pandemic preparedness: surfing the next wave · 2020. 6. 18. · •gregory h. botz, md, fccm, is a...
TRANSCRIPT
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1 © 2020 TMIT Global TMIT Global
June 18, 2020 CareUniversity Webinar #140
For resource downloads go to:
www.MedTacGlobal.org
Pandemic Preparedness:
Surfing the Next Wave
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2 © 2020 TMIT Global TMIT Global
Charles Denham, MD Chairman, TMIT Global
Founder Med Tac Bystander Rescue Care
Med Tac Bystander Rescue Care June 18, 2020 CareUniversity Webinar #140
Welcome
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3 © 2020 TMIT Global TMIT Global
To optimize webinar sound volume, please check:
• WebEx volume
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4 © 2020 TMIT Global TMIT Global
If you are still having difficulty hearing the webinar:
Please click on Participants
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5 © 2020 TMIT Global TMIT Global
Our Purpose Statement
Our Purpose:
We will measure our success by how we protect and enrich the lives of families…patients AND caregivers.
Our Mission:
To accelerate performance solutions that save lives, save money, and create value in the communities we serve and ventures we undertake.
CAREUNIVERSITY ®
EMERGING THREATS
COMMUNITY OF PRACTICE
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6 © 2020 TMIT Global TMIT Global
Speakers
& Reactors
Dr. Charles Denham
Marian E. Von-Maszewski Dr. Gregory Botz
Jennifer Dingman
Heather Foster RN
Chief William Adcox
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7 © 2020 TMIT Global TMIT Global
Disclosure Statement The following panelists certify that unless otherwise noted below, each presenter provided full disclosure information; does not intend to
discuss an unapproved/investigative use of a commercial product/device; and has no significant financial relationship(s) to disclose. If
unapproved uses of products are discussed, presenters are expected to disclose this to participants. None of the participants have any
relationship medication or device companies discussed in their presentations.
• Marian E. Von-Maszewski, MD, is Emergency Readiness Officer and Assistant Professor, Department of Critical Care, Division of Anesthesiology and Critical
Care, at The University of Texas MD Anderson Cancer Center, in Houston, TX. She has nothing to disclose.
• Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center. He received his medical degree from George
Washington University School of Medicine in Washington, DC. He completed an internship in internal medicine at Huntington Memorial Hospital and then completed
a residency in anesthesiology and a fellowship in critical care medicine at Stanford University in California. He also completed a medical simulation fellowship at
Stanford with Dr. David Gaba and the Laboratory for Human Performance in Healthcare. Dr. Botz is board-certified in anesthesiology and critical care medicine. He
is a Fellow of the American College of Critical Care Medicine. He has nothing to disclose.
• Jennifer Dingman has nothing to disclose.
• Heather Foster has nothing to disclose.
• Chief Adcox has nothing to disclose.
• Charles Denham, MD, is the Chairman of TMIT; a former TMIT education grantee of CareFusion and AORN with co-production by Discovery Channel for Chasing
Zero documentary and Toolbox including models; and an education grantee of GE with co-production by Discovery Channel for Surfing the Healthcare Tsunami
documentary and Toolbox, including models. HCC is a former contractor for GE and CareFusion, and a former contractor with Siemens and Nanosonics, which
produces a sterilization device, Trophon. HCC is a former contractor with Senior Care Centers. HCC is a former contractor for ByoPlanet, a producer of sanitation
devices for multiple industries. He does not currently work with any pharmaceutical or device company. His current area of research is in threat management to
institutions including conflict of interest, healthcare fraud, and continuing professional education and consumer education including bystander care. Dr. Denham is
a collaborator with Professor Christensen at Harvard Business School.
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8 © 2020 TMIT Global TMIT Global
Jennifer Dingman Founder, Persons United Limiting
Substandards and Errors in Healthcare
(PULSE), Colorado Division
Co-founder, PULSE American Division
TMIT Patient Advocate Team Member
Pueblo, CO
Voice of the Patient
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9 © 2020 TMIT Global TMIT Global
Charles Denham, MD Chairman, TMIT Global
Founder Med Tac Bystander Rescue Care
Med Tac Bystander Rescue Care June 18, 2020 CareUniversity Webinar #140
In the News
May 2020 Survey Results
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© 2006 HCC, Inc. CD000000-0000XX 10 © 2020 TMIT
In The News …
10
Patient Safety and COI Stories Being Followed
Nearly 200 investigations are underway at major academic
centers. Critics fear that researchers of Chinese descent are
being unfairly targeted.
The N.I.H. and the F.B.I. have begun a vast effort to root out
scientists who they say are stealing biomedical research for
other countries from institutions across the United States.
Almost all of the incidents they uncovered and that are under
investigation involve scientists of Chinese descent, including
naturalized American citizens, allegedly stealing for China.
Seventy-one institutions, including many of the most prestigious
medical schools in the United States, are now investigating 180
individual cases involving potential theft of intellectual property.
