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