Presentation on theme: "PANDEMIC PLANNING AT EPHRATA COMMUNITY HOSPITAL"— Presentation transcript:
1PANDEMIC PLANNING AT EPHRATA COMMUNITY HOSPITAL By: Beverly McAllister, MS, MT(ASCP) SCLaboratory Operations Manager
2OBJECTIVES: Identify the components of a well-defined Pandemic Plan Describe the role your facility plays in response to a pandemicDescribe your role as a laboratorian in response to a pandemic
3Components of a well-defined Pandemic Plan Pandemic Planning Committee focused on defining a process for the following:Facility Surveillance for and detection of influenzaCommunication processes are adequate and availableSupply managementSurge capacityMaintaining essential servicesSecurityRelease of information is uniform, coordinated and adequate
4Pandemic Plan Committee Direct initiative of Emergency Management CommitteeGoal: Develop a Pandemic Influenza PlanFormed in July 2006Meet on a monthly basisConsists of the following members:COOVP of Medical AffairsVP of Physician PracticesDirector of Emergency Management ServicesDirector of Facilities ManagementDirector of Public RelationsDirector of Purchasing ServicesDirector of Home CareDirector of PharmacyDirector of Ephrata Medical Equipment
5Pandemic Plan Committee members cont’d Infection Control CoordinatorLaboratory Operations ManagerEmployee Health NurseNursing EducationChaplaincyDirector of Emergency ServicesAdvanced Life Support Unit ManagerPhysician Practice Representation
6What resources have we used to develop the Pandemic Plan? 1. United States Department of Health and Human Services Pandemic Influenza Plan was used as a blueprint for pandemic influenza preparation and response.2. SCTTF planning resources
7Ephrata Community Hospital Plan as of 3/10/07 (still in development) I. Inter-pandemic and Pandemic Alert Periods1. ECH facility responsibilitiesa. ECH will respond to alerts and pandemic related issues through utilization of the EMC, Pandemic Planning Committee and the Hospital Incident Command Structure (HICS)b. Written Plan includes:a. disease surveillanceb. facility accessc. occupational healthd. use and administration of vaccines and antiviral drugse. surge capacityf. supply chain and access to critical inventory needsg. mortuary issuesc. Participation in pandemic influenza response exercises
8Plan cont’d: Inter-pandemic and Pandemic Alert Periods B. State and local responsibilities:1. ECH works within the framework of the SCTTF and through the Hospital Medical Sub-Committee a Regional Hospital Response Plan has been developed.2. Exercises with local emergency management, local first responders and receivers, regional assets including hospitals and state agencies.3. Open lines of communication through the use of faxes, direct lines, FREDS, HAN, NEDSS and RODS.4. Human Relations Department and Employee Health have developed guidelines for any legal issues affecting staff and patient care.
9Plan cont’d: Inter-pandemic and Pandemic Alert Periods C. HHS responsibilities1. ECH response plan is adopted under the guidelines of the US Department oh Health and Human Services and the PA Department of Health (DOH) Pandemic Response Plan2. ECH will utilize the Department of Homeland Security model protocols for early detection and treatment of influenza among patients and staff; knowing that these protocols can be practiced during routine influenza seasons.
10II. Pandemic PeriodA. If an influenza pandemic begins in another country:1. ECH facility responsibilitiesa. heighten institutional surveillanceb. communicate with key public health,healthcare and community partnersc. Implement a system of early detectionand treatment of healthcare personnelwho might be infectedd. reinforce infection control procedurese. accelerate staff training in accordance with thepandemic influenza education and training
11Plan cont’d: Pandemic Period- begins in another country 2. State and local responsibilitiesa. Working with HHS to provide localphysicians and hospital administratorswith updated information andguidance as the situation unfolds.
12Plan cont’d: Pandemic Period- begins in or enters the US B. If an influenza epidemic begins in or enters the United States1. ECH facility responsibilitiesa. Activate facility pandemic response plan inaccordance with the “Hospital Pandemic InfluenzaTriggers”b. Implement activities to increase capacity,supplement staff and provide supplies andequipmentc. Post respiratory/cough etiquette signsd. Maintain high index of suspicion that patientspresenting with flu-like symptoms have thepandemic strain
13Plan cont’d: Pandemic Period- begins in or enters the US e. Implement infection control practicesf. Rapid communication within and betweenhealthcare facilities and DOHg. Implement surge-capacity plansh. If pandemic strain is detected in local orcommunity, transmission can be assumed andhospital would move to the next level of response2. State and Local Health Responsibilitiesa. Provide healthcare facilities with information onthe global, national and local situationb. Work with HHS to provide guidance on infectioncontrol measures for healthcare and non-healthcare facilitiesc. work with healthcare facilities to address surgecapacity needs
14Plan cont’d: Pandemic Period- begins in or enters the US 3. HHS Responsibilities a. Assist state and local healthcare and public healthpartners on issues related to hospital infectioncontrol, occupational health, antiviral drug useand clinical management, vaccination and medicalsurge capacity.b. Provide states with materials from the StrategicNational Stockpile for further distribution tohealthcare facilities.
