation preparedness, immunizations, and Operation Lone Star marketing efforts.

Additional individual client data was collected from medical charts, including age, gender, height, weight, BMI, and chronic medical history. The data analysis will assist OLS and DSHS in targeting future public health interventions to optimize impact.

Objectives

  1. Explain the structure and function of USPHS medical response teams.
  2. Developing deployment plans for an integrated disaster response or humanitarian mission.
  3. Describe lessons learned to integrate response among Federal, State and Military assets supporting Operation Lone Star.
  4. List and present suggested remedies for multiple potential problems encountered during planning, deploying, performing duties, and return to station.
  5. Identify best practices that can be applied as a new response model for the future.

Intended Audience

Presenters

22. The HHS Disaster Behavioral Health CONOPS: Optimizing Public Health and Medical Response and Recovery for Survivors and Responders

13:15 - 14:30

Summary

Disaster behavioral health is an integral part of the overall public health and medical preparedness, response, and recovery system. It includes the many interconnected psychological, emotional, cognitive, developmental, and social influences on behavior, mental health, and substance use/abuse, and the effect of these influences on preparedness, response, and recovery from disasters or traumatic events.

Historically, coordination and effective integration of numerous and diverse behavioral health stakeholders and providers into the larger health and medical response has been a challenge at Federal, state, and local levels. In December of 2010, the Office of the Assistant Secretary for Preparedness and Response (ASPR) within the U.S. Department of Health and Human Services (HHS) initiated the HHS Disaster Behavioral Health Concept of Operations (DBH CONOPS) Working Group. The Working Group was comprised of agency representatives across HHS and aimed to develop a CONOPS to provide coordination and guidance for HHS Federal-level behavioral health preparedness, response, and recovery action for disasters and public health emergencies.

Development of a DBH CONOPS is a recommendation of both the National Biodefense Science Board and the National Commission on Children and Disasters. Effective and well-coordinated behavioral health preparedness, response, and recovery can mitigate or prevent more serious behavioral health problems in disaster survivors and responders and promote individual and community resilience. The DBH CONOPS describes the overarching conceptual framework that HHS uses to coordinate HHS-wide preparedness, response, and recovery activities in concert its authorities and responsibilities.

The goal of the DBH CONOPS is to improve coordination of departmental preparedness, response, and recovery efforts concerning behavioral health in support of state, territorial, tribal, and local efforts in a manner consistent with the National Response Framework and the National Disaster Recovery Framework. Facilitated discussion about state and local response and recovery activities and how these are supported through the DBH CONOPS will also be a focus of the session.

This interactive presentation will allow participants with and without behavioral health expertise to consider how disaster behavioral health preparedness efforts can support existing operational guidance at the Federal level and can enhance and inform overall emergency response and recovery at Federal, state and local levels.

Objectives

  1. Identify the most common evidence informed disaster behavioral health activities and interventions used to support survivors and responder as the Federal, state, and local levels.
  2. Describe the key elements of the Disaster Behavioral Health CONOPS and identify key roles and responsibilities of HHS Operating and Staff divisions in disaster behavioral health response and recovery.
  3. Discuss how the content of the Disaster Behavioral Health CONOPS can inform and optimize overall public health and medical response and recovery from disasters and public health emergencies.

Intended Audience

Presenters

23. Responder Risk in Crisis Standards of Care

15:15 - 16:45

Summary

Recently, the Institute of Medicine has released reports and recommendations on implementing Crisi Standards of Care in health emergencies. One cross cutting component to the IOM recommendations is the need to address the impact of implementing CSC on health care workers.

Although many health care workers confront life and death decisions on a daily basis, the nature of Crisis Standards of Care involve fundamental differences in both the qualitative and quantitative aspects of many health care stressors. Consequently, the IOM Committee on Crisis Standards of Care has developed a number of key force health protection actions involving leadership of diverse health care systems and health care workers themselves.

The recommendations will be presented and reviewed by several members of the IOM CSC includng the primary developer of the force mental health protection recommendations.

Objectives

  1. Identify the potential range of mental health risks in crisis standards of care.
  2. Review recent real world events involving the need to implement crisis standards of care.
  3. Explain the IOM CSC recommendations to enhance resilience in health care workers via key leadership actions of health care systems.

Intended Audience

Presenters

24. Developing Guidance to Support Allocation by HHS of Scarce Federal Resources in Disaster Settings: An Opportunity for Stakeholder Input

15:15 - 16:45

Summary

Health and Human Services (HHS) is developing guidance to assist with its decisions about allocation of resources in disaster settings. The intent of this guidance is to offer key decision makers: 1) a set of fundamental ethical principles/values to consider when making decisions about allocation of scarce Federal resources; and 2) a set of evaluation criteria that are ethically appropriate for considering specific allocation decisions.

HHS is committed to developing and clearly communicating Federal resource allocation processes and criteria in advance of a disaster. To that end, HHS is seeking individual input from stakeholders regarding the fundamental ethical principals/values and allocation criteria that HHS is developing to guide its decisions about allocation of resources in disaster settings.

This workshop will provide an opportunity for stakeholders attending the summit (e.g., local, state, regional, tribal and territorial) to review, evaluate and rate proposed allocation criteria. An overview of the initiative to date, to include background on draft criteria shall commence the session.

Various disaster scenarios will then be presented to set the context for participants to think through issues that may be faced related to the decision making process for allocation. Participants will then have an opportunity to provide stakeholder input on the proposed criteria. Participants will engage in discussions regarding the scenarios and rating the criteria.

A re-rating process will follow the discussion to aid in a final assessment of the proposed criteria.This stakeholder input will be considered as HHS finalizes guidance to support decision making related to the allocation of scarce Federal resources in disaster settings.

Objectives

  1. Discuss the possible resource limitations that may be faced in allocating Federal resources during emergencies.
  2. Identify various ethical values that might be appropriate for fair allocation of limited Federal resources.
  3. Compare the relevant perspectives regarding criteria for distributing limited Federal resources to states in emergency situations.

Intended Audience

Presenters

25. Implications of New International Agreements on Public Health Preparedness and Response

15:15 - 16:45

Summary

In the past year, several new international commitments have been undertaken by the U.S. and Canadian Governments. Among them are the North American Plan for Animal and Pandemic Influenza, released in November 2012 by the Prime Minister of Canada and the Presidents of Mexico and the United States. Additionally, the two countries have come to agreement on the implementation plan and steps for the Beyond The Border Agreement.

The panel presentation will first highlight why these two agreements are so important for both Canada and the United States and then share with participants the actionable steps that the both countries have agreed to take.

Objectives

  1. Describe an understanding of NAPAPI and the Beyond the Border agreements.
  2. Analyze how international agreements strengthen domestic resiliency.
  3. Demonstrate knowledge of the complexity in putting together and carrying out bi-national plans to increase medical and public health preparedness and response activities.

Intended Audience

Presenters

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