Medical Material and Supply Chain Management in Disasters Al Cook, CMRP, FAHRMM Director Healthcare...

Medical Material and Supply Medical Material and Supply Chain Management in Chain Management in

DisastersDisasters

Al Cook, CMRP, FAHRMMAl Cook, CMRP, FAHRMMDirector Healthcare Product DevelopmentDirector Healthcare Product Development

Integrated Business Systems and Services Integrated Business Systems and Services October 9, 2008October 9, 2008

Supply Chain Background Supply Chain Background Al CookAl Cook

Worked in both Materials Management and sales in Worked in both Materials Management and sales in Healthcare since 1972.Healthcare since 1972.

In 1999, was appointed chair of the Y2K committee In 1999, was appointed chair of the Y2K committee and reviewed distribution and manufacturing and reviewed distribution and manufacturing capacity in medical supply chain. capacity in medical supply chain.

This work with the Y2K preparedness committee This work with the Y2K preparedness committee resulted in a much deeper understanding of the resulted in a much deeper understanding of the medical supply chain and the ability for the medical supply chain and the ability for the supply chain to be somewhat elastic in the supply chain to be somewhat elastic in the distribution community while very rigid in the distribution community while very rigid in the manufacturing capacity.manufacturing capacity.


In September 2001, Al was President In September 2001, Al was President Elect of AHRMM and was contacted Elect of AHRMM and was contacted by HIDA to co-chair a group that was by HIDA to co-chair a group that was to review the events that occurred to review the events that occurred with supplies during 911 in the with supplies during 911 in the attempt to provide advice to OEM attempt to provide advice to OEM and FDA regarding the supply chain and FDA regarding the supply chain and what could be done to make the and what could be done to make the supply chain more efficient in the supply chain more efficient in the event of another WMD attack in the event of another WMD attack in the US. US.


The group reviewing the events affecting The group reviewing the events affecting the supply chain included ADVAMED, the supply chain included ADVAMED, HIGPA, HIDA, ASHP, Medical Laboratory HIGPA, HIDA, ASHP, Medical Laboratory distributors, AHA and others. This group distributors, AHA and others. This group reviewed with participants the events and reviewed with participants the events and the problems associated with those the problems associated with those events. This group then developed a events. This group then developed a recommended response and a suggested recommended response and a suggested generic supply listing for the types of generic supply listing for the types of CBRNE events that were being considered.CBRNE events that were being considered.

Medical Surgical Supply Formulary Medical Surgical Supply Formulary for Disaster Planningfor Disaster Planning

Co-Sponsored by HIDA, AHRMM, Co-Sponsored by HIDA, AHRMM, HIGPA.HIGPA.Entire Formulary still on AHRMM’s Entire Formulary still on AHRMM’s website-www.ahrmm.org.website-www.ahrmm.org.Gives general guidelines and Gives general guidelines and indicates that this is a tool to use indicates that this is a tool to use during planning and that this tool during planning and that this tool needs to be refined for each hospital needs to be refined for each hospital specific to product and equipment.specific to product and equipment.

Disaster Preparedness FormularyDisaster Preparedness Formulary

Provides a core formulary for any of Provides a core formulary for any of the Chemical, Biological, the Chemical, Biological, Radiological, Nuclear, or Explosion Radiological, Nuclear, or Explosion (CBRNE) scenarios (CBRNE) scenarios

Provides individual formularies for Provides individual formularies for each of the eventseach of the events

Provides a separate pediatric Provides a separate pediatric formulary for these eventsformulary for these events


Provides a planning guide that indicates Provides a planning guide that indicates that these are starting points for hospitals that these are starting points for hospitals in the planning stage. in the planning stage.

Suggests that through planning, hospitals Suggests that through planning, hospitals have to be self sufficient for up to have to be self sufficient for up to 72 72 hours hours after an event.after an event.

