1. POINT OF DISPENSING STAFF ORIENTATION
Wayne/Hamilton County Health Department 405 North Basin Road
Fairfield IL

2. Session Overview POD basics POD management
POD roles and responsibilities
Preparing to work at a POD
The four sessions of today’s discussion

3. Learning Objectives
After completing this module, you will be able to describe:
The purpose of a Point of Dispensing (POD)
The role of the Strategic National Stockpile (SNS) in a POD
The general structure and operations of public health PODs
How POD operations function within the Incident Command System (ICS)
How you can prepare yourself and your family for the time you spend working in a POD

4. POD basics
MASS DISPENSING PLAN

5. What is a POD?
Point of dispensing (POD) - a place where a vaccine, antibiotic or other medication is dispensed quickly to a large group of people.
General Public
Self Dispensing Sites (i.e., Hospital, Nursing Homes, etc)
First Responders

6. Why would a POD be activated?
Usually: To prevent disease in those exposed to an infection but who are not yet sick (antiviral, vaccine)
Possible: To treat an infectious disease
The treatment offered would be limited to dispensing a specific medication.

7. What Kinds of Emergencies Might Require a POD?
Natural disaster
Influenza pandemic
Bioterrorism attack
Natural disaster - After the flooding caused by Hurricane Katrina along the Gulf Coast, a number of people received emergency vaccines against diseases like Hepatitis A at mass dispensing sites.
An act of terrorism - Certain people who worked in places where anthrax- contaminated envelopes were received in fall 2001 were given antibiotic to prevent them from developing anthrax.
A naturally occurring epidemic of infectious disease - To protect the public during an influenza pandemic the government may use PODs to dispense vaccines or to treat people who are sick with antiviral medications .

8. What is the Strategic National Stockpile ?
A large CDC-managed stockpile of medicine and medical supplies to protect the American public if there is a public health emergency severe enough to cause local supplies to run out.
You can learn more about the Strategic National Stockpile at
Imagine the number of doses of medication or vaccine that would be need if a whole community were exposed to infection. In [jurisdiction X] that would mean dispensing to [NN,NNN] people.
Local supplies would probably not be sufficient. That is why the Strategic National Stockpile was created.
The medicine in the SNS is FREE for everyone.
The SNS has stockpiled enough medicine to protect people in several large cities at the same time.
Federal, state and local community planners are working together to ensure that the SNS medicines will be delivered to the affected area to protect you and your family if there is a terrorist attack or natural disaster.

9. Strategic National Stockpile Components
Push Pack/12 Hours
Vendor Managed Inventory/ hours
The SNS program is comprised of two possible deliveries in response to an event. Components to a Two-Tiered Response:
12-Hour Push Packages:
Ready for deployment to reach designated area within 12 hours of Federal activation
Pre-positioned in environmentally controlled and secured facilities
Pre-configured for rapid identification and ease of distribution
Vendor Managed Inventory:
“Tailored" to provide specific materiel depending upon suspected or confirmed agent
Will be shipped to arrive within 24 and 36-hour periods
From private pharmaceuticals and vendors

10. SNS Responsibilities SNS State and Local governments Hospitals
Send medications / vaccines
Provide technical assistance
State and Local governments
Demonstrate need for supplies
Receive, stage and store supplies
Dispense at community PODs
Hospitals
Dispense to personnel and patients

11. How Will a POD Be Set Up?
The layout of a POD is designed to facilitate accurate and rapid dispensing of a specific medication/vaccine
Basic POD floor plan
Variation
Situation
Local circumstances
A POD is not designed to represent a general treatment facility
The layout of a POD is meant to facilitate rapid dispensing of a specific vaccine or antibiotic
During actual events the floor plan of a POD will vary depending on local circumstances and the situation that created the need for a POD

12. POD layout - The general layout of a POD
- People are only removed out of the POD’s normal flow to if unable to safely take the medicine and to encourage rapid movement through the POD

13. Where will PODs be located?
POD locations must be:
Appropriate in size and layout
Able to be secured
Accessible by all
Identify a facility large or area of hospital large enough to handle the population and maintain rapid movement
Security is important to protect supplies and control the large number of people as well as secure entry and exit into and out of the building
Convenient location to ensure easy access
Community POD – parking, public transportation, good road access, wheel chair accessible
Hospital – convenient for employees

14. How will a POD be staffed?
It takes many people to run a POD
Number and mix of skills needed will depends on situation
Source of staff
Public health and hospital staff members
Other first responders
Volunteers
First responders that will be involved in POD operations include police officers, fire fighters, emergency medical services personnel and health care personnel.
PODs will be staffed by a diverse group of people representing all ages, races, occupations, and skills.

15. POD Management

16. How will POD operations be managed?
Using the Incident Command System which is part of the National Incident Management System (NIMS).
In compliance with:
with good emergency response practice
federal requirements
Time and crisis tested
It takes getting used to.
Started with the Fire Service

17. What is the National Incident Management System?
A core set of doctrines, principles, terminology, and organizational processes
Developed by the US Department of Homeland Security
For planning and response to any emergency on the local, regional, state and national levels

18. What is the Incident Command System?
A management model for command, control and coordination of an organization’s emergency response activities
Applies to management of facilities, equipment, personnel, procedures, and communications

19. Incident Command Leadership
In the hospital setting you will also have a medical technical specialist as part of the incident command staff.

