Evidence Report on Regionalization of Bioterrorism Preparedness and Response Planning Dena M. Bravata, M.D., M.S. Project Director Stanford-University of California, San Francisco Evidence-based Practice Center

Evidence Report Purpose: to synthesize the published evidence on a given topic Method: –Search literature for relevant articles –Abstract data from each article –Evaluate the evidence

1.Medical, public health –Identify key tasks for responding to bioterrorism- related events 2.Supply chain, logistics –Identify best practices for designing regional stockpiles and distribution systems 3.Emergency management –Identify key components of mutual aid agreements 4.Government documents –Identify ongoing bioterrorism response planning efforts Literature Sources

1.Design a completely new system 2.Consider bioterrorism preparedness planning in the context of existing response infrastructures Public health First responders Hospital systems Laboratories Two Approaches

Planning and Preparedness Field assessment and triage Diagnosis Management of acutely ill Prevention Surveillance Outbreak Investigation Communication Emergency Management Key Tasks  Subtasks  Resources

Preliminary Findings Many systems Few evaluations

Utility of the Evidence Report Identify regional response organizations Identify available evidence about regionalization of key tasks Simulations of regionalization –Stockpiling/distributing antibiotics/vaccine –Surveillance

To obtain a copy of the Evidence Report “Regionalization of Bioterrorism Preparedness and Response” (available after December 2003) Free of charge: – –AHRQ Clearinghouse:

Information Technology for Bioterrorism Preparedness Detection/Diagnosis (78 systems) Management and Prevention (18 systems) Surveillance systems (90 systems)* Reporting and Communication (26 systems)* Integrated Surveillance, Communication, and Command and Control (7 systems)* * High relevance to surge capacity and regionalization

Humanitarian Logistics Primary Objective: Timely mobilization of financing and goods Tasks: procurement, transport, tracking and tracing, customs clearance, local transportation, warehousing and last mile delivery Fritz Institute –Non-profit –Mission: apply logistics expertise from the corporate/academic community to humanitarian relief –