The cases began after the N.I.H., prompted by information
provided by the F.B.I., sent 18,000 letters last year urging
administrators who oversee government grants to be vigilant.
Vast Dragnet Targets Theft
of Biomedical Secrets for China 11-09-19
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© 2006 HCC, Inc. CD000000-0000XX 11 © 2020 TMIT
In The News …
August 20, 2018
Unfortunately, threats to the integrity of U.S. biomedical research exist. NIH is aware that some
foreign entities have mounted systematic programs to influence NIH researchers and peer
reviewers and to take advantage of the long tradition of trust, fairness, and excellence of NIH
supported research activities. This kind of inappropriate influence is not limited to biomedical
research; it has been a significant issue for defense and energy research for some time. Three
areas of concern have emerged:
1. Diversion of intellectual property (IP) in grant applications or produced by NIH supported
biomedical research to other entities, including other countries;
2. Sharing of confidential information on grant applications by NIH peer reviewers with others,
including foreign entities, or otherwise attempting to influence funding decisions; and
3. Failure by some researchers working at NIH-funded institutions in the U.S.
to disclose substantial resources from other organizations, including foreign
governments, which threatens to distort decisions about the appropriate use of NIH funds.
“We recently reminded the community that applicants and awardees must disclose all forms of
other support and financial interests, including support coming from foreign governments or-
other foreign entities.”
“We also expect and encourage your institution to notify us immediately upon identifying new
information that affects your institution's applications or awards. Lastly, we encourage you to
reach out to an FBI field office to schedule a briefing on this matter.”
DEPARTMENT OF HEALTH
& HUMAN SERVICES
Public Health Service
National Institutes of Health
Bethesda, Maryland 20892
LETTER TO THOSE ORGANIZATIONS RECEIVING FEDERAL GRANTS
11
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© 2006 HCC, Inc. CD000000-0000XX 12 © 2020 TMIT
In The News …
12
Patient Safety and COI Stories Being Followed
Tampa Bay Times Reports:
• Deaths of children in 1 in 10
undergoing CV Surgery at
JH All Children's
• Mutilation of children in
burn unit in Maryland
• Cover up of harm
• Retaliation against
whistleblower MD
• Patient Safety Issues in all
Johns Hopkins hospitals
• Whistle blower law suit
• Multiple malpractice suits.
• Regulatory problems
• Oversight letting team of
doctors make unannounced
visits
NYT & Propublica Reports:
• Conflicts and large payments
to Chief Med Officer – resigns
• CEO with conflicts, vote of
non-confidence – resigns
• Board Members own equity in
start up with special deals.
• Revision of conflict of interest
policies.
• Top executives barred from
serving on corporate boards
or investing in start-ups
Propublica &
Houston Chronicle Reports:
• Cardiac Complications
• Undeclared financial conflicts
of interest
• Allegations of exaggerated
quality program to lure
patients.
• Transplant program shut
down based on reporting.
• Leadership restructuring
• State and federal officials
enforcing safety standards.
• 08-08-19 Feds Cease Greater
Oversight Of Baylor St. Luke’s
Medical Center Initiated After
Patient Death
New York Times &
Washington Post Reports:
• Falsification of research in
cardiac stem care.
• Scientific misconduct
• 31 Articles Retracted
• Many patients treated
• Unknown impact of product
used in patients treated.
• Hospital paid to settle
allegations.
• Hospital pays $10M to settle
Tennessean & Beckers Hospital
Review Reports:
• Nurse medication error during
imaging with patient death
• Electronic medication
dispensing cabinet
safeguards overridden.
• Nurse indicted for reckless
homicide for fatal error.
• State Health Officials decided
no reason to discipline or take
action against nurses license.
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© 2006 HCC, Inc. CD000000-0000XX 13 © 2020 TMIT
In The News …
13
Medscape Reports:
• Duke Settles Doctored Data
Lawsuit for $112.5 Million
• Duke Whistleblower Gets
More Than $33 Million In
Research Fraud Settlement
• William Foster, who ran the
lab where the data were faked,
studied the effects of
pollutants on the lungs of
mouse models.
• Thomas alleged that Duke had
won some 50 grants from the
NIH
The Washington Post Reports:
• Baltimore Mayor Pugh involved in
self-dealing book scandal for
hundreds of thousands of dollars.
• UMMS Board Chairman announced
the board's unanimous decision
March 21 to have CEO Robert
Chrencik take a leave of absence.
• Resignations of three UMMS,
including Baltimore Mayor Pugh.
• Hours before Mr. Burch notified the
public of Mr. Chrencik's leave of
absence, the Maryland House of
Delegates unanimously fast-tracked
bill to overhaul UMMS' 27-member
board of directors.
• Kaiser Permanente paid Pugh more
than $100,000 for 20,000 copies of her
books during a period when the
company was seeking a lucrative
contract to provide health benefits to
city employees.
Medscape Reports:
• Between 2011 and 2019
William Roper, failed to
disclose his seats on the
boards of major corporations.
• At the same time, those
corporations did business
with the state, records show.
