Transcript Slide 1

Application to
Mass Dispensing
Hot Topics in Preparedness
Northwest Center for Public Health Practice
School of Public Health & Community Medicine
University of Washington
July 27, 2004
Andy Stergachis, Ph.D., R.Ph.
Professor, University of Washington
SNS Coordinator, Region 6
Roughly how complete is
your SNS plan?
A.
B.
C.
D.
100%
75%
50%
< 50%
What do you need to plan for?
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Roles, responsibilities, policies
Decision-making for requesting SNS
Site selection
Set-up and design
Staffing
Public information and communication
What is the
Strategic National Stockpile?
Federally managed logistical system
created to supplement supplies of
state and local systems during a
major public health emergency:
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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.
B.
C.
D.
Schools
Community Centers
Pharmacies
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
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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