Each hospital, after identifying the specific Each hospital, after identifying the specific products that they will need, have to products that they will need, have to examine the hospital’s internal supply examine the hospital’s internal supply chain and identify where product might be chain and identify where product might be available that might be shut down in the available that might be shut down in the event of an emergency.event of an emergency.


Identification of internal surplus that Identification of internal surplus that could be diverted to first point of could be diverted to first point of contact. contact.

Estimation of how much in terms of Estimation of how much in terms of time, internal supply chain will time, internal supply chain will support.support.

Work with distributors to determine Work with distributors to determine transportation time and pick time for transportation time and pick time for pre-established orders based on pre-established orders based on numbers of casualties expected.numbers of casualties expected.


If the internal supply chain is insufficient in If the internal supply chain is insufficient in any products to support the hospital until any products to support the hospital until first delivery, a “bulge” in the hospital’s first delivery, a “bulge” in the hospital’s working inventory has to be established.working inventory has to be established.

If the distributor is unable to provide If the distributor is unable to provide support for any of their hospitals to get support for any of their hospitals to get them through the first wave of casualties, them through the first wave of casualties, then the distributor has to create a then the distributor has to create a “bulge” in their working supply chain to be “bulge” in their working supply chain to be able to support their customers.able to support their customers.


A major catastrophic event is not a A major catastrophic event is not a hospital event, it is a “Community” hospital event, it is a “Community” event. As a community event, local event. As a community event, local community sources of medical community sources of medical surgical products should be surgical products should be identified. Local pharmacies should identified. Local pharmacies should be included in the planning as well as be included in the planning as well as any of the alternate care medical any of the alternate care medical providers and the planning should be providers and the planning should be done on a community wide basis.done on a community wide basis.


A single source of communication A single source of communication should be identified for the should be identified for the community to coordinate the flow of community to coordinate the flow of needed supplies and equipment to needed supplies and equipment to the areas of highest need and to the areas of highest need and to avoid duplication of orders from avoid duplication of orders from multiple sources within those multiple sources within those facilities.facilities.


The plan has to be practiced with the The plan has to be practiced with the community and with the supply chain community and with the supply chain participants to find the weaknesses participants to find the weaknesses and to strengthen the plan.and to strengthen the plan.

The real danger is not to plan for the The real danger is not to plan for the unthinkable.unthinkable.

Classification

Emergency Planning Recommendations for the

Local Office of Emergency Management and Material Managers

A document prepared by theHealth and Human Services National Medical Materials Coordinating Group with

the Support of Department of Health and Human Services

FINAL DRAFT

Version 0.5

November 18, 2004

This document was prepared for authorized distribution only.It has not been approved for public release.

MMCG HISTORYMMCG HISTORY

Met with OEM, FDA several times in an Met with OEM, FDA several times in an unofficial capacity to try to get their unofficial capacity to try to get their endorsement of the supply formulary and endorsement of the supply formulary and put it in the hands of planners.put it in the hands of planners.In 2003, HHS invited the members of this In 2003, HHS invited the members of this group to participate in a “private sector group to participate in a “private sector advisory group” regarding Medical advisory group” regarding Medical Materials.Materials.In 2004, this became the “Medical In 2004, this became the “Medical Materials Coordinating Council” (MMCG) Materials Coordinating Council” (MMCG) to the department of HHS. Again the to the department of HHS. Again the mission of the group was to work with the mission of the group was to work with the federal agencies to provide advice on federal agencies to provide advice on medical supply chain managementmedical supply chain management

MMCGMMCG

We were asked to identify potential We were asked to identify potential barriers to management of the barriers to management of the supply chain in the event of a supply chain in the event of a disaster. We indicated:disaster. We indicated:

– Communication and lack of universal Communication and lack of universal identifiers.identifiers.

– Clear lines of communication so that Clear lines of communication so that multiple requests for the same items multiple requests for the same items were not issued.were not issued.