15III. Pandemic ResponseA. Planning for provision of care in the facility1. Detecting the introduction of PandemicInfluenza2. Preventing the spread of Pandemic3. Managing the impact on facility and staff4. Expansion of preparedness and responseplans for bioterrorism, SARS and otherinfectious diseases to include influenza
16Pandemic Response cont’d 5. Identify criteria and methods for measuring:a. Infection control practicesb. Case reportingc. Patient placementd. Healthcare workers illness surveillance6. Review and update inventories of supplies thatwill be in high demand during the pandemic7. Review procedures for receipt, storage, anddistribution of assets received from federalstockpiles8. Approach to planning will be consistent with an“All-Hazards” response
17Pandemic Response cont’d B. Planning Process1. Committee Structure- Define members2. Planning Resourcesa. Pandemic Response Plan DHSb. SCTTF-Hospital Regional ResponsePlanc. Inter-facility multi-disciplinesd. Outside resources as identified
18Pandemic Response cont’d C. Planning Elements1. Hospital Surveillancea. Laboratory testing will be consistentand monitored closelyb. Absenteeism rates will monitored weeklyc. ED visits will be monitored through RODSand laboratory testing through NEDSSd. Data to be evaluated includes:1. admissions2. discharges/deaths3. Patient characteristics such as:age, underlying disease, secondarycomplications, illness in healthcare personnel
19Pandemic Response cont’d e. Guidelines for distinguishing betweeninfluenza and other respiratory diseasef. Symptoms of Influenza1. fever2. headache3. myalgia4. prostration5. coryza6. sore throat7. cough
20Pandemic Response cont’d 2. Hospital Communicationsa. External communications outside the facilitywill occur through the following contactindividuals: Infection Control Coordinator,VP of Medical Affairs, Public Relationsb. Internal Communications will occurthrough Incident Command3. Education and Traininga. Hospital Plan and response educationb. Hospital staff guide to the Pandemicc. Unit specific educationd. Internet Plans
21Pandemic Response cont’d D. Triage/Clinical Evaluation/Admission Process1. Identification of patients w/pandemic flu2. Separation of pandemic patients3. Identify type of care needed4. Identify “triage coordinator” for patientmanagement5. Define ED/OP clinical evaluation dispositionprocedures6. Review/streamline admission process7. Entry “Trigger points” switch from passive(signs) to active (direct questioning)
22Pandemic Response cont’d E. Facility AccessThe following criteria and procedures willbe used to limit access if pandemic occurs:1. Definition of “essential” visitors2. Protocols for limiting non-essential visitors3. Criteria or “triggers” for temporary closinghospital to new admissions/transfersa. staffing ratios, isolation capacity, risksto non-influenza patientsb. who makes decision regarding closing/communication of informationc. consult with state and local health departments ontheir role in determining what assistance they offer
23Pandemic Response cont’d F. Occupational Health1. Managing ill workersa. plan for detecting signs and symptomsof influenza in healthcare personnelbefore reporting to dutyb. policies for managing healthcare workerswith respiratory symptomsc. Consider assigning staff recovering frominfluenza to care for influenza patients2. Time-off Policies3. Reassignment of High-Risk Personnel
24Pandemic Response cont’d 4. Psychosocial health services5. Influenza vaccination and use of anti-viral drugsa. Employee annual vaccination programb. Increased vaccination coverage duringInter-pandemic periodc. Documentation of vaccination of employeesd. Program established for rapidly vaccinatingor providing antiviral prophylaxis ortreatment to healthcare personnel asrecommended by HHS and PADOH
25Pandemic Response cont’d G. Use and Administration of vaccines andantiviral drugs1. Pandemic influenza vaccine and“pre-pandemic” influenza vaccinea. Interim recommendations1. Monitor updated HHS information andrecommendations on the development,distribution, and use of vaccine2. Work with local and state health depts.on vaccine distribution plans3. Have estimated quantities of vaccine needed4. Develop vaccination prioritization plan5. Develop Pandemic Influenza Plan
26Pandemic Response cont’d H. Surge Capacity1. Plans to include addressing emergency staffing needsand increase demand for isolation wards, ICUs,assisted ventilation services and consumable anddurable supplies2. FluSurge software3. Staffinga. Assign responsibility for assessment andcoordination of staffing during an emergencythrough Hospital Incident Command Systemb. Estimate minimum number and categories ofpersonnel needed to care for a single patient or asmall group of patients with influenza on a givenday
