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The 2010 Integrated Training Summit will take place June 2-6, in Las Vegas, NV

Wednesday, June 2nd

1 & 2. Opening Ceremony & Keynote Address

08:30 - 10:00

3. General Session: The Integration of Emergency Management: The Challenges and Rewards

10:30 - 11:45

Summary

The face of emergency management today has never been more complex! Prepared organizations must not only plan internally for emergencies and incidents, but must reach out of their “silo” into the community and region to integrate planning with divergent and multi-disciplinary partners. Mr. Gabriel's emergency management experience in New York City and now in a private organization, The Walt Disney Company, gives him a unique public-private partnership perspective on multi-disciplinary planning. This keynote session will discuss the challenges to cross- sector integrative planning and preparedness and strategies for success.

Note: The description and objectives will be modified to incorporate the approach that was taken by the Disney Company to prepare for the H1N1 Outbreak that occurred earlier this spring and that persist thru the current flu season. Target audience for this workshop will be physician, emergency physicians, nurses, EMT/ Paramedics, healthcare executives, health education specialists, pharmacists, and other allied healthcare provider.

Objectives
  1. Discuss the importance of integrating emergency management activities across disciplines and sectors.
  2. Discuss the challenges and barriers to planning and preparedness integration across disciplines.
  3. List 3 successful strategies and activities to enhance emergency planning and preparedness integration.
Presenters

4. ESF 8 Integration: The American Samoa Tsunami Response

13:15 - 14:30

Focus Area

ESF #8 Integration

Summary

On September 29, 2009 an 8.3 magnitude earthquake struck the South Pacific archipelago of American Samoa and neighboring Independent Samoa generating a tsunami. The tsunami hit American Samoa at approximately 7:29am enveloping the island inhabited by 67,000 people. NDMS DMAT members from HI-1 and OR-1 were deployed and provided medical assistance to the only hospital on the Island, supplemented the EMS system, and completed an aero-medical evacuation to Hawaii. Three weeks into the response the NDMS medical mission was completed and the mental health mission commenced. Disaster mental health providers from the American Red Cross and the USPHS Office of Force Readiness and Deployment (OFRD) mental health team (MHT-1) were tasked to render mental health services to the effected population. This presentation will address how both the medical and mental health responders dealt with the limited organic capacity and capabilities of the Island. Target audience for this workshop will be physician, emergency physicians, nurses, EMT/Paramedics, respiratory therapists, healthcare executives, health education specialists, dentists, morticians, pharmacists, certified counselors, social workers, environmental health and other allied healthcare providers.

Objectives
  1. Discuss how to mobilize medical assets across agencies to effectively increase both medical capacity and capabilities to treat severe medical cases.
  2. Describe the American Red Cross disaster mental health resources and the cultural issues they faced while providing mental health services to the American Samoan native.
  3. Explain how PsySTART and clinical judgment were used to match patient needs with a level of mental health care using limited resources.
Presenters

5. Q Annum (Every Year) - An Annual Update on Changes to ESF# 8 and Federal Response

10:15 - 11:30

Focus Area

ESF #8 Integration

Summary

This course will provide attendees with and annual overview of what has occurred in the previous year, and changes in Federal Response and Federal Health and Medical Response. The course also identifies trends and current issues and projects potential future developments. This year's seminar will cover the changes in ESF#8 Response concepts, the impact of pandemic diseases, and the National Incident Management System (NIMS) implementation for healthcare. Target audience for this workshop will be physician, emergency physicians, nurses, EMT/Paramedics, healthcare executives, health education specialists, dentists, morticians, pharmacists, environmental health, and other allied healthcare provider.

