Point of Dispensing (POD) Course Who are you? Name Organization - - PowerPoint PPT Presentation

Point of Dispensing (POD) Course

Who are you?

Name Organization Position What role would you fill at the POD in an emergency response

The Strategic National Stockpile: An Overview

Purpose

Provide an understanding of the operational characteristics and capabilities of the Strategic National Stockpile (SNS)

Learning Objectives

When this training is completed, participants will be able to: Describe the mission of the SNS Describe the role of a Point of Dispensing (POD) during a public health emergency Describe when, where, how a POD is activated

SNS Mission

Deliver critical medical assets to the site of a disaster or emergency

SNS: What is it?

The Strategic National Stockpile (SNS) is a repository of antibiotics, chemical antidotes, antitoxins, vaccines, antiviral drugs and other life-saving medical materiel.

The Division of SNS

The Division of Strategic National Stockpile (DSNS) is a group of professionals at the Centers for Disease Control and Prevention (CDC) that manage the SNS and assist state and local governments. DSNS ensures the availability and rapid deployment of the SNS, provides training and technical assistance, and advises on the appropriate composition of SNS medical materiel.

Response History

Fast, Flexible & Committed

In all, DSNS has responded to 20 public health emergencies, to include:

• 2005 Hurricanes Katrina & Rita –

Numerous shipments to numerous states

• 2009 Red River Floods - Fully

functional FMS in 8 hours

• August and September 2008–

Eight FMS with pharmacy modules were shipped to Louisiana, Texas, Mississippi and Kentucky along with 12 FMS strike team members in support of Hurricanes Gustav and Ike.

• 2009 H1N1– 12 million antiviral

regimens and 85 million masks In 2012 DSNS deployed seven federal medical stations (FMS) with pharmacy modules and 15 FMS strike team members as part of federal response efforts for areas affected by Hurricane Sandy.

Besides public health emergencies, when else might SNS be used?

SNS Supplied Countermeasures

Based on Category A Threat Agents

Smallpox Anthrax Botulism Viral Hemorrhagic Fevers

And Other threats

Nerve Agents, Pandemic Influenza, Radiological, Etc. Plague Tularemia

Changes directed by the Public Health Emergency Medical Countermeasure Enterprise, a multi-agency group.

SNSSuppliedCountermeasures

Pharmaceuticals

Radiation Countermeasures Antibiotics (Oral and IV) Nerve Agent Antidotes Vaccines and Antitoxins Antivirals

Medical Supplies

IV Administration Airway Management Wound Care Burn & Blast Care

• Federal Medical Stations (FMS)

SNS: Where is the SNS?

Located in sites around the United States Sites selected because they offer an excellent combination of adequate storage and accessibility to air and ground transportation Stored in temperature and moisture controlled facilities. Materiel is rotated and kept fresh to maintain potency, using good manufacturing practices and the FDA/DOD’s Shelf Life Extension Program (SLEP)

SNS Response: The Three Pillars of Support

Rapid delivery of a broad spectrum for an ill-defined threat Large shipments of specific items when a threat is known Technical assistance and advice

12-hour Push Packages

12-hour Push Packages are caches of oral and intravenous drugs to give post-exposure prophylaxis and therapeutic treatment to persons exposed - or potentially exposed - to an unknown threat agent Designed for rapid delivery (within 12 hours

• f a federal decision) of a broad spectrum of

assets (pharmaceuticals, antidotes and medical supplies) CDC may deploy personnel to assist with handling Each package:

130 containers (max) weighing over 50 tons Fits in a wide-body cargo aircraft 500,000 10-day antibiotic regimens

Specific Item Support

Majority of SNS assets Maintained by SNS or commercial partners Shipped on pallets

Federal Medical Stations | Managed Inventory | Vaccines | Buying Power/Surge Capability

Specific Item Support

Maintain specific vaccines

Smallpox Anthrax Botulinum anti-toxin

Coordinate delivery of additional vaccines

Federal Medical Stations | Managed Inventory | Vaccines | Buying Power/Surge Capability

Specific Item Support

Federal Medical Stations | Managed Inventory | Vaccines | Buying Power | Surge Capability

