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Bioterrorism Workbook and Decision Support: The Pittsburgh Matrix

Bioterrorism Workbook and Decision Support: The Pittsburgh Matrix. Michael Allswede, D.O. Section Chief Special Emergency Medical Response University of Pittsburgh Medical Center Health System. Pittsburgh Matrix.

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Bioterrorism Workbook and Decision Support: The Pittsburgh Matrix

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  1. Bioterrorism Workbook and Decision Support: The Pittsburgh Matrix Michael Allswede, D.O. Section Chief Special Emergency Medical Response University of Pittsburgh Medical Center Health System

  2. Pittsburgh Matrix • Provide a decision support tool for hospitals and hospital systems preparing for or responding to bioterrorism events • Provide a method of determining value for bioterrorism capability • Guide funding for hospital capability development

  3. Pittsburgh Matrix: Stratification of Tasks

  4. The Pittsburgh Matrix:Medical Decision-Making Allswede, MP, Watson SJ., AHRQ Partnership for Quality, 2002

  5. Pathogen Rating • Communicability/Quarantine Needs • 0: Non-communicable/No Quarantine Example: Bot Toxin • 1: Blood and Body Fluid/Universal Precautions Example: HIV Virus • 2: Close Contact/Universal Precautions Example: Ebola Virus • 3: Airborne/HEPA Filtration Example: Variola Virus • Effectiveness of Medical Treatment • 0: Comfort Measures Only Needed Example: Salmonella • 1: Highly Effective-Survival Probable Example: Skin Anthrax • 2: Improved Survival-Survival Improved Example: Yersinia Pestis • 3. Ineffective-Survival Not Improved Example: Variola Virus • Availability of Medical Treatment • 0: Non-Pharmaceutical Treatment Example: Clear Liquid Diet • 1: Multiple Available Pharmaceuticals Example: Ames Strains • 2: Insufficient Local Supply Pharmaceutical Example: Bot Antitoxin • 3: Obscure or Experimental Pharmaceuticals Example: Variola Vaccine Allswede, MP, Watson SJ., AHRQ Partnership for Quality, 2002

  6. Effects of Preparedness Better Technology System Preparedness Allswede, MP, Watson SJ., AHRQ Partnership for Quality, 2002

  7. Anthrax Aerosol Note: Numbers represent pathogen scores (Percentages) represent estimated mortality rates Allswede, MP, Watson SJ., AHRQ Partnership for Quality, 2002 Allswede, MP, Watson SJ., AHRQ Partnership for Quality, 2002

  8. Variola Note: Numbers represent pathogen scores (Percentages) represent estimated mortality rates Allswede, MP, Watson SJ., AHRQ Partnership for Quality, 2002

  9. Decision Support Tool • Each Medical Asset can determine capacity levels based on daily census, surge disaster planning, and community outreach • Timeline will be evident so a given box can be accessed • Each box has Key Decisions and Key Resources enumerated in a logical response hierarchy

  10. Resource Valuation • Key Resources (capabilities) within each matrix box are accounted using UPMC Health System data • Survivorship estimates yield value in dollars/lives saved for each matrix Key Resource

  11. Pittsburgh Matrix: Work to do • Complete methodological workbook for other medical facilities to follow • Estimation of probability of a given attack occurrence • EX: World events change the threshold and likelihood of each given attack • Estimation of detection capability of a given attack • EX: Syndromic detection is better for larger scale events

  12. For More Information AHRQ-sponsored Workbook for Regional Bioterrorism Preparedness A collaborative effort between Research Triangle Institute, UPMC Health Systems, and Intermountain Health Care Available: September 30, 2003 Contact: Lucy Savitz at savitz@rti.org

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