• Roper has served on the
board of directors of DaVita,
Inc.
• Roper also a member of the
board of directors of three
successor companies in the
pharmacy benefits
administration industry.
• None of his corporate board
service was disclosed on
state ethics forms.
Tampa Bay Times Reports:
• Johns Hopkins All Children’s
faces record state fines.
• The planned $800,000 penalty is
the latest fallout from problems
in the hospital’s heart surgery
department.
• State regulators intend to hit
Johns Hopkins All Children’s
Hospital with some of the largest
fines levied against a Florida
hospital in recent memory,.
• The Times found that surgeons
in the hospital’s Heart Institute
made serious mistakes and their
procedures went wrong in
unusual ways. It also found that
the hospital continued to
perform heart surgeries for
years after frontline workers
raised safety concerns to their
supervisions.
New York Times Reports:
• Director of M.I.T.’s Media Lab
Resigns After Taking Money
From Jeffrey Epstein.
• M.I.T. official, Joichi Ito, left
the boards the MacArthur
Foundation, the John S. and
James L. Knight Foundation,
and The New York Times.
• He “stepped down after the
disclosure of his efforts to
conceal his financial
connections to Mr. Epstein,
the disgraced financier who
killed himself in a Manhattan
jail cell last month while facing
federal sex trafficking
charges”. acknowledged last
week that he had received $1.7
million from Mr. Epstein,
including $1.2 million for his
own outside investment funds.
Patient Safety and COI Stories Being Followed
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© 2006 HCC, Inc. CD000000-0000XX 14 © 2020 TMIT
In The News …
14
Patient Safety and COI Stories Being Followed
Beth Israel COI & Theft:
• Chinese cancer researcher,
confessed that he had
planned to take the stolen
samples to Sun Yat-sen
Memorial Hospital, and
publish the results under his
own name.
• Customs officers officers
found what they were looking
for: 21 vials of brown liquid —
cancer cells.
• The researcher admitted he
had taken the samples to
publish the work under his
own name.
June 12, 2020
Fifty-four Scientists Have Lost Their Jobs As
A Result Of NIH Probe Into Foreign Ties By Jeffrey Mervis
Some 54 scientists have resigned or been fired as a result of an ongoing
investigation by the National Institutes of Health into the failure of NIH grantees
to disclose financial ties to foreign governments. In 93% of those cases, the
hidden funding came from a Chinese institution. There are 399 scientists
“of possible concern” to NIH, and the FBI has fingered 30% (121) of them.
An additional 44 have been flagged by their own institutions. Of that pool,
investigations into 63%, or 256 scientists, came out “positive.”
Harvard Chemistry Dept:
• Jan 29, 2020 Harvard
University professor arrested
and charged with lying to U.S.
authorities about taking
millions of dollars from the
Chinese government is
considered one of the fathers
of a specialized field in
nanotechnology.
• Charles M. Lieber has led a
research lab at Harvard for
nearly 30 years and generated
in excess of $15 million in
grants from government
agencies since 2008.
Source: https://www.sciencemag.org/news/2020/06/fifty-four-scientists-have-lost-their-jobs-result-nih-probe-foreign-ties
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15 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! In the News
As Cities Move Toward Reopening,
How to Manage Risks
Consider how vulnerable you and your loved
ones are and weigh these factors Dr. Darria Long and Dr. Davld L. Katz
Source: https://medium.com/@drdarrialonganddrdavidkatz/as-cities-move-toward-reopening-how-to-manage-risks-1834a264f9d1
June 10, 2020
Along with securing the requisite data,
we propose two tactical priorities. The
first is infection risk stratification; the
second is exposure dose
management. Together, these can
inform the policies, programs, and
personal behaviors of Phase Two, even
with the limited data we now have.
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16 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! In the News
Source: https://medium.com/@drdarrialonganddrdavidkatz/as-cities-move-toward-reopening-how-to-manage-risks-1834a264f9d1
As Cities Move Toward Reopening, How to Manage Risks
Infection Risk
Stratification
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© 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue Care CareUniversity
Source: New Yorker Magazine May 13, 2020
Atul Gawande
Survive & Thrive Guide: Keeping Your Family Safe
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18 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! The 4 P’s to Address Emerging Threats
CAREUNIVERSITY ®
EMERGING THREATS
COMMUNITY OF PRACTICE
Global Patient
Safety Forum
SAFETYLEADERS ®
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19 © 2020 TMIT Global TMIT Global
Cardiac Arrest
Meaningful Use is dead. Long live something better! High Impact Care Hazards to Patients, Students, and Employees
Opioid Overdose
Common Accidents
Bullying
A Medical-Tactical Approach undertaken by
clinical and non-clinical people can have
enormous impact on los of life and harm
from very common hazards:
• High Impact Care Hazards are frequent,
severe, preventable, and measurable.
• Lifeline Behaviors undertaken by anyone
can save lives.