– Lack of the ability to transport the Lack of the ability to transport the goods into the affected areas.goods into the affected areas.

MMCG relationship to HHSMMCG relationship to HHS

Private sector group representing Private sector group representing medical distributors, medical medical distributors, medical manufacturers, and medical manufacturers, and medical providers.providers.Non government funded, meet Non government funded, meet quarterly to identify potential quarterly to identify potential barriers to supply chain management barriers to supply chain management and to identify critical infrastructureand to identify critical infrastructureThere is a Public sector group that There is a Public sector group that represents the federal agencies that represents the federal agencies that also provide HHS with inputalso provide HHS with input

MMCG relationship to HHSMMCG relationship to HHS

The private sector and public sector The private sector and public sector will meet together twice a year to will meet together twice a year to discuss the issues that affect both discuss the issues that affect both and to be briefed on any new and to be briefed on any new objectives of HHS in regards to objectives of HHS in regards to supply chain managementsupply chain management

HHS is not required to follow the HHS is not required to follow the advice of either group as it forms advice of either group as it forms policies to deal with health and policies to deal with health and safety issues.safety issues.

HSCC Status: OrganizationHSCC Status: OrganizationHealthcare and Public

Health Sector Government Coordinating Council

(GCC)

High-level federal, state and local government officials available to interact with

HSCC

Healthcare Personnel

Includes:

Doctors, nurses, pharmacists, dentists, emergency medicine and other clinicians and practitioners with direct involvement in healthcare delivery

Insurers, Payers, HMOs

Includes:

Representatives of third-party payers for medical treatment and healthcare delivery including insurance companies, HMOs and others

Information Technology

Includes:

All IT systems, capabilities and networks supporting delivery of healthcare services

Laboratories and Blood

Includes:

Laboratories and lab support services separate from medical treatment facilities, and companies and associations from the blood, tissue and organ industry

Mass Fatality Mgt Services

Includes:

Medical examiners, coroners, funeral directors, cremationists, cemeterians, clergy, and manufacturers and distributors of funeral, memorial, and cremation supplies

Each sub-council is responsible for organizing itself

Sample Priority Issues for Sub-Councils: Emergency Preparedness, Emergency Response; Vulnerability Assessment / Prioritization; Communication & Information Sharing among members, with HHS and DHS, and with other sectors

Medical Materials

CoordinatingIncludes:Manufacturers, suppliers, and distributors of medical supplies and equipment, as well as health care materials managers

Medical Treatment

Includes:

Hospitals, clinics, and other organizations/entities that deliver medical treatment

Occupational Health

Includes:

Occupational health physicians and nurses, industrial hygienists, and other occupational health professionals

Pharma and Biotech

Includes:

Manufacturers, suppliers and distributors of generic and branded pharmaceuticals and biological equipment

Cross-cutting Work Groups will be established to address priority issues that cut across sub-councils

Healthcare Sector Coordinating Council (HSCC)The HSCC is comprised of representatives and alternates from each sub-

council. Issue will be identified by Subcouncils. Coordination across Subcouncils and with the HPHGCC will be organized through the HSCC.

Healthcare and Public Health Sector Government Coordinating Council (GCC)

Healthcare Personnel

Includes:

Doctors, nurses, pharmacists, dentists, emergency medicine and other clinicians and practitioners with direct involvement in healthcare delivery

Insurers, Payers, HMOs

Includes:

Representatives of third-party payers for medical treatment and healthcare delivery including insurance companies, HMOs and others

Information Technology

Includes:

All IT systems, capabilities and networks supporting delivery of healthcare services

Laboratories and Blood

Includes:

Laboratories and lab support services separate from medical treatment facilities, and companies and associations from the blood, tissue and organ industry

Mass Fatality Mgt Services

Includes:

Medical examiners, coroners, funeral directors, cremationists, cemeterians, clergy, and manufacturers and distributors of funeral, memorial, and cremation supplies

