1. An Evaluation of Points of Dispensing (POD) Operations through Time Trials in Maricopa County, Arizona Jessica Mason PHAP – Planning Specialist at Maricopa County Department of Public Health, Phoenix, Arizona Office for State, Tribal, Local and Territorial Support Centers for Disease Control and Prevention 2016 PHAP Summer Seminar May 16, 2016 Centers for Disease Control and Prevention Office for State, Tribal, Local and Territorial Support

2. Agenda  Maricopa County, Arizona  Points of Dispensing (POD) Overview  Strategic National Stockpile (SNS)  POD Overview  POD Setup and Expandable Model  Time Trials  Purpose  Methods  Results and Extrapolations  Barriers  Conclusion & Public Health Implications

3.  About the County  Around 4.5 million people at any given time  60% of Arizona’s population  Over 9,000 square miles  Phoenix metro area is 60 miles across  Largest nuclear energy facility in the USA  Frequently holds large scale sporting events and other activities  About Maricopa County Department of Public Health (MCDPH)  Contains several buildings across the greater Phoenix area  6 Divisions The Office of Preparedness and Response is located in the Disease Control Division Maricopa County, Arizona

4. POINTS OF DISPENSING (POD) OVERVIEW Photo courtesy of MCDPH Office of Preparedness and Response

5.  A national repository of:  Antibiotics  Chemical antidotes  Vaccines  Antitoxins  Antivirals  Life-support medications  IV & IV administration  Airway maintenance supplies  Other medical/surgical items  In an emergency, these assets are used to augment federal, state, and local public health agencies  Examples of emergencies:  Biological Terrorism  Medical Surge Event  Natural Disaster  Infectious Disease Outbreak Strategic National Stockpile (SNS) Maricopa County Department of Public Health – Office of Preparedness and Response

6. Points of Dispensing (POD)  A Point of Dispensing (POD) is a pre-identified site where medication/vaccinations are given out to the public in response to a public health threat or emergency  PODs are operated mainly by Public Health volunteers  MCDPH has 24 hours to dispense to the entire population after receiving SNS resources Maricopa County Department of Public Health – Office of Preparedness and Response Locations of Maricopa County Open POD Operations

7.  Open versus Closed PODs  Open PODs Public PODs where any individual can go to receive medication  Closed PODs An organization that makes an agreement to receive initial training and supplies from MCDPH but by which the organization takes over the responsibility of dispensing to their members and their families during real life events  Three categories of PODs  PODs distributing antibiotics  PODs giving vaccinations  Dual-dispensing PODs Points of Dispensing (POD) Maricopa County Department of Public Health – Office of Preparedness and Response

8.  POD Setup  Line Staff/Line Leads  Greeting  Screening  Dispensing POD Setup and Expandable Model Maricopa County Department of Public Health – Office of Preparedness and Response

9. 2016 POINTS OF DISPENSING (POD) TIME TRIALS – MARICOPA COUNTY

10.  Purpose  To incorporate past lessons to further assess large-scale projected throughput, POD methods and trainings, and areas for improvement  To demonstrate that new- line methodology allows for scalable exponential throughput  Methods  Scalable line methodology allows eight lanes; two lanes were used for the time trials  Staffed by affiliated volunteers only  Limited OPR staff involvement  Seven evaluators strategically placed to time and record observations Purpose and Methods Maricopa County Department of Public Health – Office of Preparedness and Response

11. Results and Extrapolations LanesPOD StaffPeople Per 24 HoursPODs to Serve 3,000,000POD Staff to Serve 3,000,000 21916,219.921857030 32324,330.001235658 43132,439.84925704 53540,549.92745180 64348,659.76625332 74757,977.28524888 85564,879.68475170 Maricopa County Department of Public Health – Office of Preparedness and Response

12. Results  453 people served  The average Head of Household (HOH) form contained 5.59 people  Total throughput took an average of 4.23 minutes per car from entry to exit  In a 24 hour period this two lane POD would serve 16,220 people Maricopa County Department of Public Health – Office of Preparedness and Response

13. Barriers  Head of Household forms had a 5.59 person average, the actual average is difficult to calculate  Limited amount of vehicles to participate  An extra station was created to erase marker lines, impacting line flow to a small extent

14. CONCLUSION & PUBLIC HEALTH IMPLICATIONS

15. Graphic from Maricopa County Department of Public Health – Office of Preparedness and Response Shorter (1-2 Days) Longer (4+ Days) DURATION of Campaign Days Hours Detection DELAY             Conclusion

16.  Scalable model  Able to determine quantities of volunteers needed  Able to determine expected time taken at each station  Able to determine expected vehicle throughput Public Health Implications Maricopa County Department of Public Health – Office of Preparedness and Response  POD throughput determines how quickly individuals are served  Quick and efficient procedures save lives

17. For more information, please contact CDC’s Office for State, Tribal, Local and Territorial Support 4770 Buford Highway NE, Mailstop E-70, Atlanta, GA 30341 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: OSTLTSfeedback@cdc.govWeb: http://www.cdc.gov/stltpublichealthOSTLTSfeedback@cdc.govhttp://www.cdc.gov/stltpublichealth The findings and conclusions in this presentation are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Thank you, Questions? Jessica Mason lcq7@cdc.gov Centers for Disease Control and Prevention Office for State, Tribal, Local and Territorial Support