A primary use of models is to evaluate proposed or existing plans and designs. For example, how many people per hour can we vaccinate using this POD design? However, not all evaluation tools are mathematical models.
CDC has developed an Environmental Health Shelter Assessment Tool that can be used to evaluate a shelter (the kind used to house and feed people during or immediately after a disaster or an emergency. The tool is a checklist. Each item is some feature or attribute of the shelter that should be in place. For example, is there hot water? The items are grouped into areas such as facility, food, water, sleeping areas, sanitation, waste collection, medical care, child care, and companion animals.
Peyman Karimian, my research assistant, recently examined Master the Disaster, which was created by the Center for Public Health Preparedness, an Advanced Practice Center at the DeKalb County (Georgia) Board of Health. Peyman provided the following review:
The software is disaster designer software which creates real scenarios of disasters such as Anthrax, Botulism, Hurricane, Pandemic Flu, Plague, RDD (Radiological Dispersal Device) and Smallpox. The goal of the software is to provide real scenarios of disasters in order for people who are involved in emergency preparedness to do some exercise in case of any unforeseen disaster and with this software improve their ability to face real scenarios and be able to handle the situation in a systematic, controllable way. Each scenario has some sections and questions which provides discussion, problem solving and decision making for those who are involved in the exercise. Participants should play the assigned roles and positions and make step by step decisions based on the disaster scenario.
In each disaster, an outbreak of a disease is recognized by complaining of a person in the Emergency Department with similar symptoms of the disaster. For an instance in the Anthrax scenario a 55 year old male arrives in the emergency department of the hospital with symptoms of fatigue, fever, cough and chest pain. He started having short breath, blue nails and higher fever. Clinical tests confirmed Anthrax and more people are infected with the virus. The Software helps to handle the situation by asking questions about how and to who share information about the disaster, activation procedure and staffing plan, agency’s plan as well as federal agency’s plans. Mass Clinics are set up and different agencies are collaborating to handle the situation. The software is also a good exercise for those who are involved how to deal with issues such as mass panic, chaos erupts and media that interferes with hospital operations.
Solutions are also offered for each disaster and long term effects are also discussed. Long term effects are including medication effects, economic downturns, increasing unemployment and other social issues are also discussed. Also demobilization after the event, environmental surety of affected areas are also considered in the software.
Many jurisdictions are planning to setup and operate PODs out of convenient facilities such as schools. Patients come to the POD, and the staff there serve them. We have spent a lot of time developing our Clinic Planning Model Generator to model such PODs.
Karen McKinnis, at the Springfield-Greene County (Missouri) Health Department, has been developing and testing two other types of PODs. I thank her for sharing this information with me and allowing me to post it here.
The first type, a Private POD, uses a large room (like an auditorium) in which patients are instructed by a staff person who periodically gives instruction on how to complete the medical history form. After completing their forms, the patients leave through different color-coded doors that lead to different areas for dispensing different medications (like Tamiflu, Relenza, or NPIs). Families that need a combination of medications go another distinct dispensing area. The staff person repeats the talk periodically. (I would note that this is an interesting variant of a traditional POD that uses a batch education, almost like making patients watch smallpox education video at a mass vaccination clinic, and can be modeled in a similar way.)
The second type, a Group POD, is much more radical. In this case, the health department works with a business, a university, or some other organization with medical staff. The medical history forms are sent to the organization ahead of time. Their folks complete the forms and return them to the health department, who prepares the needed medication and sends it to the organization. The organization then dispenses the medication at their site by their medical staff.
When dispensing antibiotics, determining who should get which medication is an important question, but the rules can be confusing, and paper forms are not efficient.
Working closely with our partners at the Montgomery County, Maryland, Advanced Practice Center for Public Health Emergency Preparedness and Response, we have developed and released eMedCheck, an electronic medication screening form that can be run on a PDA.
The screening form determines who should receive Doxy, Cipro, or neither. The decision rules used in eMedCheck are identical to those in a medication screening form developed by the National Capital Region.
Instructions for downloading the software and installing it on your Palm PDA are included with the software.