Objectives
  1. Explain and discuss changes and future implications of the National Incident Management System and its application to healthcare.
  2. Describe the lessons learned and current trends in Emergency Support Function 8 (ESF#8) operations.
  3. Emergency Support Function 8 (ESF#8) operations. Discuss future trends and initiatives in Federal Health and Medical preparedness and response.
Presenters

6. Research Supporting Practice of Health System Emergency Management

13:15 - 14:30

Focus Area

Healthcare Systems

Summary

This presentation discusses two research studies that can be used to improve healthcare facilities emergency management programs. In one study, key preparedness indicators of the Veteran's Healthcare System, representing 69 capabilities in six priority areas, were identified and assessed. In the other study, Model Based Risk Analysis and Supply Chain Network Analysis are applied to individual and regional healthcare systems to assess their operational risks due to loss of critical infrastructure. Mitigation investment strategies are emphasized. Both studies will discuss outcomes specific to impacts on healthcare service delivery and their relationship to key preparedness and mitigation activities. Target audience for this workshop will be physician, emergency physicians, nurses, pharmacists healthcare executives, health education specialists, other allied healthcare provider.

Objectives
  1. Describe key indicators of preparedness that have been identified through two related studies of hospital emergency management programs.
  2. Outline healthcare infrastructure and supply chain vulnerabilities and findings related to mitigation investment strategies.
  3. Discuss study outcomes and their relationship to impacts on healthcare service delivery.
Presenters

7. Healthcare Training and Exercise Programs

13:15 - 14:30

Focus Area

Healthcare Systems

Summary

Challenging a training plan through real-world responses or through progressively difficult exercises is the only real way to test a plan for its holes. Solid healthcare training programs build a foundation from which effective plans can function. This session provides practical programmatic recommendations for implementing these programs locally or in other areas while meeting HSEEP standards and TJC/CMS stipulations. Target audience for this workshop will be physician, emergency physicians, nurses, EMT/ Paramedics, healthcare executives, health education specialists, and other allied healthcare provider.

Objectives
  1. Describe the Homeland Security Exercise Evaluation Program (HSEEP) requirements.
  2. Provide examples of successful program implementation among institutions from across the U.S.
  3. Identify some tools for implementing the program at the local facility level.
Presenters

8. Preventing the Pitfalls of Poor Planning

13:15 - 14:30

Focus Area

Leadership

Summary

Developing and implementing plans for organizations, programs and specific incidents requires specialized skills and abilities. It also requires proper staff and appropriate resources in type and quantity. Add to that complex mix of ingredients the ability to cross international boarders with your plan and you have a recipe for a major disaster IF you don't know how to measure your approach accordingly and plan for various adaptations to the original plan. Pandemic Flu is not just in our area. Pandemic means globally.

The Canadian Government has been proactive with recruiting and providing direction for a Pandemic Preparedness program knowing the importance of mitigation before an event. There are considerations to pay heed to in a Pandemic to include ensuring the continuity of Government and essential services as well as the safety of all citizens. Necessary regulations to implement emergency management across key Government Agencies, review of existing Emergency Management Acts along with related legislation and regulations, and the assurance that Government has all the powers and tools necessary to respond are major factors in this Country and are no different in Canada. Our ‘Neighbors to the North” had outstanding leadership from their Government during the SARS outbreak in 2003, and Dr. James Young was Ontario's Commissioner of Emergency Management working with the Provincial Government and across all other levels of Government in Canada to ensure that the citizens of Ontario were prepared for all possible emergencies, whatever the causes.

Dr. Young now serves as the Medical Director of the Canadian Headquarters of Pandemic 101, an organization that addresses the need for pandemic planning and preparedness and focuses their energies on developing programs that offer solutions for individuals, families, organizations and communities. Target audience for this workshop will be physician, emergency physicians, nurses, EMT/Paramedics, respiratory therapists, healthcare executives, health education specialists, dentists, morticians, pharmacists, environmental health and other allied healthcare provider.

Objectives
  1. Discuss how to set reasonable goals for mitigating damages before, during, and after and incident.
  2. Create a plan for attaining the goals set forth in Objective 1 to include resources needed both tangible and intangible, human and non-human.
  3. Exercise that plan created in objective 2 either via a table- top or full-scale exercise to include a debriefing/hot-wash following the exercise to exploit the failures and areas of improvement in the plan.
Presenters

9. Leading an Effective Response

13:15 - 14:30

Focus Area

Leadership

Summary

You know what the textbook says. You've practiced procedures in drill form. You've used mutual aid scenarios in your table-top exercises, and you've critiqued yourself to death in dozens of hot-washes over the years. You've taken all the requisite leadership courses and you've risen through the ranks of leadership in your department and community. Your management skills in emergency situations far exceed those of your peers and you sleep well at night knowing, at least thinking, that you're prepared. Fast forward to a time when a plane drops out of the sky and lands on a house in your jurisdiction. “It“ just hit the Fan and people are looking for your direction.