Each sub-council is responsible for organizing itself

Sample Priority Issues for Sub-Councils: Emergency Preparedness, Emergency Response; Vulnerability Assessment / Prioritization; Communication & Information Sharing among members, with HHS and DHS, and with other sectors

Medical Materials

CoordinatingIncludes:

Manufacturers, suppliers, and distributors of medical supplies and equipment, as well as health care materials managers

Medical Treatment

Includes:

Hospitals, clinics, and other organizations/entities that deliver medical treatment

Occupational Health

Includes:

Occupational health physicians and nurses, industrial hygienists, and other occupational health professionals

Pharma and Biotech

Includes:

Manufacturers, suppliers and distributors of generic and branded pharmaceuticals and biological equipment

Cross-cutting Work Groups will be established to address priority issues that cut across sub-councils

Healthcare Sector Coordinating Council (HSCC)

The HSCC is comprised of representatives and alternates from each sub-council. Issue will be identified by Subcouncils. Coordination across Subcouncils and with the GCC will be organized through the HSCC.

AHRQ CMS FDA HRSA IHS/TRIBAL NIH SAMHSA DOD VA STATE/LOCAL CDC

KATRINAKATRINAHurricane Katrina hit the Gulf Coast Hurricane Katrina hit the Gulf Coast Monday, August 29th 2005.Monday, August 29th 2005.

7:00AM 7:00AM CDTCDT – KATRINA MAKES LANDFALL – KATRINA MAKES LANDFALL AS A CATEGORY 4 HURRICANEAS A CATEGORY 4 HURRICANE

8:00AM 8:00AM CDTCDT Mayor Nagin reports that Mayor Nagin reports that water is flowing over levee.water is flowing over levee.

KATRINAKATRINA

KATRINAKATRINA

KATRINAKATRINA

KATRINAKATRINAThe medical response to Hurricane Katrina was plagued by confusion, a lack of supplies and breakdowns in communications, according to a new congressional report prepared for Democrats and released on Friday

It also said medical supplies from the Strategic National Stockpile failed to get into the hands of medical teams within 12 hours, as stipulated under disaster plans, but took three days to get to New Orleans _ and then there were far too few.

AHRMM’s part in Katrina AHRMM’s part in Katrina AssistanceAssistance

September 1, 2005 HHS asks for help September 1, 2005 HHS asks for help with supply chain with supply chain

The planning that we had put in The planning that we had put in place for disaster support was put in place for disaster support was put in effect. effect.


HHS asks for assistance in organizing HHS asks for assistance in organizing the requests coming from various the requests coming from various agencies for supplies. Many agencies for supplies. Many agencies were making individual agencies were making individual contacts within the distribution contacts within the distribution community for the same items.community for the same items.


CDC had listing of supply CDC had listing of supply components for field hospitals but components for field hospitals but the item number identification the item number identification numbers were the numbers used in numbers were the numbers used in the federal supply system. the federal supply system.

Some of the supplies requested were Some of the supplies requested were from a single source manufacturer from a single source manufacturer and the manufacturer was unable to and the manufacturer was unable to meet the increased demand on short meet the increased demand on short notice.notice.


Conversion lists had to be built for Conversion lists had to be built for each item on the supply list and the each item on the supply list and the identification number for each identification number for each distributor had to be researched and distributor had to be researched and entered on a large spreadsheet.entered on a large spreadsheet.In some cases, generic equivalent In some cases, generic equivalent descriptions had to be developed and descriptions had to be developed and researched at the distributor level to researched at the distributor level to identify where product could be identify where product could be located. located.


Distribution locations were identified that Distribution locations were identified that could ship large volumes without could ship large volumes without negatively impacting existing care and negatively impacting existing care and large amounts of goods were picked and large amounts of goods were picked and palletized on Sunday the 3palletized on Sunday the 3rdrd of September. of September.

