1. Copyright 2008. Medical Group Management Association. All rights reserved. Name, credentials Organization Date Preparing Your Office Practice for Disaster and Emergency Events Idaho Bioterrorism Awareness and Preparedness Program (IBAPP) Medical Group Management Association (MGMA) July 22, 2008

2. Copyright 2008. Medical Group Management Association. All rights reserved. Name, credentials Organization Date Protecting your facility, physicians, staff, and patients in the event of a natural disaster, contagious disease outbreak, bioterrorist incident, or other emergency

3. Copyright 2008. Medical Group Management Association. All rights reserved. How Can You Prepare? Learn how to diagnose and treat patients affected with avian flue or who are exposed to biological agents and toxins Train staff how to recognize potential cases Establish medical practice disaster plan Include pandemic and bioterrorism in the medical practice disaster plan Develop a screening plan to identify and direct patients with high risk for contagious disease or biological agent exposure

4. Copyright 2008. Medical Group Management Association. All rights reserved. Ten Step Response to Pandemic or Bioterrorism 1.Maintain an index of suspicion 2.Protect thyself 3.Assess the patient. 4.Decontaminate as appropriate 5.Establish a diagnosis 6.Render prompt treatment 7.Practice good infection control 8.Alert the proper authorities 9.Assist in in the epidemiologic investigation 10.Maintain proficiency

5. Copyright 2008. Medical Group Management Association. All rights reserved. Screening Patients with a High Risk for Contagious Disease or Biological Agent If there is a risk of pandemic or biological attack, train receptionists to use a script that can identify patients at risk Validate screening by triage nurse or physician Direct patient to the appropriate health care services –Monitor symptoms for the scheduled appointment –Come immediately to the doctor’s office –Go directly to a designated health care facility –Call 911 for the Emergency Medical Response (EMR) system.

6. Copyright 2008. Medical Group Management Association. All rights reserved. Sample Script for Receptionists to Use in Screening Patients Key questions –Symptoms –Travel –Military service –Mass transit –Public gatherings

7. Copyright 2008. Medical Group Management Association. All rights reserved. Sample Script for Receptionists to Use in Screening Patients Fever? Fatigue? Sore throat? Difficulty swallowing? Nausea? Vomiting? Coughing? Headache? Back pain? Chest pain? Abdominal pain? Chills? Sweats? How long have you had these symptoms? (Score: Less than week = 2 points, More than a week = 1 point) What symptoms do you have? (Score 1 point for each symptom)

8. Copyright 2008. Medical Group Management Association. All rights reserved. Sample Script for Receptionists to Use in Screening Patients Have you traveled outside the United States recently? If yes, When did you leave the US? What countries were you in? (Score 1 point for each country) When did you return? (Score: Less than a week=2 points, More than week=1 point)

9. Copyright 2008. Medical Group Management Association. All rights reserved. Sample Script for Receptionists to Use in Screening Patients Are you currently, or have you been in the military? If yes, Were you stationed outside the US? (Score 1) When were you discharged? (Score: Less than a month=2 points, More than a month but less than year=1 points)

10. Copyright 2008. Medical Group Management Association. All rights reserved. Sample Script for Receptionists to Use in Screening Patients Have you recently utilized mass transportation? If yes, (Score: If used all the time or within the past weeks = 2 points, otherwise 1 point) Subways? Buses? Trains? Airplanes? Have you attended any large gatherings recently? If yes, (Score 1 point for each positive answer) Where?

11. Copyright 2008. Medical Group Management Association. All rights reserved. Sample Script for Receptionists to Use in Screening Patients A score in the range of eight (8) or more might indicate that a patient may be at risk of exposure to a contagious disease or biological agent and should be referred to a physician or triage nurse who can better assess the situation and direct the patient to come immediately to the doctor’s office, to a designated health care facility, or to instruct the patient to call 911 and notify the Emergency Medical Response (EMR) system. If the patient is asked to come to the physician’s office, upon arrival they should be isolated immediately. Walk-in patients also should be asked the appointment triage questions at the front desk and isolated from public areas based on the scoring.

12. Copyright 2008. Medical Group Management Association. All rights reserved. David N. Gans, FACMPE Vice President, Practice Management Resources Medical Group Management Association 104 Inverness Terrace East, Englewood, CO 80112 877.275.6462 ext. 1270 dng@mgma.com