This is what happened to David Bissonette, the Disaster Coordinator for the Town of Clarence, a suburb of Buffalo, New York. Clarence is a small town in Western New York where Continental Flight #3407 fell from the sky in an ice/sleet storm in February of 2009 killing all souls on board and one on the ground. Bissonette relied on his years of training to set up an Emergency Operations Center (EOC) along with a press staging area away from the crash scene just 30 minutes into the incident. He was instrumental in helping to coordinate the efforts of First Responders and Governmental agencies ranging from Volunteer Fire Firefighters, to New York State Police and from the FBI and NTSB to the local ambulance crews. Thrown into the mix were the efforts of the Erie County Medical Examiner and the Erie County Executive. Managing the community with evacuations of citizens including the elderly and other at risk populations was a major concern. Providing spiritual and mental support for the families of the victims was also paramount. Integration of the hundreds of volunteers who came to offer help in any form was also on the table.

This session will provide guidance on how to manage this type of incident and provide confident, clear, and effective leadership in the field when “It“ happens in your neighborhood. Target audience for this workshop will be physician, emergency physicians, nurses, EMT/Paramedics, healthcare executives, health education specialists, dentists, morticians, certified counselors, social workers, environmental health and other allied healthcare provider.

Objectives
  1. Define early on, which resources the incident requires, who/what they are and how to best use them.
  2. Explain how to manage all resources responding to an incident using proven methods of integration,leadership, time management, rehabilitation of resources and stress management.
  3. Describe transition of leadership when a pre- determined operational period is ending so that effective incident management is maintained without any gaps in the operation.
Presenters

10. H1N1: Success Stories in Mass Vaccination in Response to H1N1

13:15 - 14:30

Focus Area

Public Health and Clinical Services

Summary

Aside from social distancing the biggest deterrent to the spread of H1N1 during the Fall 2009 Influenza Season has been vaccination. During this session participants will learn of the conduct of successful vaccination campaigns deployed across the country. The presenters in this session will address the components of the vaccination team, the model for service delivery and the promotion and recruitment strategy employed for the population as it was aligned with vaccine prioritization guidelines and how this may be implemented in future events. Target audience for this workshop will be physician, emergency physicians, nurses, EMT/Paramedics, healthcare executives, health education specialists, pharmacists, and other allied healthcare provider.

Objectives
  1. Describe different approaches taken and models uses to execute a mass vaccination campaign.
  2. Discuss the application of techniques to engage community in public health prevention campaign - especially in light of recommendations for vaccine prioritization.
Presenters

11. Spotlight on a Pediatric Disaster Medical Training Center

13:15 - 14:30

Focus Area

Public Health and Clinical Services

Summary

Gaps exist in pediatric emergency preparedness. We hypothesize that a multi-disciplinary, multi-institutional program focused on pediatric disaster planning and education will improve awareness and pediatric presence in our large urban county emergency preparations. To demonstrate this, we employed a federally-funded novel partnership between a private non-profit health care organization and a local-regional government emergency services agency.

Methods

With institutional and IRB approvals, we created an infrastructure to address pre-determined gaps in pediatric disaster education, research, information sciences, and hospital response. The functional-based structure included: (1) Disaster Resource Core; (2) Education and Training Core; (3) Drill and Evaluation Core; (4) Informatics Core; and (5) Administrative Core. We identified faculty and staff Core Leaders to develop strategies and direct the workflow. The Administrative Core provided overall project and financial management. The Core leadership identified 30 deliverables. Each core leader was responsible for reporting the status of their project results on a bi-weekly basis.