The supply listing was for a bed capacity The supply listing was for a bed capacity of 250 beds and we were told how many of 250 beds and we were told how many beds to pick for but not where the supplies beds to pick for but not where the supplies were being shipped to. were being shipped to.


AHRMM served as the linkage AHRMM served as the linkage between the distribution community between the distribution community and the agencies that were and the agencies that were requesting supplies. We would requesting supplies. We would convert the information from the convert the information from the spoken language into the spoken language into the computerized numbers that the computerized numbers that the distributors needed to find large distributors needed to find large amounts of goods that could be amounts of goods that could be dispatched without disturbing the dispatched without disturbing the supply chain in unaffected areas.supply chain in unaffected areas.

Katrina Lessons LearnedKatrina Lessons Learned

Horizontal distribution was Horizontal distribution was problematic and many roads were problematic and many roads were closed or impassable.closed or impassable.

Fuel availability was a significant Fuel availability was a significant issue for the drivers that were issue for the drivers that were dispatched to the area.dispatched to the area.


Field hospital addresses were not in the Field hospital addresses were not in the DEA registry nor were the registry DEA registry nor were the registry numbers available. The “ship to” numbers available. The “ship to” addresses were not usable in the vendor’s addresses were not usable in the vendor’s data base due to the computer’s on line data base due to the computer’s on line verification process for DEA numbers and verification process for DEA numbers and location addresses. The “customer” was location addresses. The “customer” was not clearly identified as the orders were not clearly identified as the orders were coming from HHS, DHS, FEMA, CDC, and coming from HHS, DHS, FEMA, CDC, and others. Some time was lost in having others. Some time was lost in having several knowledge workers engaged in the several knowledge workers engaged in the same problems from multiple agency same problems from multiple agency requests for the same item.requests for the same item.


1.1. Communication and lack of Communication and lack of universal identifiers.universal identifiers.

2.2. Clear lines of communication so Clear lines of communication so that multiple requests for the same that multiple requests for the same items were not issued.items were not issued.

3.3. Lack of the ability to transport the Lack of the ability to transport the goods into the affected areas.goods into the affected areas.

That was then, what’s new??That was then, what’s new??

Katrina alerted HHS/DHS that Katrina alerted HHS/DHS that planning had to be for CBRNE as well planning had to be for CBRNE as well as natural hazards.as natural hazards.

This was the onset for an “All This was the onset for an “All Hazards” response plan that included Hazards” response plan that included man made events as well as natural man made events as well as natural events. This included the pandemic events. This included the pandemic response planning.response planning.

Pandemic EventPandemic EventCDC predicts wide CDC predicts wide spread status spread status within 8 weeks of within 8 weeks of entry into U.S.entry into U.S.

High demand for High demand for healthcare at the healthcare at the same time a same time a widespread widespread shortage of shortage of capability due to capability due to absenteeismabsenteeism

Pandemic EventPandemic EventHigh demand for High demand for respiratory respiratory supplies and supplies and Personal Protective Personal Protective Equipment (PPE)Equipment (PPE)

Increased demand Increased demand for specific for specific respiratory related respiratory related equipment equipment (Volume (Volume Ventilators)Ventilators)

Pandemic EventPandemic EventHigh mortality rate High mortality rate combined with combined with significant significant numbers infected numbers infected will produce will produce unmanageable unmanageable demand on end of demand on end of life services and life services and increase demand increase demand on cold storage on cold storage capabilitycapability

Pandemic EventPandemic EventDemand on medical Demand on medical

products will be products will be both in the health both in the health sector as well as sector as well as the private sector. the private sector.

The need for certain The need for certain kinds of medical kinds of medical protective gear will protective gear will be expanded to be expanded to include critical include critical services and services and manufacturing.manufacturing.

