Clinic Disaster Clinic Disaster PreparednessPreparedness

Questionnaire Results:Questionnaire Results:February & August 2006February & August 2006

February 2006 & August 2006 ResultsPresented by: Susan Cheng, MPH, PhDc

Emergency Operations Plan Development Training WorkshopApril 11th and 12th, 2007

Sacramento, CA

Native American Alliance for Emergency Prep (NAEEP)

A collaboration to increase capacity among health care providers across California’s Indian Country to respond appropriately to natural and man-made disasters and health emergencies

Original Partnership between: CA Area Office Indian Health Service Indian Health Council San Diego State University County of San Diego Health and

Human Services Agency

NAAEP History (2003-2004)

Year 1 (2003): Development of health provider training workshops focused on Terrorism Preparedness (bio/chem/rad)

Year 2 (2004): Development of tabletop exercise for health providers previously attended terrorism preparedness training workshops

NAAEP (2005-2006)

Year 3 (2005): Development of Emergency Operations Plan Template

for clinics and implement all-hazards plan development training workshop

Final terrorism-preparedness workshop

Year 4 (2006): Continued all-hazards training Formed inter-agency collaboration Implemented clinic disaster

preparedness questionnaire (winter & summer 2006)

Multi-agency Collaboration

New collaboration formed to better serve all Indian Health Clinics:

CA Indian Health Service CA DHS Indian Health Program CA DHS Emergency Preparedness Office CA Governor’s Office of Emergency Services CA Governor’s Office of Homeland Security Native American Alliance Emergency Preparedness

Clinic Disaster Preparedness Questionnaire

Clinic Disaster Preparedness Questionnaire

Winter 2006: Baseline implemented (Q1) Originally IHS questionnaire with 52 questions

Summer 2006: Follow-up implemented (Q2) Added questions regarding accreditation and

access/utilization of resources (website, technical assistance)

Summer 2007: Follow-up planned (Q3)

Results: Baseline (Winter ’06)

Most clinics have emergency plan (>90%) Participated in annual drill Worked with local entities to coordinate planning

Few clinics have completed hazard vulnerability assessment

Few clinics have procedures/policies, training, facilities, equipment, or supplies for biological or chemical event

Overall better prepared for natural rather than intentional disaster

Results: Follow-up (Summer ’06)

Major improvements from baseline in:

Provisions for vulnerable populations in plan

Ability to increase capacity by 10% & 30%

Communications systems (T-3 internet & amateur radios available)

Satellite based tutorials for training

Results: Follow-up (bio/chem)

Better prepared for bio/chem event

Infectious disease/syndromic surveillance

Testing for bio/chem agent

Mass prophylaxis plan Enough prophylaxis for all staff

Inclusion in Strategic National Stockpile

N95 masks available and fit-tested for staff

Results: Follow-up (goals)

Following specific goals for 2005 – 2006 project year also improved:

California Health Alert Network (CAHAN) participation

Staff trained in Incident Command System (ICS)

Staff assigned to specific roles in ICS

Results: Follow-up (priority)

Priority Settings (Follow-up vs. baseline):

Clinics downgraded planning and preparedness tools and communications from higher priority to lower priority

Potentially project activities (workshop and T/A) helped address these topics

Most clinics still rank “supplies” as a high priority

Results: Follow-up (bio/chem)

Still need to improve preparation for bio/chem outbreak or event:

Isolating segments of facility

Surveillance for outbreak

N95 masks and staff fit-tested

Staff training on bio/chem/rad prep and contaminant ID

Results: Follow-up (coll./part.)

Collaboration and Partnerships

Inclusion in local hospital plan

Evidence collection procedure with law enforcement

Inclusion in strategic national stockpile

Comm. plan w/local media, public health, & tribal reps

Participation in CAHAN

Provisions for accessing supplies from others

Results: Follow-up (surge)

Surge Capacity & Staffing

Personnel recall policy in place

Plan to expand operational capacity

Staff trained and assigned role in ICS

Results: Comparisons

NAAEP workshop attendee clinics were overall better prepared for an emergency than non-attendee clinics

Clinics who visited the NAAEP website (http://www.naaep.org) were better prepared for an emergency than clinics who had not visited the website

Clinics with current accreditation were better prepared for an emergency than clinics without current accreditation

Clinics with past accreditation also better prepared for an emergency than clinics without past accreditation

Results: Technical Assistance

Based on the questionnaire results, select Indian Health Clinics were identified to receive on-site technical assistance (by Calvin Freeman & Barbara Aragon)

Clinics chosen to receive technical assistance were less prepared overall for an emergency compared to clinics not chosen for T/A on the baseline (winter) questionnaire

However, after receiving T/A, those clinics chosen & receiving of T/A were just as prepared as clinics who had not been chosen and had not received T/A

Therefore, the T/A successfully closed the gap between the vulnerable clinics and all other clinics

Follow-up (Q3) planned Summer ‘07

Minor revisions to questionnaire in progress New questionnaire will be implemented June 2007

Available online and electronically by email Can complete by hand and mail or fax back Can complete electronically and email back Can complete online and submit online

Previous follow-up results will be available for clinics for their convenience/reference

Follow-up (Q3): Why is this important?

Continued participation important for: Preparedness surveillance Priority/funding setting Identify clinics for technical assistance Advise project staff on workshop content

and emphasis

Acknowledgements

Big, Big Thanks!!

All California Indian Health Clinics

Inter-Agency Partners

NAAEP Staff

NAEEP Websitehttp://www.naaep.org

Bio/Chem/Rad Terrorism Prep.Workshop presentationsSelf-guided tutorialsInteractive tutorialsTesting Question Bank

Disaster plan resources Emergency Op. Plan TemplateWorkshop Manual FilesPandemic/Avian Flu Prep (new)

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