Public Health Practices

Improving biosurveillance for mass gatherings: The 2013 Boston Marathon example

Immediately following the 2013 Boston Marathon bombing, BPHC's Medical Intelligence Center worked with hospitals to ensure quality and speed of care for injured patients.

Exercise illustrates role of small, independent pharmacies in emergency response

Public health planners worked with an independent pharmacy to test patient surge during a simulated influenza pandemic.

Utah stakeholders forge healthcare coalition to strengthen surge capacity

The Northern Utah Healthcare Coalition addresses disaster medical surge issues and resource sharing in a large frontier area.

Boston health coalition builds cross-agency emergency communication structure

More than 400 Boston health and healthcare agencies created a communications coalition to respond quickly to medical surge and mass care needs.

Toolkit paves the way for hospitals to meet children's needs during a disaster

A Washington healthcare coalition created a toolkit for managing neonatal and pediatric medical needs and evacuation during an emergency.

Mesa County, Colorado

Toolkit uses just-in-time training to integrate volunteers into healthcare response

To address health professional shortages in rural areas, a Colorado APC developed interactive orientation and training tools for volunteers.

HSEEP-based emergency exercise toolkit tailors tabletop exercises to the needs of hospitals and health facilities

Chicago's toolkit walks users through planning a heat wave and medical surge scenario for a healthcare tabletop exercise.

Pandemic Influenza Planning Guidance for Healthcare Institutions

Philadelphia's Pandemic Influenza Planning Guidance for Healthcare Institutions addresses the needs and situations that may be experienced by hospitals during a pandemic.

Definitive care for the critically ill during a disaster

Five articles from the Task Force for Mass Critical Care address difficult issues around patient triage and resource allocation that may need to be implemented during an influenza pandemic.

Rapid patient discharge tool

Adaptable plans based on promising bed surge capacity practices help hospital administrators address unexpected increases in patient volume during an emergency.

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.

Health System Surge and Resource Management

An after-action report from Seattle and King County covers the objectives, tools, and results from a tabletop exercise on healthcare surge capacity during an influenza pandemic. The appendices include slides on the tabletop scenario, pre- and post-exercise evaluation surveys, and questions posed to participants.

San Francisco Job Action Sheets

San Francisco has provided over 120 specific job action sheets for public health professionals who are responding to various aspects of an infectious disease emergency. The job action sheets are based on San Francisco's functional Infectious Disease Emergency Response plan, which uses a NIMS-compliant Incident Command System organization structure.

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.

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.

Pandemic Influenza Planning Kit for Outpatient Providers

The Pandemic Influenza Planning Kit for Outpatient Providers is a clear and concise guide that nicely summarizes key information. The materials represent an integration of trusted and useful resources that are potentially useful for enhancing surge capacity at the local level. Although the planning kit does not provide tools to begin a plan or integrate plans across sectors, it provides a systematic framework for health care workers to extend planning within an organized context.

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.

Development of a Triage Protocol for Critical Care during an Influenza Pandemic (Ontario, Canada)

A collaborative, evidence-based triage protocol was designed for use as a decision-making tool when a critical care system becomes overwhelmed. The system of triage is applicable to patients with and without pandemic influenza, since all patients would share the same scarce resources.

Acute Care Services Tools (Ontario, Canada)

The Acute Care Services Tools provide the following: 1) a triage protocol for patients who may need critical care; 2) an assessment form and triage protocols for patients who may have pandemic influenza; 3) a hospital admission form for influenza patients; and 4) standing admission orders for influenza patients. The triage protocol outlines inclusion and exclusion criteria for evaluating patients who are being considered for critical care.

Pandemic Influenza Response and Management Toolkit: Appendix B: Clinical Care Guidelines: Algorithm for Initial Management of Adults and Children (British Columbia, Canada)

Three screening algorithms describe initial management of adults and children with suspected pandemic influenza. The flow charts provide criteria for self care at home, supervised outpatient management, admission for a short in-patient stay, and critical care admission. The algorithms describe initial management strategies that can be used to triage patients to home care or to other types of acute medical care.


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