Pandemic Influenza Plan - Questar III

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Section 3: Healthcare Planning and Emergency Response I. Overview Emergency response, including maintenance of critical services and surge capacity in the health care system, has been an integral part of both CDC and HRSA cooperative agreements for terrorism preparedness. Over the last five years, New York State hospitals have been developing Comprehensive Emergency Management Plans. These plans have significantly elevated their ability to respond to all hazards, including bioevents such as a smallpox and pandemic influenza outbreak. Pandemic influenza differs from many biological threats in its potential magnitude and duration, including the likelihood of second and later waves of disease. Several features set pandemic influenza apart from other public health emergencies or community disasters: • Influenza may be an acute but self-limited and uncomplicated infection that does not require medical evaluation or therapy. • Outbreaks can be expected to occur simultaneously throughout much of the U.S., making it more difficult for healthcare providers to share human and material resources that usually occur in the response to other disasters. Localities should be prepared to rely on their own resources to respond as much as possible. The effect of pandemic influenza on individual communities will be relatively prolonged (weeks to months) in comparison to disasters of shorter duration. • Because of widespread susceptibility to a pandemic influenza strain, the number of persons affected will be high. • Health care workers and other first responders will be at higher risk of exposure and illness than the general population, further straining the health care system. • Effective preventive and therapeutic measures, including vaccine and antiviral agents, are likely to be delayed and in short supply. • Widespread illness in the community could result in sudden and potentially significant shortages of personnel in other sectors that provide critical public safety services. A pandemic will overwhelm the current healthcare system. The increase in patients requiring hospitalization and critical care will result in shortages of multiple resources including personnel and equipment. This will in turn create a situation where nursing homes and homecare agencies will be required to accept more clinically complex hospital discharges and will have to care for patients they would normally discharge to the hospital. New York State Department of Health (NYSDOH) will need to authorize hospitals, adult care facilities and nursing homes to expand their capacity by utilizing common areas that would not normally be approved for use. Community Health Centers and other primary care providers will need to expand their triage and outpatient treatment capacity to relieve pressure from hospital emergency departments. All facilities will need to supplement their highly trained professional staff with volunteers and lesser trained staff. Standards of care and the current regulatory approach will, by necessity, need to be changed. NYSDOH will convene in early 2006 a panel to review the potential impact of February 7, 2006 3-3
Section 3: Healthcare Planning and Emergency Response a pandemic on standards of care including what changes may be necessary based on what components of the system are unable to meet demands. The Healthcare Planning and Emergency Response section describes the systems that will be used to expand capacity to diagnose, treat and manage patients requiring medical care during pandemic influenza. Surge capacity and management of mass fatalities must be addressed as part of the changes in standards of care. During the Interpandemic and Pandemic Alert Periods, emphasis will be centered upon developing institutional plans, protocols and drills for responding to influenza pandemic. Health care facilities included in the planning will be hospitals, primary care centers, emergency medical services, home health agencies and long term care facilities. This section will address various issues related to healthcare planning and emergency response including triage, surge capacity, infection control in healthcare facilities, volunteers, EMS and mass fatalities. The needs and activities will be articulated for all health care facilities including hospitals, long term care facilities, and home health agencies. II. Objectives Objectives of this section include: • Guide and assist hospitals in planning for a worldwide pandemic including the development of increased capacity for triage of all patients. o Hospital surge capacity • hospital beds • ventilators and other medical equipment and supplies • staffing o Non-traditional healthcare facilities • Identify the role and activities of long term care facilities during an influenza pandemic. • Identify the roles of home health agencies during an influenza pandemic. • Identify the roles of Emergency Medical Services during an influenza pandemic. • Emphasize the importance of infection control protocols. • Provide for the maintenance of mental health services for health care employees. • Recruit volunteers for increased staffing capacity during pandemic influenza. • Coordinate with local health departments (LHDs) outside NYC and the New York City Department of Health and Mental Hygiene (NYC DOHMH) and other emergency planners in NYC regarding hospital and EMS planning. • Assure the adequacy of care and disposition of the dead during mass fatality including dispositions that are outside of the current/standard means of disposal. • Identify necessary changes in local and regional healthcare, as necessary, under the extraordinary conditions of a pandemic. • Educate all healthcare providers on potential changes in the healthcare system (protocols, procedures and standards) in a world pandemic. February 7, 2006 3-4
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February206 Pandemic Plan NewYorkSt
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Introduction Pandemic influenza occ
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example, at this time, it is realis
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Acronyms (cont.) IND IHANS IRB ISHS
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Section 1: Command and Control I. O
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Section 1: Command and Control pers
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February 7, 2006 Appendix 1-A
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Appendix 1-B The Public Health Law
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Appendix 1-B communicable diseases
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Appendix 1-C Management Office or t
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Appendix 1-E Suspension of Public M
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Appendix 1-G A Guide to New York St
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Appendix 1-G health commissioner. P
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Page 67 and 68: NYSDOH Novel Influenza Case Report
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Section 4: Infection Control A. Bas
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Section 4: Infection Control Drople
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Section 4: Infection Control • Pe
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Section 4: Infection Control o Noti
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Section 4: Infection Control E. Coh
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Section 4: Infection Control If wid
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Section 4: Infection Control • En
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Section 4: Infection Control should
