1. Surge Capacity and Preparing the Workforce Michael Allswede, D.O. Associate Professor of Emergency Medicine Section Chief, Special Emergency Medical Response Department of Emergency Medicine University of Pittsburgh Medical Center Health System Pittsburgh, PA

2. Non-Contiguous Training Overview n The Non-Contiguous Training Concept is a method of planning and training the acquisition of WMD related skills n The ability to train during down-time or other hours will prove to: l Improve skill level of the staff l Cost less than standard drills n Tracking skill deficits in key personnel will improve the safety of the system

3. Non-Contiguous Objectives n Disseminate individual knowledge and skills prior to the drill n Train on objectives, not “time-based” CME/CEU n Drill for integration and for “macro” organization n Leadership training: l Must be dynamic “war game” l Model on “Sim-City”

4. Disaster Interactions n WMD events cause “triage inversion” l Least injured present first l Most injured remain for extrication l Contaminated victims precede scene information n WMD events contaminate hospitals unless hospitals are protected l Hospital personnel were among victims in Tokyo Sarin n Hospitals and providers are “non-renewable” in the short term

5. Navy ATEAMS n Afloat Training Exercise and Management System (ATEAMS) n Allows skill acquisition and maintenance to be on-going n Drills are for system evaluation, not skill acquisition n Assigns skills by duty station USS Carl Vinson

6. The Problem with Disaster Drills n Hospitals cannot stop their normal function to play in a drill l Disaster drills are pre-announced l Community drills scheduled at the convenience of community services…in the morning l Morning is busy time for hospitals u Disasters happen at night when staffing levels are thinnest

7. The Problem with Disaster Drills n Shifting extra personnel is expensive l $3,000 per hour at UPMC for ED personnel l Extra non-clinical personnel? l Extra administrative personnel? l Victim Volunteers? l EMS-Medical Command-Civic Services? u $16 Million for TOPOFF II

8. The Problem with Disaster Drills n Training a shift at a time is inefficient l 1 shift equals: u 8% of total nurses u 5% of total attendings u 0% of residents and house staff l Experienced people AVOID disaster drills l Moulage is never the real thing

9. Familiarize n Classic classroom teaching n Distance learning n Video interface n Memory enhancement tools RaPiD-T Training, City of Pittsburgh EMS, 2002

10. Acquire Skills n Virtual interface n Training room n Video demonstration n Self-learning UPMC Disaster Drill 2002

11. Practice Skills n Announced drills n Group drills n Segmented testing n Simulation TOPOFF II, Chemical Weapons Site, Chicago IL

12. Validation n Large drills n Actual events TOPOFF II Tech Rescue Site, Chicago IL

13. For More Information: Contact: Lucy Savitz, Ph.D., M.B.A. at savitz@rti.org savitz@rti.org