Wider variety of: Items Vendors Transportation sources Possibly longer response time Order tracking more complex Subject to market availability

Specific Item Support

Used as: Needs an existing facility

Medical special needs shelters

Low- to mid-acuity of care

Quarantine function Alternate care facility

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Federal Medical Stations | Managed Inventory | Vaccines | Buying Power/Surge Capability

Technical Assistance

During a Response Stockpile Services Advance Group (SSAG) on 90-minute recall Federal Medical Stations (FMS) Strike Teams on 8-hour recall, provides setup assistance RSS Task Force teams on 8-hour recall, provides operational assistance DSNS representative to the state health EOC

All self-sufficient

SNS REQUEST PROCESS

State Requests Federal Assistance Federal Officials Deploy SNS Assets SNS Augments Local & State Resources: Medical Countermeasure Distribution and Dispensing Operations Begin Need for Supplies Exceeds Local & State Resources Discussion with key officials

(HHS, DHS, CDC, State, etc)

1 2 3 4

Federal

Storage & Transport

State Local

PODs &

Treatment Centers

RSS Site

SNS Delivery Sequence

Questions?

For more information on the Strategic National Stockpile, please visit the following websites: https://www.cdc.gov/phpr/stockpile/index.htm https://nmhealth.org/about/erd/bhem/sns/

Managing a Point Of Dispensing (POD): POD Roles, Responsibilities and Site Set- Up

Objectives

By the end of this training, you will be able to describe: POD organizational structure and concepts Describe information relating to emergency

• perations plans and operational guides.

Describe POD client flow and set up.

We will learn:

Definition of POD POD Site Layout and Client Flow POD Roles and Responsibilities Just in Time Training

After the lesson you will be completing an activity where you will set up a POD

POD Definition

A Point Of Dispensing (POD) is: A temporary, usually pre-designated, facility set up by the New Mexico Department of Health As a response to disease outbreaks or bioterrorism attacks Designed to provide a large number of people with medications or vaccinations in a short period of time.

Planning

New Mexico Medical Countermeasures Operational Guide

Supplement to the New Mexico Medical Countermeasure (MCM) Plan General guide to POD operations https://nmhealth.org/about/erd/bhem/sns/

POD Site Plan

Site specific guide for POD Operations

Planning

New Mexico Strategic National Stockpile/Medical Countermeasures

Planning

New Mexico MCM Distribution and Dispensing Plan New Mexico Point of Dispensing Operations Guide

Planning

New Mexico Point of Dispensing (POD) Operations Guide

Planning

POD Site Plan: Site specific guide for POD Operations POD plans are available at the following places: The local office of emergency management The Bureau of Health Emergency Management The Public Health Divisions Regional Headquarters The New Mexico Department of Homeland Security and Emergency Management

The POD Site Plan

Every POD has a site plan that contains: Facility contact information

Address and telephone numbers at the facility

Set-up procedure Inventory of equipment on site Parking, traffic and client flow diagrams Staffing, crowd control, traffic management and security plans

Planning: POD Site Plan

Planning: Critical Contacts

Planning: Floor Plan

Planning: Parking

Planning: Traffic Flow

Activation

A POD can be activated: In a public health emergency In a local disease outbreak In a seasonal event (flu shot clinics) Upon a local Emergency Manager (EM) request When approved by the New Mexico Department of Health

Sequence of Events

Notification

Local Public Health Official (PHO) typically the Public Health Director or the Public Health Division Director or their designee and Local Office of Emergency Management (OEM) Facility Contacted Designated POD Directors will be notified by public health

• fficials

POD Staff Partners (Law Enforcement, City/County)

Set-up Just-In-Time training Dispense medication to first responders and staff Begin operations

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POD Organization

Incident Command System

Unity of Command

Every position in the POD has only one supervisor Maintain unity of command

Span of Control

Manageable span of control (5-7 people)

What is a POD Director?

