Surge Capacity and Preparing the Workforce

1
Surge Capacity and Preparing the Workforce

• Michael Allswede, D.O.
• Associate Professor of Emergency Medicine
• Section Chief, Special Emergency Medical Response
• Department of Emergency Medicine
• University of Pittsburgh Medical Center Health
  System
• Pittsburgh, PA

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Non-Contiguous Training Overview

• The Non-Contiguous Training Concept is a method
  of planning and training the acquisition of WMD
  related skills
• The ability to train during down-time or other
  hours will prove to
• Improve skill level of the staff
• Cost less than standard drills
• Tracking skill deficits in key personnel will
  improve the safety of the system

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Non-Contiguous Objectives

• Disseminate individual knowledge and skills prior
  to the drill
• Train on objectives, not time-based CME/CEU
• Drill for integration and for macro
  organization
• Leadership training
• Must be dynamic war game
• Model on Sim-City

4
Disaster Interactions

• WMD events cause triage inversion
• Least injured present first
• Most injured remain for extrication
• Contaminated victims precede scene information
• WMD events contaminate hospitals unless hospitals
  are protected
• Hospital personnel were among victims in Tokyo
  Sarin
• Hospitals and providers are non-renewable in
  the short term

5
Navy ATEAMS

• Afloat Training Exercise and Management System
  (ATEAMS)
• Allows skill acquisition and maintenance to be
  on-going
• Drills are for system evaluation, not skill
  acquisition
• Assigns skills by duty station

USS Carl Vinson
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The Problem with Disaster Drills

• Hospitals cannot stop their normal function to
  play in a drill
• Disaster drills are pre-announced
• Community drills scheduled at the convenience of
  community servicesin the morning
• Morning is busy time for hospitals
• Disasters happen at night when staffing levels
  are thinnest

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The Problem with Disaster Drills

• Shifting extra personnel is expensive
• 3,000 per hour at UPMC for ED personnel
• Extra non-clinical personnel?
• Extra administrative personnel?
• Victim Volunteers?
• EMS-Medical Command-Civic Services?
• 16 Million for TOPOFF II

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The Problem with Disaster Drills

• Training a shift at a time is inefficient
• 1 shift equals
• 8 of total nurses
• 5 of total attendings
• 0 of residents and house staff
• Experienced people AVOID disaster drills
• Moulage is never the real thing

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Familiarize

• Classic classroom teaching
• Distance learning
• Video interface
• Memory enhancement tools

RaPiD-T Training, City of Pittsburgh EMS, 2002
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Acquire Skills

• Virtual interface
• Training room
• Video demonstration
• Self-learning

UPMC Disaster Drill 2002
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Practice Skills

• Announced drills
• Group drills
• Segmented testing
• Simulation

TOPOFF II, Chemical Weapons Site, Chicago IL
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Validation

• Large drills
• Actual events

TOPOFF II Tech Rescue Site, Chicago IL
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For More Information

• Contact
• Lucy Savitz, Ph.D., M.B.A. at savitz_at_rti.org