hospital preparedness program (hpp) & public health emergency preparedness (phep) grant...
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Hospital Preparedness Program (HPP) & Public Health Emergency Preparedness (PHEP)
Grant Alignment 10/2012 1Kansas Regional Preparedness Training
2012
Grant Alignment Requirement
• White House directed– Better alignment of emergency preparedness programs
• HPP and PHEP awardee requested– Reduce duplicative/conflicting activities and redundancies DHHS preparedness awards nearing $1 billion
annually• Funding sustainability requires demonstration of
how funding has:– Increased operational efficiencies– Improved preparedness integration across the federal government,
with partners and with the public– Improved national public health and medical preparedness
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HPP-PHEP Cooperative Agreement
• Capabilities-based approach• Building upon the strong preparedness
foundation already in place• Benefits
– More coordinated and integrated public health and healthcare service delivery system planning and response
– Improved ability to leverage funding for applicable activities and infrastructure
– Reduced burden regarding duplicative and conflicting activities and reporting
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• Aims to broaden the scope of the healthcare service delivery systems preparedness from individual facilities to diverse regional healthcare coalitions (HCC)
• Allows program to identify gaps in preparedness, determine specific priorities, and develop plans for building and sustaining specific capabilities
Shift from Building to Strengthening
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Healthcare Coalition (HCC)
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Health and Human Services
Definition of healthcare coalition (HCC):
A collaborative network of healthcare organizations and their respective public and private sector response partners that serve as
a multiagency coordinating group to assist with preparedness, response, recovery, and
mitigation activities related to healthcare organization disaster operations.
Healthcare Coalition (HCC)
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One individual agency/organization Two individual agencies/organizations Hospital-only regional group Public health-only regional group A deployable response team Made up primarily of individuals, but of organizations
• A Multi-agency coordination group that includes multiple healthcare organization members (HCOs) within the response community• A collective team that assists Emergency Management and Emergency Support Function (ESF) #8 partners• A collaborative effort to plan, organize, equip, train, exercise, evaluate and outline corrective actions
IS NOTIS NOTISIS
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• Conduct non-preparedness or non-response related activities or business• “Command” the actions of Coalition members or any other response entities it might interact with during an emergency• Use only one county-level Hazard Vulnerability Assessment (HVA) for substitution of the entire regional HVA
• Focus on the cycle of preparedness, response, recovery, and mitigation activities • Promote situational awareness for HCOs• Conduct regional healthcare coalition meetings• Engage partners in Hazard Vulnerability Assessment (HVA) discussions
DOES NOTDOES NOTDOESDOES
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• Have to own the electronic systems being shared or utilized within the region• Have to have the resources locally, but have access to resources within the region
• Have the ability to share Essential Elements of Information (EEIs) data electronically across the HCC (e.g., bed status)• Utilize subject matter experts from across the region for information sharing
DOES NOTDOES NOTDOESDOES
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Healthcare Coalition (HCC)
Primary Function of HCC
Sub-state regional healthcare system emergency preparedness activities involving the healthcare
member organizations (HCOs). This includes planning, organizing, equipping, training, exercises and
evaluation.
Purpose of HCC
Healthcare system-wide approach for preparing for, responding to, and recovering from incidents that have
a public health and medical impact in the short-and long-term.
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Healthcare Coalition (HCC)
Response of HCC
HCCs should represent healthcare organizations by providing multi-agency coordination advice on decisions made by incident management regarding information &
resource coordination
Advice through:
• A multi-agency coordination group to assist incident management (area command or unified command)
OR
• Through coordinated plans to guide decisions regarding healthcare organization support
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Healthcare Coalition Member Organizations (HCO)
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Healthcare Coalition (HCC)
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• Regional-based preparedness programs already in place
• Common purpose:– To serve as a collaborative network of
healthcare organizations to assist with preparedness, response, recovery, and mitigation activities related to healthcare organization disaster operations.