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Section 4: Infection Control Policy
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Section 4: Infection Control o Staf
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Section 4: Infection Control • De
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Section 4: Infection Control • Pr
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Section 4: Infection Control The ma
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Section 4: Infection Control • Up
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Section 4: Infection Control Health
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Appendix 4-A Soiled linen and laund
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Appendix 4-B Respiratory Hygiene/Co
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Section 5: Clinical Guidelines I. O
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Section 5: Clinical Guidelines incu
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Section 5: Clinical Guidelines 1) N
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Section 5: Clinical Guidelines infe
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Section 5: Clinical Guidelines Alth
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Section 5: Clinical Guidelines Infe
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Section 5: Clinical Guidelines •
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Appendix 5-B Clinical Evaluation of
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Appendix 5-C Special Situations and
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Appendix 5-D handling soiled laundr
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DRAFT Appendix 5-E Footnotes to App
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Appendix 5-F February 7, 2006 1
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Appendix 5-F 7. Guidance on the eva
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Appendix 5-H Source: U.S. Departmen
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February 7, 2006 2 Appendix 5-I
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Appendix 5-J Clinical Presentation
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Appendix 5-J diabetes mellitus), re
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Appendix 5-J resistant S. aureus (M
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Appendix 5-K eight patients—all o
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Appendix 5-L Guidelines for Managem
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Appendix 5-L testing should be perf
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Appendix 5-L February 7, 2006 5
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Section 6: Vaccine Procurement, Dis
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Appendix 6-A Vaccine Priority Group
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Appendix 6-B Mass Clinic Planning O
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Appendix 6-C Vaccine and Antiviral
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Appendix 6-C 1. Request Phase The r
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Appendix 6-C 3. Receipt and Sign-of
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Appendix 6-C • Work with local he
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Section 7: Antiviral Medication Pro
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Appendix 7-A Characteristics of Ant
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Appendix 7-B a The drug package ins
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Appendix 7-C 7 HCWs in emergency de
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Section 8: Travel-Related Disease C
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Appendix 8-A Home or Community-Base
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Appendix 8-B Contact Identification
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Appendix 8-B • Determine the time
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Appendix 8-C Administrative Data: S
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Appendix 8-D CONTACT DAILY TEMPERAT
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Appendix 8-F Definitions: Intervent
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Appendix 8-F facility. No specific
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Appendix 8-F • Resources Required
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Appendix 8-G Business Pandemic Infl
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Appendix 8-G 4. Allocate resources
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Appendix 8-H CDC guidelines suggest
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Appendix 8-H If I am not masked I
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Appendix 8-H NYSDOH Model Influenza
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Appendix 8-H I understand that if
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Section 9: Communications I. Overvi
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Section 9: Communications and commu
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Section 9: Communications web pages
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Section 9: Communications Local Hea
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Section 9: Communications • A JIC
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Section 9: Communications backup to
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Section 9: Communications • In th
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Appendix 9-A Public Health Risk Com
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Appendix 9-C New York State Departm
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Appendix 9-C PRE-EVENT MESSAGE MAP:
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Appendix 9-C PROTECTIVE MESSAGE MAP
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Appendix 9-C TREATMENT MESSAGE MAP:
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Appendix 9-C BUSINESS CONTINUITY PR
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Section 10: Training and Education
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Appendix 10-A NYSDOH STAFF PRIVATE
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FACILITY- BASED RNs FACILITY- BASED
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Section 11: Workforce Support I. Ov
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Section 11: Workforce Support Pande
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Section 12: Highly Pathogenic H5N1
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Section 12: H5N1 in Non-Human Anima
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Section 13: Public Health Preparedn
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Appendix 13-A NYSDOH Roles Notified
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Appendix 13-B Notifications sent by
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Appendix 13-B HAN posting is used a
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Appendix 13-B notification system t
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Appendix 13-C Overview of the Healt
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Appendix 13-C • Ongoing surveilla
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Table 1. Summary of HERDS Use To da
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Appendix 13-D Commerce Access and A
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Appendix 13-D Table 3. Organization
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Pandemic Influenza Plan - Questar III

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