Medical Librarian and Disaster Preparedness
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Transcript of Medical Librarian and Disaster Preparedness
Medical Librarian and Medical Librarian and Disaster PreparednessDisaster Preparedness
Patti Reynolds, MLISPatti Reynolds, MLIS
Sarasota Memorial HospitalSarasota Memorial Hospital
Medical Library ComponentsMedical Library Components
Preservation of the library collectionPreservation of the library collection Delivery of medical information that is Delivery of medical information that is
pertinent to the event – toxicology, pertinent to the event – toxicology, infectious disease, etcinfectious disease, etc
Provision of necessary medical guidance Provision of necessary medical guidance information for emergency preparedness information for emergency preparedness within the hospital, county or region within the hospital, county or region such as guidelines, literature, etc.such as guidelines, literature, etc.
Ethical information Ethical information
Preservation of the library Preservation of the library collectioncollection
Natural disasters and emergenciesNatural disasters and emergencies Floods, hurricanes, tornadoes, fire, Floods, hurricanes, tornadoes, fire,
cyclones,tsunamis, volcanoes cyclones,tsunamis, volcanoes Man made disastersMan made disasters
Sprinkler system malfunction, arson, Sprinkler system malfunction, arson, computer systems, terrorism, computer systems, terrorism, bioterrorism; cyberterrorism, nuclear bioterrorism; cyberterrorism, nuclear accidents, chemical accidentsaccidents, chemical accidents
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Maintain Library Operations: 5800Maintain Library Operations: 5800NN/LM Libraries of MedicineNN/LM Libraries of Medicine
Back-Up Plans
Disaster Plans
Emergency Preparedness and Response Toolkit
Publishers Emergency Access Plan
http://nnlm.gov/ep
#2 Delivery of Medical #2 Delivery of Medical Information Information
Depends on the type of emergencyDepends on the type of emergency H1N1H1N1
Clear, definitive, authoritative information on Clear, definitive, authoritative information on vaccine and anti-virals: availability, clinical vaccine and anti-virals: availability, clinical studies,etc.studies,etc.
Guidance for hospital on supplies, algorithms, Guidance for hospital on supplies, algorithms, finance, state policies, etc.finance, state policies, etc.
Guidance for local doctors:Guidance for local doctors: Phone numbers, etc for Department of HealthPhone numbers, etc for Department of Health Where to send specimensWhere to send specimens Latest DOH updates – changed every other dayLatest DOH updates – changed every other day
H1N1H1N1
Policies on vaccinationPolicies on vaccination Daily changing nationallyDaily changing nationally New York, HCANew York, HCA
Ethics informationEthics information TriageTriage Mandating vaccinationMandating vaccination Duty to treatDuty to treat Duty to return to workDuty to return to work Etc, etcEtc, etc
Education and TrainingEducation and Training
Education of staffEducation of staff NIMS, HICS, local organization of emergency NIMS, HICS, local organization of emergency
preparednesspreparedness Department of HealthDepartment of Health EOC – police, fire, emsEOC – police, fire, ems Hospital Hospital
Security department – in charge of EOPSecurity department – in charge of EOP Clinical departments – mandatory educationClinical departments – mandatory education Physicians and community - all separate groups.Physicians and community - all separate groups.
DrillsDrills Need for constant drillsNeed for constant drills
Joint CommissionJoint Commission
An independent, not-for-profit organization, An independent, not-for-profit organization, The Joint Commission accredits and certifies The Joint Commission accredits and certifies
more than 17,000 health care organizations more than 17,000 health care organizations and programs in the United States. and programs in the United States.
Joint Commission accreditation and Joint Commission accreditation and certification is recognized nationwide as a certification is recognized nationwide as a symbol of quality that reflects an symbol of quality that reflects an organization’s commitment to meeting certain organization’s commitment to meeting certain performance standards.performance standards.
Tremendous emergency preparedness section Tremendous emergency preparedness section implemented in last 3 years.implemented in last 3 years.
Lessons learnedLessons learned Dramatic silos – all groupsDramatic silos – all groups
Within the hospital - departmentsWithin the hospital - departments Locally – city and countyLocally – city and county RegionallyRegionally FederallyFederally
Results of silosResults of silos Defensiveness Defensiveness
Leads to denial of informationLeads to denial of information IgnoranceIgnorance
Inability to educateInability to educate
Librarians actions and goalsLibrarians actions and goals
Embed yourself in your close and Embed yourself in your close and extended world. extended world. Listen, evaluate, research, offerListen, evaluate, research, offer Become completely knowledgeable Become completely knowledgeable
about topic – takes time – about topic – takes time – become the local knowledge expert!!!become the local knowledge expert!!!
