2-22-06

The Nebraska Medical Center Management Meeting Regarding Pandemic Planning

Trigger Points

• Looking for trigger points or thresholds in both in the community and in the hospital(s) for when parts of the pandemic plan need to be activated (ex: if a case of avian flu is diagnosed in one of the surrounding states, it triggers one part of the plan; if a case of avian flu is diagnosed in Omaha, it triggers another part of the plan; once all of the hospitals reach their normal capacity, it triggers another part of the plan; once the ED is full, it triggers another part of the plan; once all of our staffed beds are full, it triggers another part of the plan;...)

Coordination

• Is there any coordination with associated hospitals in outlier areas? (Iowa, Missouri, etc.)

Ventilators

• In addition to our current supply of ventilators, Anesthesia has said that an anesthesia machine basically does the same function as a ventilator. Stop all elective surgeries (that haven’t started yet) and use those anesthesia machines as ventilators.

Estimation of Persons Needing Hospitalization in the Omaha Area

• 2,000 in a moderate hospital situation
• 22,000 in a severe hospital situation
• The Nebraska Medical Center estimates that about 25% of these numbers they would have to deal with in some capacity
• They plan on an additional sum of about 500 to come in spread over a 4 week period of time

Staffing

• Looking for a percentage of sick calls from staff on a daily basis
• Again, looking for an external trigger (DCHD reports, Day care sick kid report, ED report, Sick kids in schools report, Employee Health visits, lab testing, etc.) to help determine if there’s anything going around and about how many people it’s affecting
• A base line on employee sick calls would be very helpful, but not sure how to obtain this

Community Triggers

• Looking for community triggers that tell administration at point a given portion of the plan needs to be activated – at point X, plan A or level B is activated

Immunization Protocols

• Who gets prioritization in a pandemic situation?
• Do we include family members, and if so, in what situations?
• Will also need to designate who “critical personnel” are
• Need to start cross-training/doing alternate job functions for critical personnel

Vendors

• Do our vendors have an emergency plan?
• We need to identify our key vendors and work with them on their contingency plans

PPE

• We need to train our employees on correct donning and doffing of PPE
• We need appropriate routine training (work in to annual training)
• We need just-in-time training (posters and other quick methods of educating)

Stockpiling

• We need to routinely check out stockpiles of emergency supplies
• What is in our emergency supply?
• Where is it?
• How do we access it?
• How do we inventory it?
• Is it rotated regularly so we keep our supply fresh?
• How many N-95 masks are we stockpiling?
• How about surgical supplies?
• Do we need more gowns or other linens?
• Check with other areas such as Medical Materials and Pharmacy to see what they will need

Altering Standards of Care

• Again, at what trigger point do we initiate this?
• When do we start to triage? Immediately? When we use all our supplies in the ER? When we get through the first unit of items we’ve stockpiled????
• We must at some point start to center our care based on preserving our supplies and our personnel. When will we start doing this? Immediately? After the first 24 or 48 hours?
• The plan must also include a long-term component – how will we continue to function in this capacity for months at a time?

Communication

• If we can get staff to work form home, how could we communicate with them?
• What type of web support can we get?
• Can we get a special telephone line for support?
• Can get fact sheets from the CDC
• Work with Marketing to deal with the media

Want Check Lists

• Information needs to be quick and easy to read, such as a check list
• Need check lists for:

-Trigger points

-Security measures

-Immunization plan

• For The Nebraska Medical Center, our immunization plan must include plans to immunize

-Staff

-Family

-Students