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Surge Capacity and Surge Capacity and Preparing the Preparing the WorkforceWorkforce
Michael Allswede, D.O. Michael Allswede, D.O.
Associate Professor of Emergency Medicine Associate Professor of Emergency Medicine
Section Chief, Special Emergency Medical Section Chief, Special Emergency Medical ResponseResponse
Department of Emergency MedicineDepartment of Emergency Medicine
University of Pittsburgh Medical Center Health University of Pittsburgh Medical Center Health System System
Pittsburgh, PAPittsburgh, PA
Non-Contiguous Training Non-Contiguous Training OverviewOverview
The Non-Contiguous Training Concept is a The Non-Contiguous Training Concept is a method of planning and training the method of planning and training the acquisition of WMD related skillsacquisition of WMD related skills
The ability to train during down-time or other The ability to train during down-time or other hours will prove to: hours will prove to: Improve skill level of the staffImprove skill level of the staff Cost less than standard drillsCost less than standard drills
Tracking skill deficits in key personnel will Tracking skill deficits in key personnel will improve the safety of the system improve the safety of the system
Non-Contiguous ObjectivesNon-Contiguous Objectives
Disseminate individual knowledge and skills Disseminate individual knowledge and skills prior to the drillprior to the drill
Train on objectives, not “time-based” CME/CEUTrain on objectives, not “time-based” CME/CEU
Drill for integration and for “macro” Drill for integration and for “macro” organizationorganization
Leadership training: Leadership training: Must be dynamic “war game”Must be dynamic “war game” Model on “Sim-City”Model on “Sim-City”
Disaster InteractionsDisaster Interactions
WMD events cause “triage inversion”WMD events cause “triage inversion” Least injured present firstLeast injured present first Most injured remain for extricationMost injured remain for extrication Contaminated victims precede scene informationContaminated victims precede scene information
WMD events contaminate hospitals unless WMD events contaminate hospitals unless hospitals are protected hospitals are protected Hospital personnel were among victims in Tokyo Hospital personnel were among victims in Tokyo
SarinSarin
Hospitals and providers are “non-renewable” in Hospitals and providers are “non-renewable” in the short termthe short term
Navy ATEAMSNavy ATEAMS
Afloat Training Exercise Afloat Training Exercise and Management and Management System (ATEAMS)System (ATEAMS)
Allows skill acquisition Allows skill acquisition and maintenance to be and maintenance to be on-goingon-going
Drills are for system Drills are for system evaluation, not skill evaluation, not skill acquisitionacquisition
Assigns skills by duty Assigns skills by duty stationstation
USS Carl Vinson
The Problem with Disaster The Problem with Disaster DrillsDrills
Hospitals cannot stop their normal Hospitals cannot stop their normal function to play in a drillfunction to play in a drill Disaster drills are pre-announced Disaster drills are pre-announced Community drills scheduled at the Community drills scheduled at the
convenience of community services…in convenience of community services…in the morningthe morning
Morning is busy time for hospitalsMorning is busy time for hospitals Disasters happen at night when staffing Disasters happen at night when staffing
levels are thinnest levels are thinnest
The Problem with Disaster The Problem with Disaster DrillsDrills
Shifting extra personnel is expensiveShifting extra personnel is expensive $3,000 per hour at UPMC for ED personnel$3,000 per hour at UPMC for ED personnel Extra non-clinical personnel?Extra non-clinical personnel? Extra administrative personnel?Extra administrative personnel? Victim Volunteers?Victim Volunteers? EMS-Medical Command-Civic Services?EMS-Medical Command-Civic Services?
$16 Million for TOPOFF II$16 Million for TOPOFF II
The Problem with Disaster The Problem with Disaster DrillsDrills
Training a shift at a time is Training a shift at a time is inefficientinefficient 1 shift equals: 1 shift equals:
8% of total nurses8% of total nurses 5% of total attendings5% of total attendings 0% of residents and house staff0% of residents and house staff
Experienced people AVOID disaster drillsExperienced people AVOID disaster drills Moulage is never the real thingMoulage is never the real thing
FamiliarizeFamiliarize
Classic classroom Classic classroom teachingteaching
Distance learningDistance learning
Video interfaceVideo interface
Memory Memory enhancement toolsenhancement tools
RaPiD-T Training, City of Pittsburgh
EMS, 2002
Acquire SkillsAcquire Skills
Virtual interfaceVirtual interface
Training roomTraining room
Video Video demonstrationdemonstration
Self-learningSelf-learningUPMC Disaster Drill 2002
Practice SkillsPractice Skills
Announced drillsAnnounced drills
Group drillsGroup drills
Segmented Segmented testingtesting
SimulationSimulationTOPOFF II, Chemical
Weapons Site, Chicago IL
ValidationValidation
Large drillsLarge drills
Actual eventsActual events
TOPOFF II Tech Rescue Site, Chicago IL
For More Information:For More Information:
Contact: Contact:
Lucy Savitz, Ph.D., M.B.A. at Lucy Savitz, Ph.D., M.B.A. at [email protected]@rti.org