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Emergency Preparedness: Working with at Risk Populations. Flu-like symptoms statistics for Lakewood site 2009. February 107 March 129 April 81 May 116 June 206 July 101. We are Sentinel providers required to report flu like symptoms to the CDC. H1N1 Taskforce – August 2009.
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Flu-like symptoms statistics for Lakewood site 2009 February 107 March 129 April 81 May 116 June 206 July 101 We are Sentinel providers required to report flu like symptoms to the CDC.
H1N1 Taskforce – August 2009 • Multi-Disciplinary team • Met once a week for 5 weeks with our CMO and nursing director • Trained Staff to train co-workers • Bilingual signage • H1N1 educational material developed depending on population’s literacy level.
H1N1 Taskforce (cont.) • Partnered with Ocean County Health Department and a sister FQHC • Distributed vital flu prevention information and handed out hand sanitizers via MMU • Deployed Mobile Medical Unit to serve as a triage area in the Lakewood site to accommodate patient overflow
Instituted H1N1 triage polices • Asked for patients with influenza-like illnesses to identify themselves upon arrival • RN assigned at each site at the security check-in point to triage patients and hand out symptoms forms • Patients with influenza-like illnesses were assigned to a different waiting room area • Encouraged staff to stay home if they had influenza-like symptoms- HR department tracked employee ILI and reviewed data with management, reallocated staff as needed. H1N1 Taskforce (cont.)
CMO and Director of Nursing attended NJ Pandemic influenza preparedness summit • CMO attended local DOH and school meetings on how to handle H1N1 • Attended Georgian Court University conference • CMO attended local Head Start Program and answered community questions • Participated in Ocean County BTAC with representatives from several agencies to follow a uniformed approach to deal with the pandemic. • Linked with local schools superintendent • Goal: to use Mobile Medical Unit to conduct mass vaccinations at school sites • In order to accommodate the overflow of patients • Met with local school and principals to tailor H1N1 administration plan to school needs Steps Taken
Steps Taken (cont.) • *GROUP EFFORT* • All staff was trained to recognize symptoms • Pre & post test • Jeopardy game with staff • Waiting room area designated as “sick” and “healthy” to prevent spread of H1N1 • Symptomatic patients were given a mask, assessed and discharged as clinically indicated. • Followed respiratory etiquette and hand hygiene • Bilingual signs with guidelines, sanitizers, and tissues • Ensured availability of appropriate Personal Protective Equipment (PPE).
H1N1: Role of the Call Center C A L L C E N T E R GOAL: “Alleviate” Patient Surge to our Health Center Sites General Public Calm the patient with “panic” calls Health Education Clinical Queries referred To RN’s Inquiries about of H1N1 disease Health Advice Inquiries about of availability of H1N1 Vaccines Info Request Infection Control measures Queries about Flu Vaccine and H1N1 vaccine Call Center representatives (Bilingual staff) fill out Flu Triage and Symptoms form and refer to Call Center RN for patient disposition Disease Management of H1N1, and risk factors Call Center RN’s followed the CDC outlined Triage Algorithm Due to the H1N1, our call volume increased approximately 25% on H1N1 related calls Calls with “flu-like” symptoms Home care Prompt referral for Doctor’s appointment based on symptoms presented Phone scripts were developed by CMO to answer H1N1 questions. Referral to ER when necessary
Preparation for vaccine arrival • Established as H1N1 Vaccine provider • Vaccinations shipped directly to site • Both sites were registered • Registered online at H1N1 vaccine system • Purchased a CDC approved vaccine storage unit (refrigerator). Connected to our 24 hour alarm monitoring company in regard to temperature oscillation.
Vaccine Arrival- October 2009 • Vaccines were immediately allocated for each of our sites including the MMU • Different LOT #’s were assigned according to specific site • Maintained detailed inventory and accountability of every vaccine (Nasal and inject able) used and on-hand • Developed log sheets to keep more effective track of inventory.
