Chapter 6 AD HOC INFRASTRUCTURE [ENTER FACILITATOR’S NAME AND CONTACT INFORMATION] Developed by Troutman Sanders LLP Developed for the Virginia Department of Health Funded by Centers for Disease Control and Prevention
Feb 06, 2016
Ch
apte
r 6
AD HOC INFRASTRUCTURE
[ENTER FACILITATOR’S NAME AND CONTACT INFORMATION]
Developed by Troutman Sanders LLPDeveloped for the Virginia Department of Health
Funded by Centers for Disease Control and Prevention
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Toolkit Presentations Instructions for Use
Toolkit Presentations are intended to be a companion to the Hospital Implementation Guide and should not be used in isolation.
The Presentations are intended to serve as a starting point for the facilitator. The facilitator should thoroughly review the Presentation prior to use in Implementation Team, CRAG or Subcommittee meetings and customize the Presentation to meet the unique needs of the meeting participants.
Pay particular to attention to the information provided in brackets ([ ]), which must be completed by the facilitator prior to use.
Included in the “Notes” section of each slide are the following types of information:
• Slide Type, which indicates whether the slide is for information or discussion, serves as a placeholder, or is some combination thereof
• Planning Guide Section(s), which will direct the facilitator to the corresponding sections of the Planning Guide and Hospital Implementation Guide for further information
• Special Instructions, which provides directions for the facilitator to customize the slide for the intended audience
• Speaker’s Notes, which provides more detailed information to supplement the material on the slide
Refer to the Hospital Implementation Guide for further guidance and helpful hints on effectively completing the process described in the Planning Guide.
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CRAG Members
[Enter names and departments of each CRAG member]
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Add slides from Altered Standards Overview and/or Chapter 1 presentation, as needed, to re-introduce the CRAG to the concept of altered standards and critical resource shortage response planning, especially if new members are involved.
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Introduction
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Why do we need an ad hoc infrastructure?
During an event, resources will become scarce for which you have no Protocol
Planning Unit will need to quickly develop Protocols in the midst of the event to respond to these shortages
Developing an infrastructure for this intra-event planning mechanism is crucial to an effective response
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Chapter Overview
Determine how the Planning Unit will decide when the development of an Ad Hoc Protocol is required
Develop the process by which an Ad Hoc Protocol will be created in the midst of a disaster
Develop a standard mechanism for communicating the creation, implementation, and operationalization of Ad Hoc Protocols
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WHEN IS DEVELOPMENT OF AN
AD HOC PROTOCOL REQUIRED?
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Development of a CRSE
Supply of the Resource
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Potential CRSE Alert
Supply of the Resource
Who will identify the declining supply of the resource?
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Ad Hoc Protocol Development
Supply of the Resource
Who will identify the need to develop an Ad Hoc Protocol?
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Identifying a Critical Resource Shortage
STATUS
Does demand exceed supply?
FORECAST
When will demand exceed supply if it doesn’t already?
DURATION
For how long will demand exceed
supply?
MAGNITUDE
To what extent does or will demand exceed supply?
MITIGATION
Options for obtaining additional supplies of
the resource.
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AD HOC PROTOCOL DEVELOPMENT
PROCESS
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Identifying Need for Ad Hoc Protocol
[____] reports a shortage to Incident Command
Incident Command activates/notifies Critical Resource Advisory Group (CRAG)
CRAG determines if an Ad Hoc Protocol is necessary by answering the following questions:
STATUS
Does demand exceed supply?
FORECASTWhen will
demand exceed supply if it
doesn’t already?
DURATION
For how long will demand exceed
supply?
MAGNITUDETo what extent
does/ will demand exceed
supply?
MITIGATIONOptions for obtaining
additional supply of the resource.
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Developing the Ad Hoc Protocol
Ad Hoc Protocol Development Subcommittee is formed
Subcommittee develops Protocol
Incident Commander activates Protocol when appropriate
Protocol is presented to CRAG/Incident Commander for review and approval
CRAG activates an Ad Hoc Protocol Development Subcommittee
Once the CRAG has determined that an Ad Hoc Protocol needs to be developed:
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Identifying Need for Ad Hoc ProtocolShortage is identified and assessed by
[_______]
[______] provides information to Incident Command
Incident Command determines there is no need to respond at this
time
STATUS
Does demand exceed supply?
FORECASTWhen will
demand exceed supply if it
doesn’t already?
DURATION
For how long will demand exceed
supply?
MAGNITUDETo what extent
does or will demand exceed
supply?
Incident Command provides simple directive for responding to CRSE
Incident Command activates a Subcommittee
to develop Ad Hoc Protocol
MITIGATIONOptions for obtaining
additional supply of the resource.
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Developing the Protocol
Subcommittee develops Ad Hoc Protocol
Incident Commander activates Ad Hoc Protocol when appropriate
Subcommittee presents Ad Hoc Protocol to Incident Command for review and approval
Incident Command provides instructions to Ad Hoc Protocol Development Subcommittee
Once Incident Command has activated a Subcommittee to develop an Ad Hoc Protocol the following process will occur:
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Ad Hoc Protocol Development Subcommittees
Liaison from Incident CommandPhysicians, nurses, and other clinical
personnel who are:• most knowledgeable about the resource• representative of the end user(s)
“Pre-trained” individualsFacilitatorEthics representative
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Instructions for Subcommittees
No more than X hours to develop algorithm Don’t forget your ethical frameworkDon’t forget your operational infrastructure – the
Protocol needs to be easy to implement Consider modifications to stretch resource firstConsider allocation criteria (inclusion, exclusion,
prioritization)
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Instructions for Subcommittees
Consider multiple tiers based on severity of shortage Consider “essential documentation” for the Protocol Identify any just-in-time training that will be required Develop process for revising Protocols Consider metrics for determining when the CRSE has
ended and the process for communicating this to the staff
Consider how to communicate all aspects of the final Protocol to various audiences
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DEVELOP AN EFFECTIVE WAY TO COMMUNICATE THE AD HOC
PROTOCOL
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Potential Audiences
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Possible Messages
Ad Hoc Protocol created
Ad Hoc Protocol content
Ad Hoc Protocol training required
Ad Hoc Protocol activated
Ad Hoc Protocol termina
ted
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Communication Methods
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What message(s) will you communicate to each audience and
how will you do this?
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Questions?Questions?