Choking & Drowning
Anaphylaxis
Major Trauma
Transportation Accidents
Med Tac
Story Article
Active Shooter
Healthcare Article
AED & Bleeding
Control Gear Article
Rapid Response
Teams Article
Battling Failure to Rescue
Automated External
Defibrillator
& Bleeding Control
Gear Placement
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20 © 2020 TMIT
Meaningful Use is dead. Long live something better! In the News: Med Tac Updates
Source: Campus Safety Nov/Dec Issue - https://www.campussafetymagazine.com/public/med-tac-training-bystanders/
Nov/Dec 2018 Issue
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21
21
www.MedTacGlobal.org
Bystander Rescue Care
for Failure to Rescue
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22
22
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Coronavirus Care
Community of Practice
Bystander Rescue Care
CareUniversity Series
23 © 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue Care CareUniversity
Ann Rhoades
Dr. Charles Denham Chief William Adcox Dr. Gregory Botz
Randy Styner Dr. Chris Fox Tom Renner David Beshk
Dennis Quaid John Nance JD Beth Ullem
John Little
Dr. Casey Clements
Dr. Steve Swensen Perry Bechtle III Fred Haise
Nancy Conrad
Dr. Mary Foley
Heather Foster
Dr. Chopra
Betsy Denham Becky Martins
Debbie Medina
Preston Head III
Charlie Denham III
Dr. McDowell
Tyler Sant Avarie Pettit Bob Chapman
Dr. C Peabody
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Coronavirus Care
Community of Practice
Bystander Rescue Care
CareUniversity Series
24 © 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue Care CareUniversity
Heather Foster RN Dr. Gregory H. Botz William Adcox, MBA
Coronavirus Survive & Thrive Guide
TM
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25 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! Essential Critical Infrastructure Workers
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26 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! Essential Critical Infrastructure Workers
40% of
Work
Force
No Family
Training
Provided
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27 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! Survive & Thrive Guide: Protecting Your Family
Survive & Thrive Guide: Preparing for Care at Home
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28 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! Survive & Thrive Guide: Protecting Your Family
Survive & Thrive Guides
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29 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! Survive & Thrive Guide: Keeping Your Family Safe
Understand
the Basics
The Basics
Form Family Team &
Health Security Plan
Care of Your
Loved Ones
Leadership Practices
• Why Checklists?
• Setting up Care Room
• Protecting Caregivers
• Protecting the Family
• Family Health Security Plan
• The Family CFO
• Engaging Family: Head,
Heart, Hands, & Voice
• Critical Concepts
• Prevention, Preparedness,
Protection, & Performance
Improvement – The 4 P’s
• How the Virus Spreads
Putting Supplies
& Gear to Work
Technologies
• Supplies & Gear
Checklist
• Seniors & At-Risk Care
Checklists to be Safe
• Innovating Solutions
Preparing for Care at Home
![Page 30: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/30.jpg)
30 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! Survive & Thrive Guide: Keeping Your Family Safe
Understand
the Basics
The Basics
Form Family Team &
Health Security Plan
Care of Your
Loved Ones
Leadership Practices
Putting Supplies
& Gear to Work
Technologies
Preparing for Care at Home
• Critical Concepts
• Prevention, Preparedness,
Protection, & Performance
Improvement – The 4 P’s
• How the Virus Spreads
![Page 31: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/31.jpg)
31 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! Survive & Thrive Guide: Keeping Your Family Safe
Understand
the Basics
The Basics
Care of Your
Loved Ones
Leadership Practices
Putting Supplies
& Gear to Work
Technologies
Preparing for Care at Home
• Family Health Security Plan
• The Family CFO
• Engaging Family: Head, Heart,
Hands, & Voice
Form Family Team &
Health Security Plan
![Page 32: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/32.jpg)
32 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! Survive & Thrive Guide: Keeping Your Family Safe
Understand
the Basics
The Basics
Care of Your
Loved Ones
Leadership Practices
Putting Supplies
& Gear to Work
Technologies
Preparing for Care at Home
Form Family Team &
Health Security Plan
• Why Checklists?
• Setting up Care Room
• Protecting Caregivers
• Protecting the Family
![Page 33: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/33.jpg)
33 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! Survive & Thrive Guide: Keeping Your Family Safe
Understand
the Basics
The Basics
Care of Your
Loved Ones
Leadership Practices
Putting Supplies
& Gear to Work
Technologies
Preparing for Care at Home
Form Family Team &
Health Security Plan
Putting Supplies
& Gear to Work
• Supplies & Gear Checklist
• Seniors & At-Risk Care Checklists to
be Safe
• Innovating Solutions
![Page 34: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/34.jpg)
Coronavirus Care
Community of Practice
Bystander Rescue Care
CareUniversity Series
Convene
Connect
Celebrate
Create
Change the World
CAUSE
Family Centric
• General Public
• Critical Essential Workers
• Professional Caregivers
• First Responders
• All Faiths Volunteers & Staff
• Educators & School Staff
• Scouts, Teams, and
Membership Organizations
![Page 35: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/35.jpg)
© 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue Care CareUniversity
SOURCE: Centers for Disease Control
Social
Distancing
Hand
Washing
Disinfecting
Surfaces
Use of
Masks
CDC Guidelines
Survive & Thrive Guide: Protecting Your Family
![Page 36: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/36.jpg)
© 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue Care CareUniversity
Survive & Thrive Guide: Protecting Your Family
Quarantine Isolation
Isolation & Quarantine
Testing, Tracing, and Treatment
![Page 37: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/37.jpg)
37 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! Survive & Thrive Guide: Keeping Your Family Safe
Coronavirus Care Community of Practice
Med Tac Bystander Rescue Care: CareUniversity Series
Family Survive & Thrive Guide: The Latest Best Practices
When: Thursday, July 2, 2020
Time:
(check your time zone)
01:00 PM to 2:30 PM Eastern
12:00 PM to 1:30 PM Central
11:00 AM to 12:30 PM Mountain
10:00 AM to 11:30 AM Pacific
Where:
This is an online event.
