1. State, federal & international roles in public health & disasters Kristine M. Gebbie, DrPH, RN Columbia University School of Nursing June 27, 2006

2. June 27 2006 Goals Review challenges in studying emergency response Present examples from current work by panelists Engage participants in identifying ways to move forward

3. June 27 2006 Perspectives Little work prior to 2001 Researchers have applied both theoretical & logic models based on familiarity Comparative analysis limited Limited community of scholars Example: WADM Utstein Model almost unknown in US

4. June 27 2006 My work Competency development After-action reports Criteria development Exercise evaluations

5. June 27 2006 Competency development Primarily qualitative National perspective Individual state or school perspective Competing sets confuse practice field Needs Organizational ownership Concurrence on division of field

6. June 27 2006 After-action reports Quarantellis work most helpful Focus on management & decision-making Does not fit HSEEP or other DHS lists Usually not published

7. June 27 2006 Criteria development Primarily qualitative Requested by federal manager but not owned by agency Resisted by agencies Not used by DHS Part of review now underway by ASPH

8. June 27 2006 Exercise evaluations Only as good as clarity of exercise objectives and precision of observations Moving toward quantifiable information Standardization of formats emerging

9. June 27 2006 Example: local public health- driven exercise Practice the process of opening and operating multiple oral medication (POD) sites for first responders & health staff, in anticipation of wider emergency prophylaxis, including Physical setup of POD sites Ordering and receiving supplies from the county stockpile Informing staff/staff families (including children) to report Record keeping, screening and distribution of prophylaxis Communication between POD sites and EOC

10. June 27 2006 Participants County health department County emergency management agency 12 hospitals 9 fire battalions Police department Sheriff 1 township warehouse

11. June 27 2006

12. 5 months of building blocks Seminars MRC Fire & Police Hospitals Workshops and tabletops Fire battalions + MRC Police Hospitals

13. June 27 2006 Preliminary drill findings Participants 3000 county staff, volunteers 160 evaluators Maximum fire battalion throughput: 600 persons/hour Range of hospital throughput: 300 per hour to 70 per hour

14. June 27 2006

18. And now two other perspectives- - -