Library as SwitzerlandLibrary as Switzerland
Interpersonal relationships Interpersonal relationships enormously importantenormously important
Build distribution list to all affected Build distribution list to all affected groups and send updates, articles, groups and send updates, articles, news, etc.news, etc.
Slowly build up distribution of Slowly build up distribution of information information
•9 million items in collection • 1 billion searches of our databases done each year• Biomedical informatics and communications
•New focus: Disaster Health Information
• NIH Institute
• Employees ~ 1300
• Budget ~ $360 M
• Free
1836
http://disasterinfo.nlm.nih.gov
Identify key steps in preparing for & responding to disasters from an information management/ information technology perspective
Disasters
PandemicsAccidents
Terrorism
Bhopal India 40 tons methyl isocyonate
Rapeseed oil1982 800 deaths
“Accidents” 92 nuclear weapons lost , U.S. lists 11
Unguarded Soviet Bio Grade Anthrax onRenaissance Island
An accident at a Soviet biological weapons facility in 1979 released a plume of anthraxthat killed people and livestock
On 4/26/86 major explosionpower reactors at Chernobyl
anthrax
sarin WTC X 2
OK City
UK, Spain, India
Terrorism
SUICIDE TERRORISTSUICIDE TERRORISTsent to the U.S.sent to the U.S.
Disaster Information ManagementDisaster Information ManagementResearch CenterResearch Center
http://disasterinfo.nlm.nih.gov
DIMRC OBJECTIVESDIMRC OBJECTIVES Organize the literatureOrganize the literature Maintain library operationsMaintain library operations Provide information &tools for Provide information &tools for
respondersresponders Research & DevelopmentResearch & Development Surge Model / PartnershipsSurge Model / Partnerships
Non-Commercial•Government reports•Homeland Security Presidential Directives•National Incidence Management System •National Response Plan Framework•Conference Proceedings•State publications•Red Cross•Commentaries •NGO publications•Official Reports•Non peer reviewed publications•Community resources •Training design & technologies•Preparedness options •Response plans for different events •Sister Agency Publications•Catalogues•Non Peer Reviewed Journals•Cosco Magazine
Commercial
The Public Health System
MCOs
Home Health
Parks
Economic Development
Mass Transit
Employers
Nursing Homes
Mental HealthDrug Treatment
Civic GroupsCHCs
Laboratory Facilities
Hospitals
EMS Community Centers
Doctors
Health Department
Churches
Philanthropist
Elected Officials
Tribal Health
Schools
Police
Fire
Corrections
Environmental Health
Who will Identify, Organize, Preserve, Distribute this varied, diverse, Non-Commercial Literature (& Commercial)?
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Support emergency personnel with disaster information
400 librarians EOC / TOC / DIC
Teamed with disaster planners & responders
“just- what-I-need” information “just-in-time”
Answer: The Disaster Information SpecialistA new subspecialty of library science
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The Disaster Information Specialist
•Information needs•How they search•Data mining•Create tutorials5800
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LIBRARIAN CYBRARIAN
http://toxtown.nlm.nih.gov
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Information & Tools for emergency preparedness & response activities
TOXMAP
PTSD/TBI screener
CHEMM
R & D -Web 2.0 R & D -Web 2.0 Tools Tools
Virtual Worlds & Games for Virtual Worlds & Games for Training & SimulationsTraining & Simulations
3-D computer 3-D computer simulated simulated environments environments Users interact Users interact via avatars via avatars (virtual (virtual characters)characters)Parcels of Parcels of land can be land can be bought, bought, developed, developed, and and customizedcustomizedExamples: Examples: Second Life, Second Life, Google Lively, Google Lively, WebkinzWebkinz
We are Not !
Bellevue Hospital Bellevue Hospital 90 patients presented in 5 hours; 194 triaged/treated in 24 90 patients presented in 5 hours; 194 triaged/treated in 24
hourshours Hospital lost track of patients, ran out of supplies and Hospital lost track of patients, ran out of supplies and
struggled with MD staffingstruggled with MD staffing
NYU Downtown HospitalNYU Downtown Hospital Typically treats 5-10 patients per hour; on Sept 11 treated 175 Typically treats 5-10 patients per hour; on Sept 11 treated 175
per hour (over 1,500 total)per hour (over 1,500 total) Lost electricity, steam, gas, phone and computer services, and Lost electricity, steam, gas, phone and computer services, and
had dangerously reduced water pressurehad dangerously reduced water pressure
St. Vincent’s HospitalSt. Vincent’s Hospital Treated nearly 800 patientsTreated nearly 800 patients Shared water lines and telecommunications lines with WTC, Shared water lines and telecommunications lines with WTC,
systems were disruptedsystems were disrupted
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Hospital Surge Response: Hospital Surge Response: September 11, 2001September 11, 2001
200 injured, 100 killed200 injured, 100 killed Kent County Hospital received 40 patients Kent County Hospital received 40 patients
in first hour; 25 were intubatedin first hour; 25 were intubated Ran out of critical supplies and ventilatorsRan out of critical supplies and ventilators Struggled to support family membersStruggled to support family members Communications problems from disaster Communications problems from disaster
scenescene Ultimately, 16 New England hospitals Ultimately, 16 New England hospitals
received 196 burn victims including a received 196 burn victims including a pediatric hospital that received 16 adultspediatric hospital that received 16 adults
(Dacey, MJ. (2003). NEJM, 1990-2)(Dacey, MJ. (2003). NEJM, 1990-2)
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Hospital Disaster Experience: Hospital Disaster Experience: RI Nightclub Fire (2003)RI Nightclub Fire (2003)
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ARE WE READY ?