Register Now!
I can't make it
Dear Charles "Chuck",
We are launching a monthly webinar specifically for families
from the general public and critical infrastructure worker families from 16 industry sectors. They include medical and security
volunteers for faith-based organizations and community
membership organizations such as scouts. In this first webinar
we are addressing the latest science for practicing social
distance, hand hygiene, high contact surfaces, and use of
masks.
You will hear from emergency medicine, critical care, security
leaders, and infectious disease experts from leading medical
centers. We will present video and resources provided on the web that may be used to help care for COVID-19 patients. Our
speakers will be supported by a reactor panel of leading
experts.
This emergency response initiative is part of the Global Med
Tac Bystander Rescue Care program for the public.
SPEAKERS:
Charles R. Denham, MD
Founder Med Tac Bystander Rescue Care
Chairman, TMIT Global
Gregory Botz, MD
Professor of Anesthesiology and Critical Care
UT - MD Anderson Cancer Center
Adjunct Clinical Associate Professor,
Stanford Medical School
Heather Foster RN
Hospital Infection Preventionist
You will be invited.
Spread the word
and invite all
Families and
Colleagues.
![Page 38: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/38.jpg)
38 Med Tac Bystander Rescue Care
May 21, 2020 CareUniversity Webinar #139
For resource downloads go to:
www.MedTacGlobal.org
Coronavirus Survive & Thrive Guide
for Caregiver & Critical Worker Families
![Page 39: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/39.jpg)
39 © 2019 TMIT
97% May 2020
*Source: TMIT High Performer Webinars, Post-Event Surveys
94%
Ave.
*NPSBenchmarks. 2020 NPS® Benchmarks Survey Report, Part 1. US Data. Available at: https://www.npsbenchmarks.com
70%
60%
50%
96%
75% USAA
Banking
61%
89%
59%
100% 100%
94% 98%
100%
87%
94%
88% 89%
96% 92%
100%
97% 94%
100%
94% 93% 95% 95% 97% 96%
97%
88%
97%
80%
*TMIT average score calculation is based on
NPS scores for June 2018 through May 2020.
Sept Nov Jan Feb Mar Apr May June July Aug Sept Oct Nov Jan Feb Mar May June Aug Apr July Oct Dec Dec
2018 2019
90%
2020
![Page 40: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/40.jpg)
40 © 2019 TMIT
71%
16% 12%
2% 0% 0% 0% 0% 0% 0%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
Very
Strongly
Agree
10
Strongly
Agree
9
Agree
8
Agree
7
Very
Strongly
Disagree
1
Disagree
3
Strongly
Disagree
2
Neutral
6
Neutral
5
Negative to
Neutral
4
100% Agreed and 86%
Strongly or Very Strongly
Agreed, and 71% Very
Strongly Agreed
Anonymous Survey Questions
Source: TMIT High Performer Webinar Series; Coronavirus Survive & Thrive Guide for Caregiver & Critical Worker Families – May 21, 2020
I would like to attend the
CORONAVIRUS CARE & SAFETY Webinar Series
![Page 41: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/41.jpg)
41 © 2019 TMIT
• Any flexible topic
• Availability of ppe for home and how to get it
• Back to work, safety for families,
• Best immune system prophylaxis to fight it off best
• Caring for second wave, return to schools
• Covid in the future
• Emotional and mental health support for both the affected individual and
caregivers
• Getting the people to understand how bad this virus is
• How do we isolate an individual when there is no space to really isolate
them?
• How do we share this with the communtiy
• How scouts bsa troops can help.
• Intensive care treatment alternative protocols - how to pivot safely with
drug shortages
• Lessons learned, "re-opening" plans and precautions imperative to the
prevention of a "second wave"
• Mental health and resiliency
• Ppe for certain situations, testing of patients for elective procedures
• Preparing for the next wave (individuals and families); caring for family
members who are sick while keeping yourself and other family members
safe
• Preventing transmission
• Safety, prevention and treatment
• School recommendations
• Special populations that have to travel for treatment.
