Download - Point of Dispensing: The Spectrum
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Point of Dispensing: The Spectrum
Leah Matteson MS, RN, CNS
New York State Department of Health Bioterrorism Epidemiology Program
518-486-2151
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Point of Distribution Standard Operating Guide
n CD n Compilation of Best Practices n Uniformity of PODs across the State n Counties and Healthcare Organizations n Placed on Commerce System-HIN-SNS n Ongoing Working Plan n Able to individualize specific components
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Point of Distribution Standard Operating Guide
n Guide n Attachment List and Descriptions of
Attachments n Template Version 1 and 2 n Attachment 19-Medication Information
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State POD
Purpose
1. Develop Capacity to Provide Prophylaxis to Critical Infrastructure Personnel
2. Provide support to LHDs and Healthcare Facilities
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Dispensing – The Most Critical Action
What is a POD?
n It is a place to dispense prophylactic (disease preventing) medications or vaccines to large numbers of people as rapidly as possible
n It is not a place for treating the ill!
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Goal of Dispensing Program
n Provide medication to X population in Y time
n Decrease the pool of individuals who may get ill n Provide Information
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Phases of a Dispensing Program
n Phase 1 n Notification and recall of critical infrastructure
n Phase 2 n Prophylaxis of critical infrastructure and families
n Phase 3 n Set up of POD network
n Phase 4 n Public Notification and Opening of PODs
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Issues to Consider When Designing Your Dispensing Campaign
n Time n Population n Staffing n 48-hour goal n Number of PODs and Uniformity of PODs n Treatment Center Coordination n Push and Pull Methods
The POD should be the foundation of your dispensing campaign.
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Determining the Number of PODs
TP ÷ (HPP-S) ÷ PPH = PODs n TP = total population requiring prophylaxis n HHP = the number of hours to provide
prophylaxis n S = the time required to set-up the clinic n PPH = persons per hour
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Assumptions with this Formula
n The PODs operate 24 hours a day n The population is equally distributed n The PODs perform at 100% capacity at all
times n A constant flow of people enter and leave n Staffing is constant, trained and adequate
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POD Site Selection
n Site selection n Walk-to accessibility by public n Under cover/out of weather n A/C and heat/AEDs n Adequate bathrooms, water, electricity n Ample parking n Served by mass transit n Geographically dispersed
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POD Site Selection - 2
n Hours of Operations n Opening of all sites
n Security n Ensure that POD workers are aware of security concerns n Controllable entrance and exit sites
n Based on n Epidemiology of event n Population distribution
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Pre-Event Policy Issues
n Adult pick-up for family members and information required for that
n Medication Receipt/Signature Authority/Prescribing Agent/Pediatric Care
n 24-hour phone number n Data Collection n Worried Well n Family Movement n Unaccompanied Minor
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Pre-Event Policy Issues - 2
n Hours of Operation n Prophylactic Regimen n Who can dispense? n Segmented vs. non-segmented n MOU/MOA n Critical Infrastructure n Medication Caches for First Responders
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Spectrum of Dispensing
n Cities Readiness Initiative (CRI)
n The goalposts have moved….. U.S. intelligence agencies assess that a large-scale aerosol release of anthrax is well within the technical capability of al-Qa’ida and other foreign or domestic terrorist organizations.
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Hours
Days
DELAY in Detection
Time is Critical
Shorter (1-2 Days)
Longer (4+ Days)
DURATION of Campaign
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POD Network Pull to Sites Push to Sites Mobile Dispensing Sites Drive Through Sites Postal Option
Spectrum of Dispensing
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People come to where the pills are
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Taking the pills to where the people are
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The “Weights” of Dispensing
Patient Education
Legal Requirements
Parking
Epidemiology Security
Patient Tracking
Clinical Accuracy
Mental Health
Staffing
Screening/ Triage
IND
Medical Records
Transportation
Quality Control
Inventory Storage
Hours of Operations
Registration
Labeling
Length of Regimen
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Balancing the Weights of Dispensing
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n Theory of Dispensing
D → W → P
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POD Components/Stations
n Command & Control ICS -Remain at Command Center
n Greet-Provide Forms-Provide Education n Triage-Fast Track - Green/Red
n move families together!
n Medical Evaluation n Dispensing/Pharmacy n Exit/Form Collection n Remember-Time and Efficiency!
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POD Components/Stations
Med
ical
Eva
luat
ion
Triage
Command andControl
Pharmacy
Dispensing
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Web Site References
n SNS Version 10 https://commerce.health.state.ny.us/hpn/hanweb/sns/sns.shtml
n BERM http://www.ahrq.gov/research/biomodel/index.asp
http://www.hospitalconnect.com/aha/key_issues/disaster_readiness/resources/vaccinationmodel.html
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Spectrum of Dispensing
QUESTIONS / COMMENTS