Pandemic EventPandemic EventEstimates on Estimates on duration will be 12-duration will be 12-20 weeks. 20 weeks. Manufacturing Manufacturing capacity will be capacity will be stressed with both stressed with both the increased the increased demand as well as demand as well as the shortage of the shortage of resources and raw resources and raw materials to produce materials to produce products.products.

Pandemic EventPandemic EventPlanning efforts are Planning efforts are underway now to underway now to determine best determine best alternatives in alternatives in preparationpreparation

It may take It may take superhuman effort superhuman effort to plan before to plan before responding. responding.

So what should we do????So what should we do????Stay tuned to Stay tuned to AHRMM and the AHRMM and the pandemic pandemic advisories that will advisories that will come from them.come from them.

Evaluate your Evaluate your current stocking current stocking levels on PPE, levels on PPE, particularly N95 particularly N95 masks.masks.

So what should we do????So what should we do????Determine the Determine the supply in terms of supply in terms of days of demand on days of demand on hand.hand.Consider with the Consider with the medical staff the medical staff the possible impact of possible impact of a pandemic on the a pandemic on the daily demand rate daily demand rate for respiratory for respiratory products.products.

So what should we do????So what should we do????Identify those PPE Identify those PPE products which can products which can be freely be freely substituted by substituted by brandbrandDetermine in Determine in advance where advance where alternative alternative products might be products might be considered or considered or where re-usable where re-usable might be prudentmight be prudent

So what should we do????So what should we do????Work closely with Work closely with your distributors your distributors and manufacturers and manufacturers and understand and understand their response their response plans to a plans to a pandemic. Work pandemic. Work with your with your community community planners and planners and understand their understand their response plans to a response plans to a pandemic.pandemic.

AHRMM Pandemic Flu Guidelines AHRMM Pandemic Flu Guidelines for Materials Managersfor Materials Managers

May 8, 2006May 8, 2006

Stages of Preparedness Level for Stages of Preparedness Level for Materials Managers related to Materials Managers related to

Pandemic Flu Levels Pandemic Flu Levels (This includes the Avian Flu; a.k.a. H5N1, H5, or (This includes the Avian Flu; a.k.a. H5N1, H5, or

bird flu.)bird flu.)

InterpandemicInterpandemicPandemic Pandemic

AlertAlertPandemicPandemic PostpandemicPostpandemic

InterpandemicInterpandemic

ImpactImpact Risk of human infection or disease is considered to be lowRisk of human infection or disease is considered to be low

CommunityCommunityDevelop direct communication with disaster or bio-terrorism Develop direct communication with disaster or bio-terrorism

coordinator in your facility, county, or region to ensure duplication coordinator in your facility, county, or region to ensure duplication of activity is limited or eliminatedof activity is limited or eliminated

SuppliesSupplies(see slide (see slide

7)7)

Maintain normal supply level, stay in close contact with distribution Maintain normal supply level, stay in close contact with distribution channel for planning, obtain a copy of the distributor's disaster channel for planning, obtain a copy of the distributor's disaster

plan to ensure supply lines to the customers, and pleaseplan to ensure supply lines to the customers, and pleaseDO NOT HOARD SUPPLIESDO NOT HOARD SUPPLIES

Equipment Equipment

Ventilator/Respirators and IV Pumps undergo preventative Ventilator/Respirators and IV Pumps undergo preventative maintenance checks. Prepare a list of local medical equipment maintenance checks. Prepare a list of local medical equipment

rental companies and inquire on availability of specific equipment rental companies and inquire on availability of specific equipment such as ventilators/respiratorssuch as ventilators/respirators

StaffingStaffing

Prepare list of alternate workers in the event of staff shortages in Prepare list of alternate workers in the event of staff shortages in Materials Management. Consider cross training of staff. Update Materials Management. Consider cross training of staff. Update

phone records and prepare your protocol for calling in relief phone records and prepare your protocol for calling in relief workersworkers