• You have covered most topics i was looking at
• Your content seems great. Best source for the real straight info.
The topics I wish to have covered in the
CORONAVIRUS CARE & SAFETY Webinar Series
Source: TMIT High Performer Webinar Series; Coronavirus Survive & Thrive Guide for Caregiver & Critical Worker Families – May 21, 2020
![Page 42: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/42.jpg)
42 © 2019 TMIT
65%
6% 3%
12%
6% 3%
0% 3% 3%
0%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
Very
Strongly
Agree
10
Strongly
Agree
9
Agree
8
Agree
7
Very
Strongly
Disagree
1
Disagree
3
Strongly
Disagree
2
Neutral
6
Neutral
5
Negative to
Neutral
4
85% Agreed and 71%
Strongly or Very Strongly
Agreed, and 65% Very
Strongly Agreed
Anonymous Survey Questions
Source: TMIT High Performer Webinar Series; Coronavirus Survive & Thrive Guide for Caregiver & Critical Worker Families – May 21, 2020
I would like to invite individuals or groups to
CORONAVIRUS CARE and SAFETY Series
![Page 43: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/43.jpg)
43 © 2019 TMIT
76%
12% 8%
4% 0% 0% 0% 0% 0% 0%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
Very
Strongly
Agree
10
Strongly
Agree
9
Agree
8
Agree
7
Very
Strongly
Disagree
1
Disagree
3
Strongly
Disagree
2
Neutral
6
Neutral
5
Negative to
Neutral
4
100% Agreed and 88%
Strongly or Very Strongly
Agreed, and 76% Very
Strongly Agreed
Anonymous Survey Questions
Source: TMIT High Performer Webinar Series; Coronavirus Survive & Thrive Guide for Caregiver & Critical Worker Families – May 21, 2020
I believe there is value in
Locally Led Coronavirus Safety Programs
![Page 44: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/44.jpg)
44 © 2020 TMIT Global TMIT Global
For resource downloads go to: www.MedTacGlobal.org
Marian E. Von-Maszewski, MD Emergency Readiness Officer
Assistant Professor, Department of Critical Care
Division of Anesthesiology and Critical Care
The University of Texas MD Anderson Cancer Center
Houston, TX
Coronavirus Survive & Thrive Guide
![Page 45: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/45.jpg)
June 18, 2020
Pandemic Preparedness: Surfing the Next Wave Maintaining Safe Patient Care during the Endemic Phase of COVID-19
![Page 46: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/46.jpg)
MD Anderson
Marian Von-Maszewski, MD
Emergency Readiness Officer
Office of the Chief Operating Officer
Associate Professor
Department of Critical Care
No financial disclosures
46
![Page 47: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/47.jpg)
47 Overview
• Preparations for the first wave
• Lessons learned
• Preparations for the “next wave”
• What to prioritize / how to prioritize readiness efforts
![Page 48: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/48.jpg)
48 Preparations for the first wave – Situational Awareness
https://coronavirus.jhu.edu/map.html
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49 Preparations for the First Wave
• Pandemic Plan
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50 Preparations for the First Wave - Supplies
• Pandemic Inventory
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51 Preparations for the First Wave - Supplies
• Pandemic Inventory
PPE
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52 Preparations for the First Wave - Supplies
• Pandemic Inventory
PPE PAPRs
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53 Preparations for the First Wave - Supplies
• Pandemic Inventory
PPE
Respiratory Supplies
PAPRs
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54 Preparations for the First Wave - Supplies
• Pandemic Inventory
PPE
Respiratory Supplies
Hand Sanitizer Pharmacy Laboratory Supplies
PAPRs
![Page 55: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/55.jpg)
55 Preparations for the First Wave - Facilities
• Airborne Infectious Isolation Rooms
• Hospital survey
• Identification of spaces beyond surge capacity
• Conversion of patient care spaces
• Ventilators
• Standard ICU ventilators
• Anesthesia machines
• Other machines
![Page 56: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/56.jpg)
56 Preparations for the First Wave - Staffing
• COVID Care teams
• PPE training
• Basic protocols
• Emergency response
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57 Preparations for the First Wave – Patient Care
• Screening based on CDC guidelines and State Department travel advisories initiated in late 1/2020
• Screening questions on arrival
• Algorithms for risk stratification management
• Signage regarding travel and symptoms
• Business travel restricted for employees
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58 Preparations for the First Wave - Leadership
• Security – UTP-H
• PPE, transport routes, limiting entry points
• Incident Command system
• Activated in late January for two weeks
• Transitioned to hospital leadership
• Texas Medical Center Collaborative
• SouthEast Texas Regional Advisory Council
![Page 59: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/59.jpg)
59 Lessons Learned – National
• Specific metropolitan areas were overwhelmed quickly
• Nursing homes were at high risk of rapid spread
• Supply shortages became moving targets
• Rush to publish
• Fear of medical facilities
• Medical workforce decreased due to school closures
• Information flows through social media
![Page 60: Pandemic Preparedness: Surfing the Next Wave · 2020. 6. 18. · •Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center](https://reader034.vdocuments.mx/reader034/viewer/2022051805/5ff9ebb0f9b43072e1059ad4/html5/thumbnails/60.jpg)
60 Lessons Learned – Regional / Local
• Standardized bed reporting developed
• Limited testing and long turn-around time led to decreased engagement
• Capacity Capability
