This document provides interim guidance for 9-1-1 Public Safety Answering Points (PSAPs), the EMS system and medical first-responders and will be updated as needed. The information contained in this document is intended to complement existing guidance for healthcare personnel, “Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection in a Healthcare Setting“.
From the abstract:
Nonclinical healthcare processes are sometimes created on an ad hoc basis and hence over time may grow unnecessarily complex and difficult to assess, teach, improve, or transfer. Intentionally designing processes are more likely to yield an efficient and effective process. Originally developed in industry, Design for Six Sigma (DFSS) is a method for planning new processes applicable to healthcare. Benefits from using DFSS include well-defined process steps and documentation that makes processes easier to teach, monitor, control, and transfer to other units. We describe the DFSS process and provide an example of its application to an employee influenza vaccination program at a New England hospital.
Pandemic influenza is a “crowding disease” – historically, it thrives in densely-populated areas such as those provided by correctional environments. The CDC recommends “closing places where groups of people gather,” but this is not possible for the majority of correctional facilities. To protect staff and inmates, consider adult social distancing: stagger shifts, use e-conferencing or teleconferencing when possible, and make every reasonable effort to keep sick staff members at home.
For the past week, the media has been filled with stories about the swine flu epidemic. During this time, it’s important that your staff know the facts about the swine flu so they can better care for their patients and prevent the possible spread of infection.
– Centers for Disease Control and Prevention
– Pandemic Flu
– World Health Organization
An influenza pandemic is projected to have a global impact requiring a sustained, largescale
response from the healthcare community to provide care to sick patients. Healthcare workers will be at very high risk of becoming infected when caring for patients with pandemic flu unless adequate health and safety measures are in place, in advance of the pandemic, that will protect them. There is no existing comprehensive federal OSHA standard with mandatory and enforceable provisions that require planning and preparation designed to protect healthcare workers from exposures to pandemic influenza. Nevertheless, it is essential that workplaces plan and prepare for safety and health issues before the flu arrives.
In an effort to assess the extent of employer efforts in planning adequate safety and health measures for healthcare workers, a group of unions developed a “pandemic flu preparedness survey” to assess the level of preparedness on a facility basis. The survey was distributed to union leaders across the country who represent healthcare workers in unionized facilities. One hundred four (104) facility surveys were collected by six unions in fourteen states.
Three years ago, Congress appropriated billions of dollars to HHS for the agency’s pandemic influenza plan after animal outbreaks of the extremely pathogenic avian flu virus were discovered in a dozen countries throughout the world. Today, even though scientists say the threat of a pandemic is still very real, the nation’s interest in the issue has subsided, and HHS says it does not have the requested resources to fully implement the plan it proposed.
And that leaves the nation’s hospitals–already operating under tight budgets–not only with less funding, but also with the decision whether to expend resources preparing for a catastrophic event that might not occur for years.
GAO has conducted a body of work over the past several years to help the nation better prepare for, respond to, and recover from a possible influenza pandemic, which could result from a novel strain of influenza virus for which there is little resistance and which therefore is highly transmissible among humans. GAO’s work has pointed out that while the previous administration had taken a number of actions to plan for a pandemic, including developing a national strategy and implementation plan, much more needs to be done. However, national priorities are shifting as a pandemic has yet to occur, and other national issues have become more immediate and pressing. Nevertheless, an influenza pandemic remains a real threat to our nation and the world.
For this report, GAO synthesized the results of 11 reports and two testimonies issued over the past 3 years using six key thematic areas: (1) leadership, authority, and coordination; (2) detecting threats and managing risks; (3) planning, training, and exercising; (4) capacity to respond and recover; (5) information sharing and communication; and (6) performance and accountability. GAO also updated the status of recommendations in these reports.
From the press release:
A new NGA Center Issue Brief highlights strategies to safeguard the state workforce during a pandemic outbreak, such as avian influenza. A pandemic has the potential to keep up to 30 percent of a workforce home due to illness, school closings and caring for relatives. States are developing strategies such as telecommuting, extended leave and benefits and cross-training employees for essential tasks to mitigate a pandemic illness outbreak.
Pandemic influenza could produce a public health emergency that is more daunting than any other type of naturally occurring, accidental, or terrorist-instigated event that our nation has experienced or is likely to experience. First, an influenza pandemic could affect essentially every community in the nation almost simultaneously – i.e., within the space of a few weeks – and, if comparable to or more severe than the influenza pandemic of 1918, could result in 25 percent or more of the population ultimately experiencing life-threatening illness and/or being forced to dispense with normal activities to care for victims. Second, response activities within each affected community not only will need to be sustained for several months, generally with little or no outside help, but also might be degraded due to substantial influenza-induced absenteeism across the participating entities – public and private. Third, coping with degraded functioning in virtually every aspect of society could be so demanding as to preclude the initiation of significant recovery activities for many months.
Source: U.S. Department of Health & Human Services, January 15, 2009
From the press release:
U.S. states and territories have made progress toward planning for an influenza pandemic, but major gaps remain, according to a federal assessment released today.
The HHS science advisor to the secretary led 12 federal departments and two White House offices in developing reviewing state and territory operating plans, called for by the National Strategy for Pandemic Influenza: Implementation Plan.
State operating plans scored best in protecting citizens. The plans showed no or few major gaps in addressing mass vaccination operations during each phase of pandemic, ensuring surveillance and laboratory capability during each phase of a pandemic, in acquiring and distributing medical countermeasures and in ensuring communication capability.
All state plans did not address or showed major gaps sustaining operations of state agencies, and supporting and protecting state government workers so that the state government could continue to function during an influenza pandemic.
The report noted that continuity of operations for all state agencies merits significant attention if substantial socio-economic disruptions are to be avoided during an influenza pandemic. Even the best plans can fail if managers cannot accommodate the significant absenteeism and disruptions in supporting services and supplies that an influenza pandemic is almost certain to produce.