Public Health Practices

Exercise integrates planning for people with functional needs in general population shelter

A Georgia health district helped to coordinate an exercise that built support services for physical disabilities, mental disorders, dementia, and wheelchair access into disaster shelter planning.

Interactive, visual tool helps people with communication needs stay safe in emergency shelters

A visual tool helps emergency shelter residents and staff communicate shelter procedures, medical needs, and feelings without need for speech.

Preparing the way for functional and access needs in general population shelters

An Arizona partnership between public health and independent living advocates helped purchase adaptive and durable medical equipment to support people with functional needs in general population shelters.

Retrofitting a city bus for medical evacuations and respiratory therapy

Chicago first responders developed ways to provide oxygen therapy on buses during large-scale evacuations.

Workbook for healthcare providers in rural communities

Texas agencies collaborated with healthcare providers to develop a toolkit for emergency planning in rural areas.

Standards and Guidelines for Healthcare Surge during Emergencies

The California Department of Public Health has outlined a process for dealing with the complex issues of clinical care surge capacity during a public health emergency. The tools could serve as an educational model for other states that are attempting to address this challenging topic.

Alternate Care Sites

Part of Missouri's strategy for countering surge during a pandemic includes using Mass Casualty Incident Trailers as alternate care sites. The unique approach relies on recruiting hospitals to host the trailers and maintain essential resources for their communities. The supply manifests are detailed and concrete checklists that represent thorough operational planning.

Alternate Care Site Primer for Volunteers

An online educational tool from the University of Minnesota Preparedness and Emergency Response Learning Center provides comprehensive just-in-time training for volunteers working at an alternate care site during a major emergency.

Ketchikan alternate care site templates

Planners in Ketchikan, Alaska, developed tools for establishing alternate care sites along with communication templates for tracking patient triage and care during a disaster.

Surge Capacity Guidelines and Templates

The Surge Capacity Guidelines and Templates provide a broad and interconnected approach to managing patient overload in hospitals, medical clinics, and alternate care sites. The overall structure of each document is similar, yet each focuses on specific areas that are germane to each response strategy.

Influenza Care Centers (ICC)

Santa Clara County has developed the concept of Influenza Care Centers (ICCs) as part of its Pandemic Influenza Plan. The proposal includes development of several ICC levels designed to cohort care for people with influenza infection. Cohorts may include people with insufficient care resources at home and people who cannot stay at home because they require a higher level of care.

Santa Clara Clinical Triage Guidelines

The Santa Clara Clinical Triage Guidelines include a protocol and a flow chart that use a modified pneumonia severity index to triage influenza patients. Patients are stratified by objective criteria (e.g., blood pressure, oximetry, age) to hospital admission, Influenza Care Center admission, palliative home care, or recovery at home.

Alternate Care Facilities Project

A concept paper and site assessment tool from Seattle-King County provide specific and concrete information on establishing alternate care facilities (ACF). The concept paper focuses on useful issues for public health agencies and their healthcare partners to consider when developing initial plans for ACFs in a community.

Lateral Thinking Pan Flu Education and Training

A variety of educational materials introduce the benefits of lateral thinking/six hats techniques and apply this approach to collaborative planning for multi-agency pandemic influenza projects. The materials were developed by the Tarrant County, Texas, Advanced Practice Sessions, with funding from NACCHO and the CDC.

Medical and public health surge in Alexandria

This document presents the concept of Community Care Stations (CCS). These facilities are designed to provide initial assessment triage and would be opened when the hospital system begins to become overwhelmed. The document describes triage criteria, lists required supplies, and presents a staffing plan for the CCS. It also describes criteria for opening and supplying Alternate Care Facilities (ACF) in the area.

Influenza Specialty Care Units

A concept of operations for setting up alternate care sites details the plan for establishing Influenza Special Care Units (ISCUs) in Massachusetts. The documents indicate that hospitals should collaborate and develop one ISCU for a cluster of hospitals in every region. These documents constitute an option for a local public health agency, a state health department or even private sector health services, because they provide a concept of operations for developing alternate care statewide.

Community Based Assessment Centres (New Zealand)

The Community Based Assessment Centres plan offers practical information on establishing sites for initial screening and triage of patients with suspected pandemic influenza. The materials are noteworthy, because they provide a concept of operations for establishing alternate care sites in such a way that the approach could be incorporated into state, local, or hospital preparedness efforts.

Pandemic Influenza Response and Management Toolkit: Appendix D: Alternative Care Site Management Tools (British Columbia, Canada)

Fraser Health's toolkit outlines key parameters for establishing alternate triage and care centers by providing guidance for selecting a site, organizing personnel, conducting triage and process flow, and discharging patients. The materials are still in draft form, and any triage or care site would need to modify the materials to fit its individual needs.

Reopening Shuttered Hospitals To Expand Surge Capacity (National)

Shuttered hospitals possess the structural attributes that may allow them to provide better care, as opposed to other proposed alternate care sites within a community. This lengthy guidance describes the rationale and strategies for re-opening shuttered hospitals to enhance medical surge capacity in a community.

Providing Mass Medical Care with Scarce Resources: A Community Planning Guide (National)

A robust and extensive guide describes mass casualty planning in the essential areas of emergency medical services, hospital/acute care, alternative care settings, palliative care, and legal/ethical issues. A pandemic influenza case study is included to assist planners in preparing for a pandemic event.

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