The person responsible for making sure POD functions are carried out Manages all POD staff Makes decisions about POD operations in consultation with the ROC (Regional Operations Center) Works with facility staff Ensures safety Designates the location of the command center, supply room, break room, entry and exit points

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Screening Treatment Greeting Support

POD Set Up

Pods are scalable to allow for the size of the venue or ease of throughput Increasing complexity could include, for example:

• A Triage area may be

added

• Additional screening

areas for forms review

Modular POD Walk-through

Just-In-Time Training (JITT)

A three-part training given to all staff introduces job tasks and job aids: 1) Operational Briefing (15 min) 2) Section breakout (20 min) 3) POD walk-through

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PODs are not for sick people. If the situation requires it, triage will occur prior to entering the POD. The Triage staff will ask questions and gather information from incoming clients.

Client Flow: Triage

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In most situations, clients who are experiencing acute illness or symptoms of the disease we are treating will be referred away from the POD and to a treatment facility for medical attention.

Client Flow: Triage

Client Flow: Triage

POD sites only serve healthy, unexposed persons. Persons who are sick or potentially exposed need to be referred to the closest medical care facility. Typically Triage is conducted outside of the POD

• entrance. It may be conducted in the parking lot prior

to people getting out of their vehicle. Not all POD activations require a Triage station to be set up. As part of the situation briefing you will be advised whether a Triage station is needed.

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The Greeter is at the entrance of the POD

Client Flow: The Front Door

Greeters

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The responsibility of the Greeter is to welcome the clients and initiate their process through the POD. Clients that have functional needs (special needs) may also be identified and may be provided assistance by Support staff.

Client Flow: The Front Door

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Every effort should be made to keep families together throughout the POD process.

Client Flow: Families

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Clients will be provided with any forms they need to complete in

• rder to receive vaccination or

medication. Clients will also receive information or education about the current threat and about the medication or vaccination that is being offered at the POD.

Client Flow: Greeting

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Clients will be provided with any forms they need to complete in

• rder to receive vaccination or

medication. Clients will also receive information or education about the current threat and about the medication or vaccination that is being offered at the POD.

Client Flow: Forms

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The intake paperwork given to the clients upon arrival at the POD needs to be reviewed for completeness, contraindications, and signatures prior to receiving their medication or vaccination. Form review can take place at a Screening, at a Forms Review Station, or at Treatment,

Client Flow: Forms Review

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• S

Clients that have functional needs may also be identified during the screening phase and may be provided assistance by Support staff.

Client Flow: Screening

Dispense Assist

• On-line, pre-POD Screening

system.

• Can be preformed prior to

POD or at the POD.

• Set-up at Screening Station or

separate kiosk

Client Flow: Screening

Screening and Intake Forms Paper vs Dispense Assist Discrepancies Refer to medical screening at the POD Refer to NMPDIC Refer to Health Care Provider

Client Flow: Screening

Client Flow: Screening

Client Flow: Screening

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The Treatment Station is where the client receives their vaccination/medication. Clients will also have received information sheets that provide information about the vaccine or medication they have just received. Information will be reviewed with the client at the treatment station.

Client Flow: Treatment

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During an emergency a standing order may be issued that approves non-medical personnel to dispense antibiotic or other pill form medication.

Client Flow: Treatment

When dispensing medication be sure to provide the clients with the drug information forms that accompany the medication.

The Support Station is where the client may receive exiting information. If there is an observation period required, the staff at this station oversee it. When available an EMS unit will be standing by for further treatment or transport. It is at this station that staff provide for special client needs.

Client Flow: Support

Set-up

Tables Chairs Signs Forms Pens Medicines Trash receptacles Bio-hazard receptacles

Set-Up

Introductions

Designate leaders

Brief set-up staff

Client Entry and exit points Location of table and chairs Facility configuration POD flow

Operational Briefing

Introductions Badges and ID Facilities/Parking Mission statement Command structure Safety Briefing

Personal Protective Equipment (PPE)

Designate Teams and Leaders Just-in-time Training Job aid sheets Staff Prophylaxis Walk-through Note: Staff prophylaxis and Walk through may

• ccur simultaneously

allowing the staff to be the walk through patients.

A POD

Open for Business

Dispense Assist

The Basics* Public Health Emergency Planners* Hospitals Closed PODs https://www.dispenseassist.net/Training.html

Questions