20. POD Operations Section Organizational Structure
Operations Section Chief
POD Operations
Section
Organizational
Structure
Triage Unit Leader
Floater/Greeter Unit Leader
Security Task Force 1
(Interior)
Forms Distribution Unit Leader
Pharmacy Unit Leader
Security Task Force 2
(Exterior)
Video Orientation Unit Leader (as required)
Vaccine/Prophy Abx Unit Leader
May need to have each role performed. May not have a separate person for each role depending on situation.
USE U PDATED ORG CHART FROM TOOLKIT
Interior Clinic Traffic Control Unit
Child Care Unit Leader
Exit/Evaluation Unit Leader
EMS/Transfer Unit Leader

21. ICS essentials for POD workers
You will be assigned a role with a limited and specific set of tasks to perform
You will report to one and only one supervisor
As a POD supervisor, you will have a limited number of people reporting to you (span of control 3-7)

22. Incident Command Essentials for POD workers
Incident Commander is the boss
All POD activities are designed to meet the objectives set by the Incident Commander
Effective communication is key

23. Successful communication is key
Do not use jargon or acronyms
Only the Public Information Officer may speak with the media
Follow your supervisor’s guidance on communication with friends and family
Report rumors directly to your supervisor
Know how to use any communication equipment assigned to you
Report problems and rumors directly to your supervisor.
Because POD workers will have many different professional backgrounds use only plain talk. Do not use jargon or acronyms.
Only the Public Information Officer is authorized to speak with the media. This is to ensure that one clear message is communicated. A POD worker who is approached by a member of the media should refer him/her to the PIO.
Follow your supervisor’s guidance on communication with friends and family.
Be sure you know how to use any communication equipment assigned to you.
If someone approaches you with a request for information, pass him/her to the PIO

24. POD roles and responsibilities
Now we shall discuss the roles and responsibilities of POD workers.

25. How Will You Know When and Where to Respond?
If you are needed, you will be:
contacted by a designated person in health department
given specific information about where and when to report
On site, you will report to the staff sign-in area where you will be given an assignment

26. How Long Will You Be Working in the POD?
Shifts are usually 8-12 hours
The POD will be in operation until the mission has been achieved
A POD will be in operation until completion of prophylaxis for the MDA

27. What Should You Bring ? Bring as little as possible Bring
Photo identification – required
POD Go Pak
Specific equipment, as requested – e.g. stethoscope
Food will be provided to you while you work at the POD
There will not be much room to store personal items
A Go Pack (prepared in advance) contains…

28. How Will You Know What to Do When You Arrive at the POD?
Job Action Sheet
Just-in-time training
You will first be assigned a specific job
The job action sheet will describe your responsibilities
You will receive just-in-time training before you begin your shift

29. Job Action Sheet Job title Job mission To whom you report
Tasks to perform

30. Just-in-time Training
The training delivered at the time of an incident
Focused on providing the knowledge and skills you need to fill your role -
JITT for short

31. How Will You be Assigned a Role?
Incident Commander or designee will assign a role based on
Your skills
Needs of the operation
You may be re-assigned as the needs of the operation change
Roles are not an assessment of your skills
Give examples ( a nurse may work in medical screening or greeting)

32. POD roles The jobs required to run a POD are many and varied.
All roles are important to the success of the POD.
Volunteers can provide essential services both in a medical and non-medical capacity.
Professional public health staff will be present to provide the expertise and skills to support clinic functions.

33. How Will You be Protected?
All appropriate precautions will be taken to protect POD workers.
Vaccination or medication being dispensed before the POD opens
Supply and training on appropriate personal protective equipment
Safety officer always present
Facilities for food & rest
- Personal protective equipment includes gowns, gloves, mask, goggles

34. Dealing with stress Working at a POD may be stressful
Monitor self and others for signs of stress and fatigue
POD attendees and co-workers may vent anger - don’t take it personally
Mental health workers will be available on site
Report any serious problems to your supervisor.

35. What are signs of stress and fatigue?
Lack of concentration
Increased number of non-critical errors
Critical errors
Irritability
Worry
Feeling ill
In yourself and fellow POD workers signs of stress and fatigue might include the following…

36. What Are Ethical Guidelines for Working in a POD?
Treat members of the public with fairness
and respect
Courtesy
Confidentiality
No favoritism or discrimination
Don’t spread rumors
Honor your commitment to work at a POD until the mission is complete
Your fellow staff members and the public
are relying on you.

37. What Do You Do When It's Time to Leave?
Your supervisor will tell you when your shift is complete
When leaving your supervisor may ask you to:
brief him/her
turn in a report or equipment
Always check out at the staff desk any time you leave a POD

38. What Do You Do When It's Time to Leave?
Your supervisor will tell you when the mission is complete and your service is no longer needed
You will be asked to participate in a debriefing called a ‘hot wash’

39. What liability protection am I afforded?
Health department employee
Hospital employee
Volunteer
Licensed medical professional
Member of MRC or other organization

40. Where Can You Get Additional Training?
Wayne/Hamilton County Health Department
CT offers training for POD workers

41. Conclusion
A POD is established to dispense a vaccine, antibiotic or other medication quickly to a large group of people usually to prevent disease.
The clinic flow is intended to maximize movement through the POD.
PODs are managed using the Incident Command System.
Imperative of acting quickly and accurately

42. Conclusion
Each POD worker will be assigned a specific role which will be described in a Job Action Sheet.
Safety of POD workers is paramount.
Plan and train now to be an effective POD worker.