Pandemic Influenza Plan - Questar III

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Section 3: Healthcare Planning and Emergency Response • Identification of early signs and symptoms in order to recognize and thus prevent the spread of disease • Recognition of colleague stress and exhaustion ACFs should make arrangements for immunization of both residents and staff. All residents of ACFs should be given the opportunity to complete both Health Care Proxies and/or End-of-Life decisions documents (Living Wills). These documents should be clarified or confirmed as appropriate. The fundamental effect of a pandemic flu event on the Adult Care Facility bed capacity is uncertain at best. Many who survive the initial disease onslaught will require some degree of rehabilitation, and others will likely require long-term residential care, perhaps at a higher acuity level. The mortality level is undetermined, and the eventual outcome may not exceed the bed supply at the ACF level, but may impact higher care levels. As the level of clinical service and living arrangements vary widely across ACF providers, NYSDOH will provide guidance to ACFs which recognizes this variability. C. Home Health Agencies (Certified Home Health Agencies, Licensed Home Care Agencies, Long-Term Home Health Care Programs and Hospices) In a pandemic, the use of home health services as an alternative to hospitalization will be a key component in helping to control hospital surge. Therefore, it is important that home health agencies focus planning efforts on keeping patients out of the hospital and if possible, enhancing capacity so that hospital patients can be discharged more quickly. Home Health Agencies (HHA) during the Interpandemic and Pandemic Alert Periods should: • Review their emergency preparedness plans and incorporate any necessary revisions specific to the outbreak. • Review the procedures and the process for accessing the HPN. • Ensure that information contained on the Communication Directory is accurate and up-to-date. All home care agencies must maintain an up-to-date patient roster which utilizes the Patient Classification System in Appendix 3-A. The agency’s plan must include a strategy for meeting the care needs of patients in accordance with their classification, that is, reducing service to Level 2 and 3 patients while maintaining service to the Level 1 patients. Patients should be classified on admission and periodically as their condition warrants. This information, as well as information on next of kin/responsible party, should be readily accessible for agency administrative staff. February 7, 2006 3-17
Section 3: Healthcare Planning and Emergency Response The agency’s plan should include working with home health agencies in neighboring counties and local nursing homes to temporarily admit patients to those providers. LHDs may need to work closely with their NYSDOH Regional Office to secure support for some of their public health activities (e.g., Points of Dispensing) so that LHD staff may be freed to care for their most fragile home care patients. The following concepts should be reviewed and reinforced with staff: • Information on disease prevention strategies • Infection control techniques • Identification of symptoms to promote early detection and minimize the spread of disease The HHA should make arrangements to provide or arrange for immunization of their patients and staff. Many agencies have tele-medicine equipment that could be used to monitor patients while limiting face-to-face contact. This technology could be extremely valuable during a pandemic. D. Primary Care Providers (Community Health Centers, Physician Offices, Urgent Care Centers) During a pandemic, the effective delivery of outpatient services and the use of primary care facilities as additional triage sites can be critical. The important functions that primary care facilities/providers should incorporate into their planning are: • Collaboration with hospital and LHDs to establish telephone hotlines to provide advice to the public on whether to stay home or to seek care. This may help reduce the volume of “worried well.” • Serve as a referral point for hospital triage sites if it is determined that patients can be managed on the outpatient basis. • Serve as additional triage (and treatment) sites to provide patients an alternative to presenting at the hospital, thus easing the burden on hospital EDs. Key planning considerations for these settings are: • development of triage and treatment procedures that minimize the risk of disease transmission (e.g., physical separation of patients, “sick call” hours). • review and reinforcement of the following concepts with staff: • infection control practices; • enhancement of triage and treatment capacity through increase hours of operation and the use of volunteers. • collaboration with hospitals and LHDs on public service messages that announce facility availability and hours of operation. February 7, 2006 3-18
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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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Appendix 1-G 8. State Institutions
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Appendix 1-G b. Governor May Invoke
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Appendix 1-G may direct, pursuant t
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Appendix 1-G c. Commissioner of Gen
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Appendix 1-G Designation of emergen
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Appendix 1-G physician’s assistan
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Appendix 1-H Summary of Public Offi
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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 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-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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