We Can Be !
32National Naval Medical Center NIH Clinical Center Suburban Hospital NLM
The Bethesda Hospitals’ The Bethesda Hospitals’ Emergency Preparedness Emergency Preparedness
Partnership (BHEPP)Partnership (BHEPP) 2004 Congress earmarked $ 12.9 million to 2004 Congress earmarked $ 12.9 million to
develop a partnership to respond to an extreme develop a partnership to respond to an extreme patient surge need in event of major DC disaster patient surge need in event of major DC disaster
Leverage combined resources of 3 adjacent hospitalsLeverage combined resources of 3 adjacent hospitals Conduct research to improve the responseConduct research to improve the response Develop an exportable model for surge needsDevelop an exportable model for surge needs
BHEPP VIDEOBHEPP VIDEO
http://www.suburbanhospital.org/Emergency/EmergPreparedness.aspx
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• Digital Pen
• Patient Data Exchange
• Patient RFID Tracking
• Digital Pen
• Patient Data Exchange
• Patient RFID Tracking
PatientInformation
Management
•Virtual World Disaster Training•Virtual World Disaster Training
Responder Training
• Prescription Drug access in Disaster
• Disaster Information Specialist
• Lost Person Finder
• Prescription Drug access in Disaster
• Disaster Information Specialist
• Lost Person Finder
Information Access
•Laser Back-up
• Dark Fiber Back-up
• MARS Radio Back-up
• Wireless Voice Bridge
•Laser Back-up
• Dark Fiber Back-up
• MARS Radio Back-up
• Wireless Voice Bridge
Communications
BHEPPNLM Role: 11 Disaster R & D Projects
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Digital Pen&"Electronic" Paper
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A disaster generates mass
casualties
Digital Pen Work Flow
Digital pens capture patient
triage data
Triage data is available through BHEPP network
Digital pen transmits triage data to system
Data reports are available for
emergency personnel
2009 – View Triage Data2009 – View Triage Data
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2009 – View Summary 2009 – View Summary ReportsReports
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Lister Hill National Center for Biomedical Communications
Disaster occurs with mass casualties
Injured are
triaged
Staff/volunteerscapture text & photos of victims –
initial & updates
Purpose: To address a surge of lost persons in a local disaster, by developing a system to enter, search for,&display their descriptions&pictures.
Public search & entry of photos & descriptions via
LPF web site, mobile email
LPF Database (MySQL),Web server,
Image file storage,Email interface
Notification and status by wall displays, email,
web, etc. Includes statistics for disaster
management/awareness
Lost Person Finder
NLMResources to Support NLMResources to Support the Response to the the Response to the Earthquakes in HaitiEarthquakes in Haiti
Lister Hill National Center for Biomedical Communications
Disaster occurs with mass casualties
Injured are
triaged
Staff/volunteerscapture text & photos of victims –
initial & updates
Purpose: To address a surge of lost persons in a local disaster, by developing a system to enter, search for,&display their descriptions&pictures.
Public search & entry of photos & descriptions via
LPF web site, mobile email
LPF Database (MySQL),Web server,
Image file storage,Email interface
Notification and status by wall displays, email,
web, etc. Includes statistics for disaster
management/awareness
Lost Person Finder
46Person Finder: Haiti Earthquake
PFIF Data Exchange
Found in HaitiiPhone App
Smartphone
Interactive Notification Wall
Haiti Earthquake Person Locator (HEPL)
http://hepl.nlm.nih.gov
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The successful response to Disasters requires the coordination of multiple elements based in federal, state or local authority, or in
the private sector
• patients, who may require rescue or medical evacuation
• treatment facility-an existing hospital, portable field hospital
• competent health care workforce
• appropriate medical equipment and non-perishable medical supplies
• appropriate drugs, vaccines, tests and other perishable medical supplies
• a system of medical records
• a health care financing mechanism.
ConclusionConclusion
GOALTo Deliver
“Just What I Need” Information, “Just in Time”
Use Informatics technologies to provide tools, communications literature, perform research to enhance
the Public Health