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AD HOC INFRASTRUCTURE

AD HOC INFRASTRUCTURE. [ENTER FACILITATOR’S NAME AND CONTACT INFORMATION]. Developed by Troutman Sanders LLP Developed for the Virginia Department of Health Funded by Centers for Disease Control and Prevention. Toolkit Presentations Instructions for Use.

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AD HOC INFRASTRUCTURE

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  1. AD HOC INFRASTRUCTURE [ENTER FACILITATOR’S NAME AND CONTACT INFORMATION] Developed by Troutman Sanders LLP Developed for the Virginia Department of Health Funded by Centers for Disease Control and Prevention

  2. Toolkit Presentations Instructions for Use • Toolkit Presentations are intended to be a companion to the HospitalImplementation Guide and should not be used in isolation. • The Presentations are intended to serve as a starting point for the facilitator. The facilitator should thoroughly review the Presentation prior to use in Implementation Team, CRAG or Subcommittee meetings and customize the Presentation to meet the unique needs of the meeting participants. • Pay particular to attention to the information provided in brackets ([ ]), which must be completed by the facilitator prior to use. • Included in the “Notes” section of each slide are the following types of information: • Slide Type, which indicates whether the slide is for information or discussion, serves as a placeholder, or is some combination thereof • Planning Guide Section(s), which will direct the facilitator to the corresponding sections of the Planning Guide and HospitalImplementation Guide for further information • Special Instructions, which provides directions for the facilitator to customize the slide for the intended audience • Speaker’s Notes, which provides more detailed information to supplement the material on the slide • Refer to the Hospital Implementation Guide for further guidance and helpful hints on effectively completing the process described in the Planning Guide.

  3. CRAG Members • [Enter names and departments of each CRAG member]

  4. Add slides from Altered Standards Overview and/or Chapter 1 presentation, as needed, to re-introduce the CRAG to the concept of altered standards and critical resource shortage response planning, especially if new members are involved.

  5. Introduction

  6. Why do we need an ad hoc infrastructure? • During an event, resources will become scarce for which you have no Protocol • Planning Unit will need to quickly develop Protocols in the midst of the event to respond to these shortages • Developing an infrastructure for this intra-event planning mechanism is crucial to an effective response

  7. Chapter Overview • Determine how the Planning Unit will decide when the development of an Ad Hoc Protocol is required • Develop the process by which an Ad Hoc Protocol will be created in the midst of a disaster • Develop a standard mechanism for communicating the creation, implementation, and operationalization of Ad Hoc Protocols

  8. WHEN IS DEVELOPMENT OF AN AD HOC PROTOCOL REQUIRED?

  9. Development of a CRSE CRSE Normal Demand for the Resource Supply of the Resource

  10. Potential CRSE Alert CRSE Normal Who will identify the declining supply of the resource? Demand for the Resource Supply of the Resource

  11. Ad Hoc Protocol Development CRSE Normal Who will identify the need to develop an Ad Hoc Protocol? Demand for the Resource Supply of the Resource

  12. Identifying a Critical Resource Shortage DURATION For how long will demand exceed supply? STATUS Does demand exceed supply? MITIGATION Options for obtaining additional supplies of the resource. FORECAST When will demand exceed supply if it doesn’t already? MAGNITUDE To what extent does or will demand exceed supply?

  13. AD HOC PROTOCOL DEVELOPMENT PROCESS

  14. Identifying Need for Ad Hoc Protocol [____] reports a shortage to Incident Command Incident Command activates/notifies Critical Resource Advisory Group (CRAG) CRAG determines if an Ad Hoc Protocol is necessary by answering the following questions: MITIGATION Options for obtaining additional supply of the resource. STATUS Does demand exceed supply? FORECAST When will demand exceed supply if it doesn’t already? DURATION For how long will demand exceed supply? MAGNITUDE To what extent does/ will demand exceed supply?

  15. Developing the Ad Hoc Protocol Once the CRAG has determined that an Ad Hoc Protocol needs to be developed: CRAG activates an Ad Hoc Protocol Development Subcommittee Ad Hoc Protocol Development Subcommittee is formed Subcommittee develops Protocol Protocol is presented to CRAG/Incident Commander for review and approval Incident Commander activates Protocol when appropriate

  16. Identifying Need for Ad Hoc Protocol Shortage is identified and assessed by [_______] DURATION For how long will demand exceed supply? MAGNITUDE To what extent does or will demand exceed supply? MITIGATION Options for obtaining additional supply of the resource. STATUS Does demand exceed supply? FORECAST When will demand exceed supply if it doesn’t already? [______] provides information to Incident Command Incident Command determines there is no need to respond at this time Incident Command activates a Subcommittee to develop Ad Hoc Protocol Incident Command provides simple directive for responding to CRSE

  17. Developing the Protocol Once Incident Command has activated a Subcommittee to develop an Ad Hoc Protocol the following process will occur: Incident Command provides instructions to Ad Hoc Protocol Development Subcommittee Subcommittee develops Ad Hoc Protocol Subcommittee presents Ad Hoc Protocol to Incident Command for review and approval Incident Commander activates Ad Hoc Protocol when appropriate

  18. Ad Hoc Protocol Development Subcommittees • Liaison from Incident Command • Physicians, nurses, and other clinical personnel who are: • most knowledgeable about the resource • representative of the end user(s) • “Pre-trained” individuals • Facilitator • Ethics representative

  19. Instructions for Subcommittees • No more than X hours to develop algorithm • Don’t forget your ethical framework • Don’t forget your operational infrastructure – the Protocol needs to be easy to implement • Consider modifications to stretch resource first • Consider allocation criteria (inclusion, exclusion, prioritization)

  20. Instructions for Subcommittees • Consider multiple tiers based on severity of shortage • Consider “essential documentation” for the Protocol • Identify any just-in-time training that will be required • Develop process for revising Protocols • Consider metrics for determining when the CRSE has ended and the process for communicating this to the staff • Consider how to communicate all aspects of the final Protocol to various audiences

  21. DEVELOP AN EFFECTIVE WAY TO COMMUNICATE THE AD HOC PROTOCOL

  22. Potential Audiences

  23. Ad Hoc Protocol activated Ad Hoc Protocol created Ad Hoc Protocol training required Ad Hoc Protocol terminated Ad Hoc Protocol content Possible Messages

  24. Communication Methods

  25. What message(s) will you communicate to each audience and how will you do this?

  26. Questions?

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