Results

We employed 7 faculty/staff leaders and 20 support staff over the two year period. We successfully completed 25 of 30 deliverables. Four of the five outstanding deliverables are manuscripts not yet accepted for publication. The Center conducted one national symposium and two national consensus forums with over 70 invited faculty and 350 participants. The family reunification summit produced a set of 44 recommendations. The national summit produced 24 manuscripts that were published in the Journal of Trauma August 2009 supplement. In addition, the Center partnered with local government and community organizations to coordinate three conferences: Grant funded disaster preparedness efforts, Pediatric Medical Surge, and Emergency Preparedness and Disaster Planning for Children with Special Health Care Needs. These meetings were attended by approximately 350 participants. The Center developed two web-based software programs: Pediatric Emergency Decision Support System (PEDSS) - designed to support disaster planners in preparing for a surge of children, and SurgeWorld—a serious simulation game supporting real-time pediatric triage. The Education and Training Core trained over 300 individuals in person. The Center conducted research and published 11 manuscripts and 8 abstract and poster presentations.

Discussion

Through continued work of the Center, we have documented on-going gaps in disaster preparedness planning and preparation efforts throughout our county and nation. Critical gaps exist in pediatric hospital-based surge capacity and pediatric-focused expertise in an all-Hazard approach. As evidenced by the creation of the National Commission on Children and Disasters, pediatric disaster preparedness is of national concern and remains an issue to be addressed. Through this focused structured approach, we have developed several tools to support hospital preparedness efforts now and in the future.

Conclusion

Results from our regional and national experience indicate there are continued gaps in pediatric disaster preparedness, especially for children with special needs. Additional work is needed to help prepare first responders and first receivers for pediatric medical needs and a surge of children. In areas where efforts exist, progress is being made, but deficits remain. Based on our work and others, we conclude that an organized national pediatric disaster network would help generate and test pediatric-focused disaster preparedness programs. Furthermore, investigators can test evidence-based preparedness efforts in such a network.

Highlights on Work of Others at the Federal Level: DHS Office of Health Affairs

In an effort to mitigate some of the gaps in pediatric preparedness that have been identified, the Office of Health Affairs within the US Department of Homeland Security has launched a major initiative involving children, the Federal Emergency Management Agency's (FEMA) Children's Work Group. One of the significant goals of the workgroup is to examine the draft recommendations for the Interim Report of the National Commission on Children and Disasters (NCCD) and to develop plans to implement those recommendations that fall within FEMA's control. Results of this examination are expected in early Spring of 2010.

Objectives
  1. Describe why the special needs group of children require specific disaster preparedness efforts.
  2. Discuss current gaps in pediatric disaster preparedness.
  3. Describe the anticipated results of a focused pediatric disaster preparedness effort.
  4. Describe the actions taken at Federal Level to improve the integration the needs of children in disaster preparedness, response and recovery plans.
Presenters

12. Patient Movement Out

13:15 - 14:30

Focus Area

Scarce Resource Management & Medical Evacuation

Summary

During this session, speakers will present issues and challenges of moving patients out of harms way. The first speaker(s) will present how it takes a community of efforts to address this complex issues of patient movement. The second speaker will discuss the communication challenges of convincing communities to move, particularly the older population. Finally, a third speaker will discuss local, State and Federal assets that may be utilized during the process of moving patients out. Target audience for this workshop will be physician, emergency physicians, nurses, EMT/ Paramedics, healthcare executives, health education specialists, certified counselors, environmental health and other allied healthcare provider.

Objectives
  1. Identify the public, private and civil sector organizations that would form an evacuation megacommunity, focusing on medical evacuation and the special needs population.
  2. Explore the keys to establishing an effective evacuation megacommunity.
  3. Identify and describe the demographic pre-conditions of older adults most willing to evacuate during a disaster.
  4. Develop effective behavioral health messaging techniques to increase the level of willingness for older adults to evacuate during the event of a disaster.
Presenters

13. Identifying and Using Resources for Effective Preparedness and Response For Seniors and Persons with Disabilities

13:15 - 14:30

Focus Area

Scarce Resource Management & Medical Evacuation

Summary

Seniors and persons with disabilities may have unique and different needs that should be considered before, during and after an incident. Given the functional needs of seniors and persons with disabilities, well-established networks and tools within various levels of government and in the non-profit sector are available for responders to use to more quickly identify seniors and persons with a disability with special medical needs. At-risk individuals are best served when these networks and tools are utilized during a disaster by public health and medical planners and responders.

