application to mass dispensing hot topics in preparedness northwest center for public health...
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Application to Mass DispensingHot Topics in Preparedness
Northwest Center for Public Health PracticeSchool of Public Health & Community Medicine
University of WashingtonJuly 27, 2004
Andy Stergachis, Ph.D., R.Ph.Professor, University of Washington
SNS Coordinator, Region 6
Roughly how complete is your SNS plan?
A. 100%B. 75%C. 50%D. < 50%
What do you need to plan for?
• Roles, responsibilities, policies
• Decision-making for requesting SNS
• Site selection
• Set-up and design
• Staffing
• Public information and communication
What is theStrategic National Stockpile?
Federally managed logistical system created to supplement supplies of state and local systems during a major public health emergency:
• 12 strategically located Push Packages (12hr PP)• Vendor Managed Inventory (VMI)• Stockpile Managed Inventory (SMI)• Technical Assistance Response Unit (TARU)• Chempack Program
12-hour Push Package• 50+ tons of pharmaceuticals,
equipment, and other medical supplies.
• Color coded for ease in identifying needed material:– Biological, Chemical &
Biological, All Scenarios, Chemical Antidotes, Bandages
• Antibiotics– Unit of use 10-day courses– Suspension– Intravenous
Vendor Managed Inventory
• Inventory owned by the SNS program and managed by pharmaceutical vendors– Vendors maintain the VMI stock
as a bulge within their pipeline and rotates stock to keep it current and eliminate waste.
• Represents 90% to 95% of the SNS inventory• Used in Florida, re: anthrax attack
CHEMPACK Program• The CHEMPACK program
forward-deploys chemical antidotes
• Elements of the program:– Maintained locally and readily
available to EMS and Hospital Emergency Departments
– Remotely monitored for environment and security by the SNS Program
• Washington was one of the three pilot programs
Roles, Responsibilities, Policies
• Who has authority to request SNS?
• What are the relevant laws and authorities?
• What is the process for requesting SNS?
• How is the request coordinated with regular emergency management procedures?
?
Responsibilities
• The state is responsible for receiving, storing, staging (RSS), & distributing the SNS supplies to the points of distribution (PODs).
• Local health officials are responsible for setting up and operating dispensing or immunization clinics/sites.
Decision-Making to Request SNS
• Identify Criteria, e.g.– Suspected BT attack– Chemical agent or ionizing radiation– Hospitalization of large numbers of patients
• Determine if local supplies sufficient, e.g.– Number of casualties– Epidemiology of agent of concern
• Consultations• Notifications
Set-Up and Design• Critical Components:
– Incident Command
– Triage & Registration
– Dispensing – Express & Other
– Counseling and Education
– Record Keeping
– Security
• Throughput Model
Types of Patient Groups
• No Complications – healthy
– Express dispensing
• Complications – pre-existing illnesses/allergies, pregnant, etc.
– Assess and provide more involved counseling
• Persons with acute illnesses
– Transport
• Crisis counseling and mental health intervention
Which of the following sites are you considering for mass
dispensing clinics?
A. Schools
B. Community Centers
C. Pharmacies
D. Other
Site Selection
• How many?
• Where?
– Familiar Locations
– Accessible
• Size and Characteristics
• Hours of Operation
• Agreements
Do you have a plan for mobilizing volunteers for
mass dispensing clinics?
A.Yes
B.No
Staffing• Public Health Department
• Volunteers
– Recruit
– Train
– Call-Up Procedures
• Who can dispense?
• Prescribing physician
Public Information and Communication
• Notifications to public of POD openings
• Coordinate through Public Health Information Officer and Joint Information Center (JIC)
Lessons Learned from Exercises of SNS: Planning
• Hold face-to-face meetings
• Establish and solidify mutual aid agreements
• Scale plans to accommodate scenarios
• Harmonize SNS plans with other plans
• Clarify roles
• Update contact information and make it accessible
• Emphasize regional planning ASTHO 2004
Resources
• www.bt.cdc.gov/stockpile/index.asp
• Mass Prophylaxis/Vaccination Campaign Staffing Model: www.ahrq.gov/research/biomodel.htm
• www.phppo.cdc.gov/phtn/antibiotic
• Exercising the SNS: Lessons learned and tools for application, www.astho.org
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