• Other supplies limited, but not absent
• Changing PPE guidelines led to safety concerns among medical teams
• Decreased healthcare activity and revenue led to staff furloughs, decreased pay and lay-offs
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61 Lessons Learned – Institutional Patient Care
• Outpatients encouraged to include family caregivers in visits via electronic communication
• Inpatient rounding / communication processes changed to engage patient families & caregivers via electronic interactions
• Inpatients provided with means to maintain contact and educated in use of electronic devices
• COVID-diagnosed patients discharged with instructions for continued infection control practices – hand hygiene, use of masks, social distancing
• Dedicated ambulatory units established for continued care of patients with COVID diagnosis to avoid harm from delayed or cancelled appointments and procedures
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62 Lessons Learned – Institutional Staff
• Changing PPE guidelines led to concern and required face-to-face reassurance by leadership and Infection Control practitioners
• Care teams with potential exposure needed closer engagement with Employee Health
• Addressing providers’ families concerns for exposure
• Communications
• Institution intranet site with resources, policies and algorithms due to evolving guidelines
• Daily Coronavirus Briefing for ~600 institution leaders with updates on statistics, supplies, hospital status
• Administrative workforce moved to “work from home” to decrease footprint in the hospital thereby limiting potential exposure of patients
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63 Lessons Learned – Institutional Practices
• Daily Safety Briefing led by Patient Safety Officer includes review of COVID-related events
• Email account for COVID-related questions and concerns
• Core Leadership Team formed for daily evaluation of institution operations
• Guided reduction of operations and subsequent re-opening, screening guidelines, testing strategies
• Social gatherings in work areas halted
• Supply chain needed clinical input – contacted by multiple “vendors”
• Adoption of Protected Code Blue response based on AHA Interim Guidelines
• Avoid delays in response by using consistent practices for all
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64 Preparations for the Next Wave
• Encourage patients to continue mask use and social distancing
• Continue decreased footprint of administrative staff
• Maintain entry screening and hygiene practices
• Establish social distancing parameters in staff areas, waiting rooms and public areas
• Pandemic supply usage monitored and modeled to predict needs
• Initiation of PPE security practices
• ICU capacity models changed to reflect staffing capabilities
• Facilities Resilience to close down or divert operations as needed
• Scientific review of patient management to optimize therapy
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65 Prioritization of Readiness Efforts
• Maintain bi-directional regional reporting efforts
• Collaboration of hospital systems to optimize bed capacity
• Maintain / increase pandemic supply processes
• Develop consistent treatment algorithms
• Continue staff monitoring
• Develop tiered staffing models for ICU surge
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66 Prioritization of Readiness Efforts
• Maintain readiness plans
• Natural disasters
• Social unrest
• Information Technology failures
• Financial uncertainty
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67 Prioritization of Readiness Efforts
• Continue patient & family education
• Ongoing staff training
• Maintain pandemic stance
• Translate scientific data into best practice
• Attention to supply chain
• Sustain data-driven safety & quality initiatives
• Focus on caregiver well-being
• Assess resiliency regularly
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68 Conclusions
• Endemic phase operations
• Visitation
• Staffing challenges
• Evolving guidelines
• Routine medical care
• Medical education & training
• Have vigilance, not vertigo
• Utilize proven patient safety approach
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© 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue Care CareUniversity
Meaningful Use is dead. Long live something better! Survive & Thrive Guide: Keeping Your Family Safe
Response
Rescue
Recovery
Resilience
Readiness
Activate
Mobilize
Care Monitor
Family Health Safety Plan
© HCC Global
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70 © 2020 TMIT
National Survey Questions
My family is ready to take care of a loved
one with Coronavirus in our home
Very
Strongly
Agree
10
Strongly
Agree
9
Agree
8
Agree
7
Very
Strongly
Disagree
1
Disagree
3
Strongly
Disagree
2
Neutral
6
Neutral
5
Negative
to Neutral
4
What READINESS information
would you like to have?
70
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71 © 2020 TMIT
National Survey Questions
My family knows what actions to take if a loved
one becomes infected with Coronavirus.
Very
Strongly
Agree
10
Strongly
Agree
9
Agree
8
Agree
7
Very
Strongly
Disagree
1
Disagree
3
Strongly
Disagree
2
Neutral
6
Neutral
5
Negative
to Neutral
4
What information would help you RESPOND
when a loved one becomes infected?
71
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72 © 2020 TMIT
National Survey Questions
My family knows what do when someone
develops severe COVID-19 symptoms.
Very
Strongly
Agree
10
Strongly
Agree
9
Agree
8
Agree
7
Very
Strongly
Disagree
1
Disagree
3
Strongly
Disagree
2
Neutral
6
Neutral
5
Negative
to Neutral
4
What information would help your family
react if someone develops severe symptoms (Rescue)?
