State, federal & international roles in public health & disasters Kristine M. Gebbie, DrPH, RN Columbia University School of Nursing June 27, 2006

June Goals Review challenges in studying emergency response Present examples from current work by panelists Engage participants in identifying ways to move forward

June Perspectives Little work prior to 2001 Researchers have applied both theoretical & logic models based on familiarity Comparative analysis limited Limited community of scholars Example: WADM Utstein Model almost unknown in US

June My work Competency development After-action reports Criteria development Exercise evaluations

June Competency development Primarily qualitative National perspective Individual state or school perspective Competing sets confuse practice field Needs Organizational ownership Concurrence on division of field

June After-action reports Quarantellis work most helpful Focus on management & decision-making Does not fit HSEEP or other DHS lists Usually not published

June Criteria development Primarily qualitative Requested by federal manager but not owned by agency Resisted by agencies Not used by DHS Part of review now underway by ASPH

June Exercise evaluations Only as good as clarity of exercise objectives and precision of observations Moving toward quantifiable information Standardization of formats emerging

June Example: local public health- driven exercise Practice the process of opening and operating multiple oral medication (POD) sites for first responders & health staff, in anticipation of wider emergency prophylaxis, including Physical setup of POD sites Ordering and receiving supplies from the county stockpile Informing staff/staff families (including children) to report Record keeping, screening and distribution of prophylaxis Communication between POD sites and EOC

June Participants County health department County emergency management agency 12 hospitals 9 fire battalions Police department Sheriff 1 township warehouse

June

5 months of building blocks Seminars MRC Fire & Police Hospitals Workshops and tabletops Fire battalions + MRC Police Hospitals

June Preliminary drill findings Participants 3000 county staff, volunteers 160 evaluators Maximum fire battalion throughput: 600 persons/hour Range of hospital throughput: 300 per hour to 70 per hour

June

And now two other perspectives- - -