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PowerPoint Presentation - Office of Preparedness and Response - DHMH


									                                                                           Assessment of the 2007 Maryland Hospital Preparedness
                                                                                 Program: Applying New Federal Guidelines
                                                                           Sadia Aslam, MPH, Heather Brown, MPH, Marsha Davenport*, MD, Al Romanosky, MD, PhD,
                                                                                              Isaac Ajit, MD, MPH, Sherry B. Adams, RN, CPM
                                                                                                                                                                        Office of Preparedness and Response
                                                                                                                                                                  Maryland Department of Health and Mental Hygiene

This evaluation provided a baseline assessment of the 2007 Maryland Hospital Preparedness                                                                                                                      Table 2:
Program (HPP) under the new federal guidelines from the Office of the Assistant Secretary for                                                                                                              Level One Sub-
Preparedness and Response (ASPR).                                                                                                                                                                            Capabilities
                                                                                                                                                                                                                                                                                                               15% (No)                                           21% (No)
                                                                                                                                                                                                    1. Interoperable
                                         BACKGROUND                                                                                                                  Table 1:                                                                        Table 3:
                                                                                                                                                             Overarching Capabilities               2. Bed Availability
The Office of Preparedness and Response (OP&R) provides expert technical guidance ,                                                                                                                                                               Level Two Sub-
                                                                                                                                                            1.National Incident                     3. Emergency System for                        Capabilities
coordination, and leadership for Maryland’s Department of Health and Mental Hygiene (DHMH) on                                                               Management System                       Advance Registration of
preparedness programs. DHMH serves as the lead for the Emergency Support Function 8 Public                                                                                                          Volunteer Health                        1. Alternate Care sites
                                                                                                                                                            (NIMS) Compliance                                                                                                                                             85% (Yes)                                          79% (Yes)
Health and Medical to coordinate public health emergency response in the State of Maryland.                                                                                                         Professionals (ESAR-VHP)                2. Mobile Medical Assets
                                                                                                                                                            2. Education and
                                                                                                                                                            Preparedness Training                   4. Fatality Management
                                                                                                                                                                                                                                            3. Pharmaceutical Caches
Maryland is compromised of 24 jurisdictions divided into 23 counties and Baltimore City. The                                                                3. Exercises, Evaluation
                                                                                                                                                            and Corrective Actions                  5. Medical Evacuation and               4. Personal Protective
estimated population for the State is 5,618,344 people. There are 46 acute care hospitals and 16                                                                                                    Shelter in Place Planning               Equipment
                                                                                                                                                            4. Needs of At-Risk
state facilities participating in the Maryland Hospital Preparedness Program. Figure 1 shows the                                                                                                    6. Telecommunications
                                                                                                                                                            Populations                                                                     5. Decontamination                                         Figure 2: Capability to staff the                       Figure 3: Capability of acute
number of participating acute care hospitals serving each county in Maryland. The participating                                                                                                     Service Priority (TSP)
                                                                                                                                                                                                                                                                                                       positions for its Incident Command                      care hospitals to report bed
state facilities are located in Allegany, Baltimore, Baltimore City, Carroll, Montgomery, Washington                                                                                                Program
                                                                                                                                                                                                                                                                                                       System for acute care hospitals.                        availability within 1 hour.
and Wicomico counties.                                                                                                                                                                              7. Partnership/Coalition