72
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73 © 2020 TMIT
National Survey Questions
My family has a safety plan to return to work and play
when the Coronavirus social restrictions are relaxed
Very
Strongly
Agree
10
Strongly
Agree
9
Agree
8
Agree
7
Very
Strongly
Disagree
1
Disagree
3
Strongly
Disagree
2
Neutral
6
Neutral
5
Negative
to Neutral
4
What information would help your
family return to the new normal (Recovery)?
73
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74 © 2020 TMIT
National Survey Questions
My family has a plan to make them less
vulnerable to epidemics in the future
Very
Strongly
Agree
10
Strongly
Agree
9
Agree
8
Agree
7
Very
Strongly
Disagree
1
Disagree
3
Strongly
Disagree
2
Neutral
6
Neutral
5
Negative
to Neutral
4
What information would help you
become more resilient in the future?
74
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75 © 2020 TMIT Global TMIT Global
Speakers
& Reactors
Dr. Charles Denham
Marian E. Von-Maszewski Dr. Gregory Botz
Jennifer Dingman
Heather Foster RN
Chief William Adcox
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76 © 2020 TMIT Global TMIT Global
Jennifer Dingman Founder, Persons United Limiting
Substandards and Errors in Healthcare
(PULSE), Colorado Division
Co-founder, PULSE American Division
TMIT Patient Advocate Team Member
Pueblo, CO
Voice of the Patient
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77 © 2020 TMIT Global TMIT Global
RESOURCES
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78 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better!
Flattening the Curve: Avoid the Surge
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www.GlobalPatientSafetyForum.org Emerging Threats Community of Practice
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Readiness for Epidemics including preparedness for testing and
volume surges
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81 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! Threat Safety Science: The Context of Emerging Threats
81
Emerging Threats
•Threat Velocity: The speed of new threats challenging us are appearing much faster
than ever before.
•Threat Spectrum: The range of different threats challenging us are increasing as well.
• Invisible and Visible Threats: Many of the threats are invisible to us until they are
upon us. The Coronavirus COVID-19 is an example of a threat that is invisible. Many
who are infected with the virus are asymptomatic AND contagious.
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82 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! The Security Leader’s Perspective
Major Medical Centers – What you might expect to encounter:
1. Limited access points
2. Exterior access screening for everyone
3. Lines and delays
4. Limiting patient visitors and access to only patients and person
involved in direct patient care of the support of direct patient care.
5. No visitors under 18 years of age
6. Reducing and cancelling of elective surgery
7. Off-site screening and testing for COVID19
8. Public areas limited with social distancing recommended
9. Limited food services within the hospitals for visitors
10. Limited or eliminated valet services
11. Crowding and delays
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83 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! The Security Leader’s Perspective
Hospital Challenges for Security
1. PPE, Sanitizing and cleaning supplies are now in greater demand
and harder to obtain. The value of these has gone up and now
must be protected in ways not previous done.
2. Reduced access point while controlling access into the hospitals
3. Limiting visitors
4. Utilization of PPE
5. Patient surges
6. Reduced staffing
7. Fear
8. Added responsibilities
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84 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! The Security Leader’s Perspective
Police and Security – Changes occurring:
1. Non-violent crimes and misdemeanors not being accepted by jails and Juvenile centers
2. Diversion programs for habitual trespassers, alcohol intoxication, etc. closing
3. Some reporting of problems with Emergency Commitments due to illness
4. Setting up alternatives to first responders' homes for quarantine
5. Establish “drive up” testing and prioritized first responders and health care workers
6. Enhanced Sanitizing of police buildings, prisoner holding areas and vehicles
7. Staffs supplied with additional disinfecting wipes and hand sanitizer
8. PE deployments and testing (Nationwide shortages) 9. Communication Centers asking screening questions of
callers to better inform responding personnel and establish social distancing.
10. Limiting police responses to non-life threatening or crimes in progress calls
11. Taking more Reports over the phone instead of a police officer response.
12. Performing “Doorway Triage” at the scene of all 911 calls and asking complaints to come outside on calls.
13. Modified and reduced staffing plans 14. Civilian employees working from home where
possible 15. Repurposing of police officers assigned to special
assignments 16. Require social distancing inside police facilities to
include modified roll calls 17. Recommending officers sanitize their duty belts
and equipment, changing out uniforms at work or immediately upon reaching home to avoid contact with family
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85 © 2020 TMIT Global TMIT Global
Meaningful Use is dead. Long live something better! The Security Leader’s Perspective
What we all can do:
1. Understand the virus and obtain information from credible sources only
2. Educate our children. Answer their questions. Understand their fear.
Establish new routines and expectations
3. Explain basic hygiene practices to our families and everyone’s responsibility
to practice good hygiene and help more frequently clean the most touched
surfaces
4. Support each other, their families and your community
5. Don’t try to over stock thus emptying out grocery stores