FundingFunding

Check with local, state and governmental agencies for funding Check with local, state and governmental agencies for funding opportunities. This may fall under the responsibility of your opportunities. This may fall under the responsibility of your

facility's disaster coordinatorfacility's disaster coordinator

Pandemic AlertPandemic Alert

ImpactImpact

Human-to-human spread is still localized, suggesting that the Human-to-human spread is still localized, suggesting that the virus is becoming increasingly better adapted to humans virus is becoming increasingly better adapted to humans

but may not yet be fully transmissible (substantial but may not yet be fully transmissible (substantial pandemic risk)pandemic risk)

CommunityCommunity

Align planning with clinical leaders and disaster coordinator(s), Align planning with clinical leaders and disaster coordinator(s), prepare for support of satellite treatment centers that may prepare for support of satellite treatment centers that may be utilized to keep flu patients away from medical centers if be utilized to keep flu patients away from medical centers if

possiblepossible

SuppliesSupplies(see list below)(see list below)

Increase in flu patients will place pressure on supplies within Increase in flu patients will place pressure on supplies within medical facilities, increase supply quantities accordingly, medical facilities, increase supply quantities accordingly,

again, pleaseagain, pleaseDO NOT HOARD SUPPLIESDO NOT HOARD SUPPLIES

Equipment Equipment All ventilators/respirators and IV Pumps ready for serviceAll ventilators/respirators and IV Pumps ready for service

StaffingStaffing Monitor the need for calling on relief workersMonitor the need for calling on relief workers

FundingFunding Focus on supply needsFocus on supply needs

PandemicPandemic

ImpactImpact Increased and sustained transmission in the general population, Increased and sustained transmission in the general population, likely that 30% or more of population infectedlikely that 30% or more of population infected

CommunityCommunity Full activation of supply acquisition and distribution related to high Full activation of supply acquisition and distribution related to high volume of flu patientsvolume of flu patients

SuppliesSupplies(see list (see list

below)below)

Continue to increase purchases and frequency to handle the Continue to increase purchases and frequency to handle the increased volume without hoarding, realize that this may last increased volume without hoarding, realize that this may last

4-8 weeks 4-8 weeks

Equipment Equipment All available ventilators/respirators and IV Pumps are in active All available ventilators/respirators and IV Pumps are in active

service; maintaining, cleaning, and turnaround are critical. service; maintaining, cleaning, and turnaround are critical. Rental equipment ordered and in use.Rental equipment ordered and in use.

StaffingStaffing Monitor the need for calling on relief workersMonitor the need for calling on relief workers

FundingFunding Focus on supply needsFocus on supply needs

PostpandemicPostpandemic

ImpactImpact Return to Interpandemic stageReturn to Interpandemic stage

CommunityCommunity De-commission of community services, move back to focus on De-commission of community services, move back to focus on main activity centersmain activity centers

SuppliesSupplies(see list (see list

below)below)Supply levels should taper down with decreased patient activitySupply levels should taper down with decreased patient activity

Equipment Equipment Disinfecting, repair and maintenance after high activity Disinfecting, repair and maintenance after high activity

StaffingStaffing Return staff to normal dutiesReturn staff to normal duties

FundingFunding Check with local, state and governmental agencies for funding Check with local, state and governmental agencies for funding opportunities. This may fall under the responsibility of your opportunities. This may fall under the responsibility of your

facility's disaster coordinatorfacility's disaster coordinator

Supply ListSupply ListGloves ExamGloves Exam Suction CathetersSuction Catheters

Gowns Disposable IsolationGowns Disposable Isolation Suction CanistersSuction Canisters

Masks N95Masks N95 Oxygen MasksOxygen Masks

Masks ProcedureMasks Procedure Ventilator TubingVentilator Tubing

Masks SurgicalMasks Surgical

Shields Face Shields Face Respiratory Etiquette signsRespiratory Etiquette signs

Stethoscopes Stethoscopes DisposableDisposable

TissuesTissuesGel Hand Alcohol Based - personal Gel Hand Alcohol Based - personal

sizesize

Disposable Blood Pressure CuffsDisposable Blood Pressure Cuffs Wipes Disinfectant for SurfacesWipes Disinfectant for Surfaces