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Don’t Recreate the wheel! Use existing networks.
Kansas Healthcare Coalitions
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• Most states are choosing to utilize their current regional structure for healthcare coalitions
• Some are using State as one coalition• Few states are using city or county
based communities
Non-Kansas Healthcare Coalitions
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Five Year Grant Period
Working in close collaboration with internal and external subject matter experts (SMEs), ASPR and CDC developed a set of new performance measures for 2012-2013 that enable ASPR and its HPP awardees to:
• Enhance situational awareness • Provide technical assistance• Support program improvement and inform policy• Increase transparency• Promote sound stewardship of Federal tax dollars by using the
data to assess impact of public funding and ensure that the American taxpayer sees a return on his or her investment.
– The development of program measures and continuous quality improvement enables Healthcare Systems Evaluation Branch (HSEB) within ASPR to critically evaluate the ability of the HPP program to perform its intended goals.
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The Assistant Secretary for Preparedness and Response (ASPR) has always supported region-based approaches for preparedness planning. This has been a part of the preparedness program for many years.
You can learn more from the ASPR 2009 report, From Hospitals to Healthcare Coalitions: Transforming Health Preparedness & Response in Our Communities. In this report, ASPR highlighted the seven Kansas regional hospital groups as a best practice for collaborative efforts resulting in shared resources and stronger relationships. This is the structure that will continue to be used moving forward.
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Challenges & SolutionsChallenge Example #1: Preparedness funding realities
Possible Solutions: • Capitalize on policy initiatives and resources
• Military. Force Multiplier--A capability that, when added to and employed by a combat force, significantly increases the combat potential of that force and thus enhances the probability of successful mission accomplishment.
• Racing. Drafting or slipstreaming is a technique where two vehicles or other moving objects are caused to align in a close group reducing the overall effect of drag
• Collaboration Effect
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National Healthcare System
Gap
Coalitions
Regional Preparedness
100% Prepared
Collaboration Effect
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National Healthcare System
100% Prepared
Gap
Coalitions
Regional Preparedness
Collaboration Effect
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National Healthcare
System
100% Prepared
Achieving Success
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Challenges & SolutionsChallenge Example #2: Coalition integration into disaster response
Possible Solution:
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Challenges & SolutionsChallenge Example #3: “surge” capacity“Surge” capacity is shrinking
Possible Solution: Coalition immediate bed availability
Immediate bed availability (IBA) is built into the existing systemUses regional capacityExpanding local capabilitiesBuilds on current regional structuresBuilds on regional collaboration
IBA principlesConstant acuity monitoring across the coalition Patient awareness and continuous discharge planning20% acute care offload (IBA)
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Immediate Bed Availability
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Stroke/MIs
High Acuity Psychiatric patients
ICU Patients
Acute Surgical Patients
Imminent OB deliveryLesser Acuity
Awaiting discharge
Behavioral Health Issues
Social Issues
Post Operative Patients
Elective Procedures Cancelled
Home
Community Health Centers
Long Term Care
Acute
Hospitals Coalition Partners
20%
EVEN
TCoalitions & Immediate Bed Availability
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• Coordinated near-simultaneous attacks targeting commuter trains
• 191 dead
• More than 2,600 injured
Challenges & SolutionsCase Study: Madrid 3/11/2004
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Challenges & SolutionsCase Study: Madrid 3/11/2004
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Challenges & SolutionsCase Study: Madrid 3/11/2004
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• 1000 acute care beds/coalition• 20% IBA• Results in 200 beds immediately avail/coalition• 100 coalitions in the United States• Across the U.S., 20,000 beds available—
immediately• Madrid = 2,000 patients
- Require 10 coalitions engaged
Challenges & SolutionsFunctional IBA? Discussions across HCCs
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ResourcesBest Practices
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Coalition Strengthening Documents
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Kansas defined Tier 1-4 Coordination
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