This session presents an overview of various networks and tools such as those available through the Administration on Aging and the Interagency Coordinating Council on Emergency Preparedness and Individuals with Disabilities. This session also presents a functional needs approach to planning for and responding to at-risk individuals during a public health and medical emergency.

Objectives
  1. Describe the demographic and cultural aspects of seniors and individuals with disabilities.
  2. Demonstrate an understanding of C-MIST, a functional needs approach for emergency planning and response for at-risk individuals.
  3. Describe resources to identify at-risk individuals who may have special medical needs.
Presenters

14. Public Health and Medical Response to the Haitian Earthquake: Challenges and Solutions

15:15 - 16:45

Summary

On January 12, 2010 a catastrophic magnitude 7.0 earthquake struck the island of Haiti. The Haitian Government reported that between 217,000 and 230,000 people had been identified as dead and an estimated 300,000 injured. Communication systems, air, land, and sea transport facilities, hospitals, and electrical networks were damaged by the earthquake, which hampered rescue and aid efforts This session will provide attendees with information on issues involved with the U.S. public health and medical response to the Haiti Earthquake. Representatives of the Department of Health and Human (DHHS) Services Incident Response Coordination Team, the DHHS United States Public Health Service (USPHS), the Department of Defense (DoD) Navy Medicine mission, and other agencies will discuss solutions from their perspectives.

Target audience for this workshop will be physicians, emergency physicians, nurses, EMT/Paramedics, respiratory therapists, healthcare executives, health education specialists, dentists, morticians, pharmacists, certified counselors, social workers, environmental health and other allied healthcare providers.

Objectives
  1. Describe the roles of HHS, DoD, USPHS, and other stakeholders during the overall response to the Haiti Earthquake.
  2. Identify some of the operational issues faced by responders in their respective areas of responsibility during the crisis.
  3. Discuss how some of the lessons from this event may be applied to similar future occurrences in the United States.
Presenters

15. Pediatric Disaster Medicine: Practical Approaches with a Focus on the Haiti Response

15:15 - 16:45

Summary

Significant progress has been made in developing accurate and reliable field MCI triage systems for children. Participants in this session will learn about practical strategies for initial triaging of pediatric patients and will also have the opportunity to experience a hands-on demonstration using the triage tools.

The session will focus on some of the routinely encountered pediatric disaster related illnesses and injuries. Following the introduction to triage, the participants will be asked to develop differential diagnoses, and given additional information, decide upon a treatment course based on the cache treatment options available. Concepts in pediatric therapeutic decisions, drug delivery and dosage forms will be addressed. The session will follow a “day in the life” format, first covering a 24 hour operational period in the setting of a DMAT field hospital and a second 24 hour operational period in a field medical shelter (FMS).

The similarities and unique challenges presented by both environments will be discussed. Appropriate triaging, development of a differential diagnosis and discussion of treatment options will be completed by the participants with guidance from the instructors. Target audience for this workshop will be physician, emergency physicians, nurses, EMT/Paramedics, respiratory therapists, healthcare executives, health education specialists, pharmacists, environmental health and other allied healthcare provider.

Objectives
  1. Describe appropriate use of a pediatric triage tool in disaster operations.
  2. List 3 commonly encountered pediatric disaster related illnesses or injuries.
  3. Create treatment plans based on the information presented.
Presenters

16. Strength in Diversity: Catastrophic Care for All American Communities

15:15 - 16:45

Summary

Misunderstandings and misinterpretations between the affected community and disaster healthcare responders, in addition to outright suspicion of outsiders, has proven to be at times an insurmountable hurdle on the community and the individual level between provider and victim. Diversity and unique contributions to the American melting pot of diverse cultures has been the life-blood of America since the beginning. Yet priorities, protocols, and behavior norms remain embedded in our cultures, regions, communities, and neighborhoods. Common sense to the victim, may not be common sense to the disaster responder, which include physicians, nurses, EMS and other healthcare providers.

Responder priorities may not be shared by the victim or community. Target audience for this workshop will be physician, emergency physicians, nurses, EMT/Paramedics, respiratory therapists, healthcare executives, health education specialists, dentists, morticians, pharmacists, certified counselors, environmental health and other allied healthcare provider.

Objectives
  1. Describe changing demographics and their implications to disaster responders.
Presenters
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