The purpose of the HPP is develop emergency preparedness capacity and capability for the
healthcare system at both State and national levels. The Maryland HPP focuses on enhancing
                                                                                                                                                                                                                                                                                                                          ACHIVEMENTS and LESSONS LEARNED
                                                                                                                                                     Table 1,2 &3: Components of Overarching Capabilities, Level One Sub- Capabilities and Level Two Sub-                                     All of the acute care hospitals completed Phase 1 of the assessment tool. In addition, this
preparedness and response activities for acute care hospitals, State facilities, pre-hospital                                                        Capabilities
                                                                                                                                                                                                                                                                                              assessment shows the progress that hospitals have made under the new federal guidance for the
emergency medical services, community health centers, and long-term care facilities. Tables 1, 2 &3
                                                                                                                                                                                                           METHODS                                                                            Maryland’s HPP. The Maryland acute care hospitals participating in the HPP continue to enhance
list the HPP sub-capabilities for Overarching, Level and Level II . This evaluation provided a baseline
                                                                                                                                                                                                                                                                                              their emergency preparedness efforts. However, one of the lessons learned related to the design of
assessment of the 2007 Maryland HPP under new federal guidelines from ASPR.                                                                           Maryland developed an evaluation tool to monitor the progress of its acute care hospitals and State
                                                                                                                                                                                                                                                                                              the assessment tool. A major limitation of the assessment tool was that the questions were mostly
                                                                                                                                                      facilities funded under the ASPR HPP in 2007. The evaluation tool was administered in two phases.
                                                                                                                                                                                                                                                                                              “yes” or “no” categorical questions. Therefore , the data provided only limited information about the
                                                                                                                                                      Phase I was designed to assess compliance with the National Incident Management System (NIMS)
                                                                                                                                                                                                                                                                                              programs, Future assessment tools for the Maryland HPP should use a more detailed measure to
                                                                                                                                                      and was conducted in June 2008. Phase II was conducted in July 2008, and focused on factors such
                                                                                                                                                                                                                                                                                              evaluate the program.
                                                                                                                                                      as education and training, reporting bed availability, evacuation and fatality management planning,
                    1                                          4
                                                                                                                                                      access to alternate care sites, stockpiling medications, and other preparedness and medical surge
                                                   1                       2
                                                                                                                                                      capabilities. The evaluation tool was distributed to both acute care hospitals and state facilities via
                                          1                                                                                                                                                                                                                                                   All healthcare entities, especially acute care hospitals, are key partners during public health
                                                                                                                                                      email. Hospital emergency planners completed the survey and returned to OP&R via email. Basic
                                                                   11          1                                                                                                                                                                                                              emergencies. On-going monitoring of these programs is critical to identify gaps for quality
                                                       1                                                                                              summary statistics were calculated. The data for the acute care hospitals and state facilities were
                                               5                                                                                                                                                                                                                                              improvement and areas to target for expanding medical surge response capacity and capability. In
                                                                                                                                                      analyzed separately because these facilities have different roles and responsibilities in the healthcare
                                                                                                                                                                                                                                                                                              addition, this is assessment helped to target funding priorities of the current and future Maryland HPP
                                                                   2                                                                                  system. Only data from the acute care hospitals are presented in this poster.
                                                           6                       1
                                                       1               1                                                                              Forty-six acute care hospitals received the assessment tool. All 46 acute care hospitals completed
                                                                                   1       1
                                                                                                                                                      Phase I. The findings from this assessment showed that for NIMS compliance, 85% of acute care                                                                                     Acknowledgement
                                                                                                                                                      hospitals (as seen in Figure 2) reported having the capability to staff the positions for its Incident                                  •Office of the Assistant Secretary for Preparedness and Response/ Hospital Preparedness Program
                                                                                               1                                                                                                                                                                                              • Maryland Hospital Association
                                                                                                                                                      Command System. For Phase II, approximately 74% of acute care hospitals completed the
                                                                                                                                                                                                                                                                                              •Acute Care Hospitals and State Facilities in Maryland
                                                                                                                                                      assessment. A key goal for Maryland is to enhance medical surge capabilities. Figure 3 shows that                                       •Mark Bailey and Terri Andrews (OP&R) for working on HPP Project
                                                                                                                                                      79% of acute care hospitals can report their bed availability within 1 hour. Further, 82% of acute care
      Figure 1: Number of Hospital by Counties in Maryland
                                                                                                                                                      have designated alternate care sites.

                                                                                                   * CAPT Marsha Davenport completed this work as a CDC-CEFO assignee to the Maryland Department of Health and Mental Hygiene. CAPT Davenport is currently assigned to the U.S. Department of Homeland Security.

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