Disposable ThermometersDisposable Thermometers

Vaccines/anti-viral MedicationsVaccines/anti-viral Medications Morgue PacksMorgue Packs

IV SuppliesIV Supplies

Note that quantities should increase based on patient volume Note that quantities should increase based on patient volume changes in most cases and not by simply increasing by "weeks" or changes in most cases and not by simply increasing by "weeks" or

"months" of supplies", this should be managed via close "months" of supplies", this should be managed via close communication with the distributorscommunication with the distributors

Links for More Information:Links for More Information:

MainMain

http://www.pandemicflu.govhttp://www.pandemicflu.gov

OverviewOverview

http://www.pandemicflu.gov/plan/pdf/panflu20060313.pdf.http://www.pandemicflu.gov/plan/pdf/panflu20060313.pdf.

Medical Office ChecklistMedical Office Checklist

http://www.pandemicflu.gov/plan/pdf/medofficesclinics.pdfhttp://www.pandemicflu.gov/plan/pdf/medofficesclinics.pdf

The Latest News 2-08The Latest News 2-08

DHS ANNOUNCES DHS ANNOUNCES RELEASE OF RELEASE OF APPLICATION APPLICATION GUIDANCE GUIDANCE

FOR OVER $3 BILLION FOR OVER $3 BILLION IN GRANT PROGRAMSIN GRANT PROGRAMS


Homeland Security Homeland Security Presidential Directive 21Presidential Directive 21

1.1. Establishes the need for all hazards planningEstablishes the need for all hazards planning2.2. Establishes specific timelines and responses Establishes specific timelines and responses 3.3. Establishes a need to work with the private Establishes a need to work with the private

sector when practicalsector when practical4.4. Establishes the need for mass casualty to be Establishes the need for mass casualty to be

included in the planning effort.included in the planning effort.5.5. Establishes the need to be capable of Establishes the need to be capable of

distributing countermeasures within 48 distributing countermeasures within 48 hours of authorization hours of authorization


OSHA releases Guidelines OSHA releases Guidelines for Business Continuityfor Business Continuity

1.1. Estimates the volumes that would be Estimates the volumes that would be needed in private industry and in needed in private industry and in healthcare.healthcare.

2.2. Suggests that businesses might consider Suggests that businesses might consider building individual stockpiles of PPE building individual stockpiles of PPE equipment for those who will have to equipment for those who will have to interface to the publicinterface to the public

3.3. OSHA asks for commentsOSHA asks for comments


MMCG responds to OSHA MMCG responds to OSHA suggestionssuggestions

MMCG points out that the suggestion of changing MMCG points out that the suggestion of changing N95 masks four times per 8 hour shift severely N95 masks four times per 8 hour shift severely underestimates the demand.underestimates the demand.This sudden uncontrolled demand may destabilize This sudden uncontrolled demand may destabilize the supply chain causing concerns with current the supply chain causing concerns with current care demands.care demands.Shelf life of masks is not indefinate and Shelf life of masks is not indefinate and businesses have no method of stock rotation since businesses have no method of stock rotation since they do not normally consume these products they do not normally consume these products daily. Questions about storage conditions and daily. Questions about storage conditions and obsolesence need to be addressed.obsolesence need to be addressed.

Contact InformationContact Information

Al Cook, CMRP, FAHRMMAl Cook, CMRP, FAHRMM

Director Healthcare Product Director Healthcare Product DevelopmentDevelopment

Integrated Business Systems and Integrated Business Systems and ServicesServices

Office: 803-736-5595 x135Office: 803-736-5595 x135

Cell: 803-378-9260Cell: 803-378-9260

[email protected]@ibss.net

Questions???Questions???

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