27Pandemic Response cont’d c. Determine how the hospital will meet staffing needs asnumber of patients with pandemic influenza increasesor staff become ill1. consider patient-care responsibilities to clinicaladministrators2. recruiting retired healthcare personnel3. Using trainees4. Using patients’ family members in ancillaryhealthcare capacityd. Collaborate regionally under the regional hospitalresponse plan
28Pandemic Response cont’d e. Increase cross-training of personnelf. List essential support staff personnel titlesg. PADOH-”emergency staffing crisis”credentialingh. Identify insurance and liability issues relatedto non-facility staffi. Use of healthcare providers from othersystems
29Pandemic Response cont’d 4. Bed Capacitya. Review and revise admission criteria for times whenbed capacity is limitedb. Polices and procedures for expediting discharge ofpatients who do not require on-going carec. Plan with homecare agencies for follow-up on earlydischargesd. “Triggers” for canceling elective surgical procedurese. Disposition of those patients requiring emergencyprocedures
30Pandemic Response cont’d f. Bed tracking through DOH Facility ResourceEmergency Data Systems (FREDS)g. Hospital licensed bed expansion during thePandemich. Discussion regarding “Altered Standards ofCare in Mass Casualty Events”i. Polices and Procedures for shifting patientsbetween nursing units to free up bed space incritical care areas and cohorting of patientsj. MOU’s with other healthcare facilitiesk. Identification of areas to be vacated for cohorting ofpandemic patients
31Pandemic Response cont’d 5. Consumable and durable suppliesa. Evaluation of existing system for tracking medicalsupplies to detect rapid consumptionb. Consider stockpiling enough consumable resourcessuch as masks for duration of pandemic eventc. Assess anticipated needs for consumable anddurable resources, and determine trigger point forordering extra suppliesd. Anticipate need for antibiotics to treat bacterialcomplications of influenzae. Establish contingency plans for situations in whichprimary sources of medical supplies become limited
32Pandemic Response cont’d I. Security1. Healthcare facility plan for additionalsecurityJ. Mortuary Issues1. Assess current capacity for refrigeration ofdeceased persons2. Discuss mass fatality plans with local andstate health officials and medical examiners3. Identification of temporary morgue sites4. Determine scope and volume of suppliesneeded to handle the dead.
33Planning for provision of care in the non-hospital setting 1. Effective Managementa. plan to establish and staff telephonehotlinesb. develop training modules, protocols,and algorithms for hotline staffc. Provide public education materialsd. clinics and offices should have plans that include:education, staffing, triage, infection control inwaiting rooms, communication with healthcarepartners and public health authorities
34Planning for provision of care in the non-hospital setting- cont’d e. communication planf. plan for procuring suppliesg. participation in community plan fordistribution of vaccine and antivirals
35Planning for provision of care in the non-hospital setting- cont’d a. create planning committeeb. decision making and coordinatingstructurec. How to conduct surveillance forpandemic influenza in healthcarepersonnel and for residential facilitiesin population servedd. staff education
36Planning for provision of care in the non-hospital setting- cont’d 3. Alternative care sitesa. bed capacity and spatial separation ofpatientsb. facilities and supplies for hand hygienec. lavatory and shower capacity for largenumber of patientsd. food servicee. medical service
37Planning for provision of care in the non-hospital setting- cont’d f. staffing for patient care and supportservicesg. cleaning and disinfection suppliesh. environmental servicesi. safety and security
38RELEASE OF SUPPLIES FROM STRATEGIC NATIONAL STOCKPILE EPHRATA COMMUNITY HOSPITAL(EMERGENCY MANAGEMENT COMMITTEE)COUNTY(LEMA)PENNSYLVANIA STATE DEPT. OF HEALTH(PEMA)Governor informs PEMA to submit requestFederal and State hold conference call and decide to deploy SNSFEDERALDEPARTMENT OF HEALTH AND HUMAN SERVICES(FEMA)
39Role of Laboratorian during a pandemic Perform necessary tests to determine presence or absence of influenza virus in a patientReport positive influenza results to Pennsylvania Department of Health via PA-NEDSS reporting systemReport information to infection control coordinator