| Preparedness |
- Identify strengths and/or gaps in EMP and EOP, including potential vulnerabilities found in infection prevention assessments
- Establish protocols as they relate to outbreak or emerging pathogen management
- Ensure adequate surveillance and detection of threats
- Participate and provide input into education and training of HCP
- Participate in HICS exercises and drills
- Provide input into resource and staffing needs
- Develop strategies for limited/constrained resources/surge capacity
- Provide input into occupational health considerations
- Provide input into policies for isolation and cohorting
- Input into application of laws/regulations
- Review “State Crisis Standards of Care”
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- Identify practices that could undergo change during a facility or emerging pathogen outbreak
- Create list of stakeholders
- Identify/recruit leaders/administrators and champions
- Create and convene implementation team
- Decide on common language for dissemination and implementation goals
- Obtain formal commitments for team members
- Establish how implementation team will meet and interact
- Conduct KAP survey(s) for review by implementation team
- Identify barriers to change and facilitators to change (e.g., language(s), how information accessed and accepted, stakeholders’ knowledge, attitudes, and practices (KAP), findings of needs assessments)
- Tailor interventions to adapt them to setting
- Work with implementation team on fostering empowerment
- Identify early adopters
- Obtain formal commitments for early adopters
- Identify approaches to dissemination (likely via HIMT and specifically PIO)
- Identify when/how scale up will occur
- Identify needs for technical assistance
- Identify needs for clinical supervision
- Train stakeholders: consider “train the trainer” strategies, develop and distribute educational materials, conduct dynamic and ongoing training and drills with stakeholders, simulate changes
- Obtain formal commitments for stakeholders
- Provide feedback to educational providers/trainers and participants
- Identify needs and methods for reminders/training refreshers for stakeholders
- Identify which changes will be mandated and how they will be monitored
- Develop resource sharing agreements
- Identify revisions to professional roles and clinician teams (e.g. Job Action Sheets)
- Conduct local consensus discussions
- Identify/develop methods for patient/family/visitor education
- Identify financial impacts, including potential contracts, enhancements, altered incentives/disincentives, fees
- Identify changes to infrastructure, including record systems, physical structure, equipment, service sites
- Assess liability considerations
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| Mitigation |
- Reinforce roles for HIMT
- Evaluate and recommend alternative management strategies based on suspected mode of transmission
- Advocate for resources
- Work with staff/HIMT to ensure adequate supplies, isolation rooms, RME, etc., and input into what may be needed from regional stockpile inventory
- Work with staff/HIMT in HCP training in PPE
- Manage HCP exposures
- Provide guidance for cleaning/disinfection of RME and environment
- Provide input into strategy for continuing activities
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- Refine approaches based on preparedness activities and knowledge of specific outbreak/crisis
- Remind stakeholders of roles and responsibilities
- Intervene with patients/family/visitors to enhance uptake and adherence
- Inform stakeholders, including opinion leaders, media, public (likely via HIMT and PIO)
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| Response |
- Fill designated role in HIMT (likely Medical-Technical Specialist)
- Identify/draft clinical guidance
- Adjust clinical support activities depending on mode of transmission
- Monitor incident for infection prevention implications
- Post-exposure management
- Input into adapting airflow for surge capacity
- Provide input into physical plant/waste management
- Provide input into post-mortem placement or storage
- Collaboration with communications staff/PIO in education of staff, public, media
- Consultation with risk management, ethics specialists, local and national public health as needed
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- Enact revised professional roles (JAS) and clinical teams
- Enact decided-on changes to infrastructure, staff, recordkeeping, finances, and site
- Keep stakeholders, including mass media, informed (via PIO)
- Provide technical assistance (likely via HIMT)
- Provide clinical supervision
- Capture and share local knowledge (via HIMT and/or implementation team)
- Facilitate relay of clinical data to providers (likely via HIMT)
- Provide reminders for stakeholders, including patients/families/visitors
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| Recovery |
- Identify infection prevention risks/vulnerabilities
- Provide input into collaborative strategies with regional partners for delivery of essential services, if needed
- Provide input into recovery priorities and immediate operating needs
- Input into revision of policies and procedures based on actions required during the response phase
- Input into when to shut down HICS and return to normal operations
- Collaboration with communications staff/PIO
- Input into how laws/regulations affected the response
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- Return to normal operations (roles, responsibilities, teams, infrastructure, site, etc.)
- Conduct audit of how changes were implemented and provide feedback
- Purposefully reexamine implementation plan
- Obtain and use stakeholder feedback (empowerment evaluation)
- Obtain and use feedback from patients/family/visitors
- Keep stakeholders, including media, informed of recovery (via PIO)
- Assess ongoing monitoring needs
- Assess potential research needs
- Assess funding needs and opportunities
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