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(HPP) Performance Measure Manual

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<strong>HPP</strong> 6.1<br />

4. Please identify the type of incident, exercise,<br />

or planned event upon which the request for<br />

EEI was based [Check all that apply]:<br />

• Extreme weather<br />

(e.g., heat wave, ice storm)<br />

• Flooding<br />

• Earthquake<br />

• Hurricane or tropical Storm<br />

• Hazardous material<br />

• Fire<br />

• Tornado<br />

• Biological hazard or disease,<br />

please specify<br />

• Radiation<br />

• Other, please specify<br />

5. Please provide the name and date of the<br />

incident, planned event, or exercise<br />

6. Please state how many of each type(s) of<br />

local partners responded to the request:<br />

• HCOs<br />

• HCCs<br />

• LHDs<br />

• Other, please specify<br />

7. Please identify the requesting entity (e.g.,<br />

health and medical lead at the State, substate,<br />

regional, or local level). [Check one of<br />

the following]<br />

• State health and medical lead (or<br />

designee)<br />

• Sub-state regional health and medical<br />

lead (or designee)<br />

• Local health and medical lead (or<br />

designee)<br />

• Other, please specify<br />

8. Please identify the types of EEI requested.<br />

[Check all that apply]<br />

• Facility operating status<br />

• Facility structural integrity<br />

• The status of evacuations or shelter inplace<br />

operations<br />

• Status of critical medical services (e.g.,<br />

trauma, critical care)<br />

• Critical service or infrastructure status<br />

(e.g., electric, water, sanitation, heating,<br />

ventilation, and air conditioning)<br />

• Bed or patient status<br />

• Equipment, supplies, medications,<br />

vaccine status or needs<br />

• Staffing status<br />

• Emergency Medical Services (EMS)<br />

status<br />

• Epidemiological, surveillance or lab data<br />

(e.g., test results, case counts, deaths)<br />

• School-related data (closure,<br />

absenteeism, etc.)<br />

• POD or mass vaccination sites data (e.g.,<br />

throughput, open or set-up status, etc.),<br />

please specify<br />

• Other, please specify<br />

9. Please identify the type of IT or other<br />

communication system used to request EEI<br />

from local partners.<br />

10. Please identify the type of IT or other<br />

communication system local partners used<br />

to submit requested EEI.<br />

11. Barriers or challenges to submitting<br />

requested EEI within the requested<br />

timeframe (please describe types of local<br />

partners experiencing challenges and types<br />

of EEI not submitted within requested<br />

timeframe).<br />

How is this measure<br />

operationalized?<br />

This measure intends to capture information on<br />

the communication of incident-specific EEIs. Data<br />

elements for this measure should be based on: the<br />

incident commander’s determination of<br />

specifically required health and medical EEI for<br />

that incident (and tasked to the health and<br />

medical lead, or equivalent entity, to collect),<br />

specific local partners (i.e., entities that will report<br />

EEI to the incident commander or designee) and<br />

the requested timeframe determined by the<br />

incident commander or designee.<br />

Information Sharing<br />

Pre-Incident<br />

Healthcare<br />

Response<br />

Preparedness<br />

Hospital Preparedness Program (<strong>HPP</strong>) <strong>Performance</strong> <strong>Measure</strong> <strong>Manual</strong>,<br />

Guidance for Using the New <strong>HPP</strong> <strong>Performance</strong> <strong>Measure</strong>s Page | 37

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