H1N1 Administration Plan • Group # 1 Registration Duties: • - Consent forms filled out • Review consent form • Properly filled out • DOB, address, mother’s name, guarantor, verify phone numbers • Refer patient to Clinical • 8- 10 people (bilingual) • Group # 5 • Help with breaks coverage • Make sure that each vaccinator has plenty of supplies • Group # 6 • Traffic Control • Assist with any function of event • Group # 2Clinical Duties: • Clinical eligibility, help fill Consent forms • Help Review questionnaires • Answer Medical questions • Refer patient to Vaccinators • 2 RNs (bilingual) • Group # 3Vaccine Administrators Duties: • - Administration of vaccines • Vaccine Administrators Sign forms • Give consent form to Group #4 • Each partnered up with a bilingual staff member • Group # 4Vaccinator Assistant Duties: • Fill out yellow cards with patients name and DOB • Give the VIS statement along with the yellow card • Keep Consent form on desk to file
Target population CDC defined high risk groups The Communities throughout New Jersey Opened to general public (after CDC guidelines were changed) Forms of advertisement Our website Our call center NJDHSS Website Radio- WOBM Word of mouth Partnered with local private doctors and hospitals Flyers distributed in strategic locations around the communities Local Libraries WIC office Schools Partnered with LPD to assist with security and safety
How we did….H1N1 Vaccine Administration Events • Date: # of Vaccines given Location: • 10-26 218 Spruce Street Lakewood (Mobile Medical Unit) • 10-28 270 Clifton School Lakewood (Mobile Medical Unit) • 11-04 300 Clifton School Lakewood (Mobile Medical Unit) • 11-05 100 Lakewood Square (Mobile medical unit) • 11-10 60 Long Beach Island (Mobile Medical Unit) • 11-10 685 Toms River Site (5 to 7) • 11-12 256 Lakewood Square (Mobile medical unit) • 11-14 1519 Lakewood site from 10 to 3 • 11-16 435 Oak Street School (Mobile medical unit) • 11-18 210 Ella Clark School • 11-19 565 Lakewood Town Square (Mobile medical unit) • 11-20 617 Toms River Site 2-7 pm • 11-21 701 Lakewood site from 10 to 3 • 11-23 504 Bais Faiga Girls School Lakewood (Mobile medical unit) • 11-24 985 Lakewood Site 5-8 p.m. • 12-19 0 (cancelled due to inclement weather) • 12-22 485 Lakewood Site 5- 8 p.m. To date OHI has administered approximately 13,000 H1N1 Vaccines
Where did the patients come from? Ocean Passaic Bergen Sussex Middlesex Atlantic Burlington Monmouth Camden New York Pennsylvania Ocean County
Our Staff- Joined efforts We used hand held radios for communication this ensured a smooth flow throughout the event All departments worked together for one cause Security helped with crowd control in and out of sites
Pictures of events Lakewood Town Square 11/19/09 Servicing our Orthodox Community 565 total Our Lakewood site 11/14/09 Servicing our Community 1519 total
Feedback from those receiving vaccines • “This is was an excellent experience” • “Excellent staff and customer service” “You did an awesome job” • “The wait was minimal, thank you” • “Thank you for your efforts to help our community, you are truly appreciated” • “Very • organized”
Compliments: All departments were allowed to participate-H1N1 employee task force Team Building Exercise It was very organized Employee family a priority It seemed flawless Great team effort Minimal wait time We were able to reach out to our community Enjoyed working with everyone Open access for everyone who needed vaccine Recommendations: Additional mobile sites Documentation on consent was correct More H1N1 events More Patient education regarding preparedness for emergency situations More Call center staff available to answer calls regarding event On site data entry available during event, instead of after Continue outreach with vaccination programs Staff Feedback
A special thanks… to all our staff… Theresa Berger, Chief Executive OfficerDr. Carmen Mallamaci, Chief Medical OfficerBridget Hogan, Chief Operating OfficerPhil Silverman, Chief Financial OfficerVito Veneruso, Safety OfficerAmy Ramos, RN, Call Center ManagerEd Harvey, PAR ManagerHannah Maldony, Director of NursingLoida Lebron, Community Outreach Coordinator