Planning infrastructure
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PLANNING 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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PLANNING INFRASTRUCTURE

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Planning infrastructure

PLANNING 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

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.


Implementation team

Implementation Team

  • [Enter names and departments of each Implementation Team member]


Chapter overview

Chapter Overview

  • Identify the “Convener”

  • Establish an “Implementation Team”

  • Identify a resource to facilitate the planning activities

  • Determine the Planning Unit for key activities

  • Establish CRAGs for each Planning Unit

  • Set forth clear expectations for planning process


Planning infrastructure

  • Add slides from Altered Standards Overview presentation, as needed, to introduce the Implementation Team to the concept of altered standards and critical resource shortage response planning.


Introduction to planning guide

Introduction to Planning Guide


Background

Background

  • Hospitals have done extensive planning for disasters and public health emergencies

  • Planning for modifying the delivery of care or allocating specific resources and services has lagged behind other planning efforts

  • A comprehensive framework for dealing with shortages of critical resources was lacking

  • This is complex and requires a multi-disciplinary approach that combines input from many perspectives

    • Medical- Operational

    • Ethics- Public Health

    • Legal


Critical resource shortages planning guide contributors

Critical Resource Shortages Planning GuideContributors


Planning guide framework

Planning Guide Framework

Develop the critical resource shortage planning infrastructure

Conduct a Critical Resource Vulnerability Analysis

Develop an ethical framework

Develop an operational infrastructure

Identify or develop resource-specific Protocols

Create an ad hoc infrastructure

Engage in collaborative planning with other HMDOs

Determine how the CRSRP will be evaluated and maintained

Obtain approval of the CRSRP and integrate into relevant EOPs

Develop comprehensive communication plans for key audiences


Terms to know

Terms to Know

  • Allocation

  • Critical resource

  • Critical resource shortage event (CRSE)

  • Critical Resource Shortage Response Plan (CRSRP)

  • Disaster or emergency

  • EMS provider

  • Goal

  • Health and Medical Delivery Organization (HMDO)

  • Modification

  • Planning Unit

  • Protocols


Hospital implementation guide

Hospital Implementation Guide

  • “Teacher’s Edition” of the Planning Guide

  • Written for the Implementation Coordinator and Team

  • Chapter Overviews include:

    • Introduction

    • Responsibility

    • Goals for Chapter

  • Subsections include:

    • Planning Guide text

    • Goal

    • Rationale for inclusion in Planning Guide

    • Real World Examples

    • Action Items for conducting the activity

    • Helpful Hints for implementation

    • Implementation Aids


Implementation toolkit

Implementation Toolkit

  • Planning Guide

  • Hospital Implementation Guide

  • Project Management Tools and Resources

  • Meeting Facilitation and Consensus Building Tools and Resources

  • Other Helpful Resources


Planning infrastructure1

Planning Infrastructure


Planning infrastructure2

Planning Infrastructure

Convener

Implementation Team

Planning Unit

Planning Unit

Planning Unit

CRAG

CRAG

CRAG

Subcommittee

Subcommittee

Subcommittee

Subcommittee

Subcommittee

Subcommittee


Planning units

Planning Units

Region

Community

Health System

Hospital


Considerations for choosing a planning unit

Considerations for Choosing a Planning Unit

  • Size

  • Authority

  • Expertise

  • Existing relationships

  • Existing planning efforts


Considerations for choosing crag members

Considerations for Choosing CRAG Members

  • Skills and resources needed for assigned key activitiy(ies)

  • Represent a broad spectrum of disciplines

  • Strong combination of stakeholders


Expectations

Expectations

  • Roles of CRAG members

  • CRAG meeting logistics

  • Budget

    • Cost

    • Contributions from CRAG members

    • Other funding sources

  • Incentives for CRAG members


Key activities

Key Activities


Strong foundation

Education & Communication

Protocol

Protocol

Protocol

Protocol

Protocol

Protocol

Protocol

Protocol

Building the CRSRP

Strong Foundation

Ad Hoc

Operational Infrastructure

Ethical Framework


Critical resource vulnerability analysis

Critical Resource Vulnerability Analysis

  • Develop a list of critical resources

  • Prioritize the list of critical resources

  • Identify mechanisms for mitigating depletion of the resources

  • Determine which critical resources should be immediately considered for Protocol development

  • Revisit the CRVA at appropriate intervals


Which is the appropriate planning unit

Which is the appropriate Planning Unit?

Region

Community

Health System

Hospital


Who should be on the crag

Who should be on the CRAG?


Expectations1

Expectations

  • There will be [#] meetings for this CRAG.

  • The meetings will be held [dates] at [place].

  • [Name] will facilitate each meeting.

  • [$] will be budgeted to this group for expenses incurred.

  • Each member will be compensated [$].


Ethical framework

Ethical Framework

  • Identify ethical principles

  • Define the ethical Goal

  • Determine implementation specifications


Which is the appropriate planning unit1

Which is the appropriate Planning Unit?

Region

Community

Health System

Hospital


Who should be on the crag1

Who should be on the CRAG?


Expectations2

Expectations

  • There will be [#] meetings for this CRAG.

  • The meetings will be held [dates] at [place].

  • [Name] will facilitate each meeting.

  • [$] will be budgeted to this group for expenses incurred.

  • Each member will be compensated [$].


Operational infrastructure

Operational Infrastructure

  • Determine process for activation and termination of the CRSRP

  • Determine process for activation and termination of each Protocol

  • Develop structure for making resource allocation decisions

  • Develop infrastructure for reviewing and revising CRSRP during a CRSE

  • Define “essential documentation”


Operational infrastructure cont

Operational Infrastructure cont.

  • Develop process for responding to non-compliance

  • Identify resources for psychological and emotional support

  • Develop a communication plan

  • Develop strategy for providing palliative care during a critical resource shortage event

    • Determine goal

    • Develop standard definition

    • Identify mechanisms for providing palliative care


Which is the appropriate planning unit2

Which is the appropriate Planning Unit?

Region

Community

Health System

Hospital


Who should be on the crag2

Who should be on the CRAG?


Expectations3

Expectations

  • There will be [#] meetings for this CRAG.

  • The meetings will be held [dates] at [place].

  • [Name] will facilitate each meeting.

  • [$] will be budgeted to this group for expenses incurred.

  • Each member will be compensated [$].


Protocol development

Protocol Development

  • Identify existing surge plan

  • Identify any relevant Governmental Protocols

  • Develop Protocol

    • Determine modifications

    • Develop allocation algorithm

  • Develop an operational plan

    • Identify triage officer(s) and/or triage committee(s)

    • Identify information needed to finalize, revise, modify, or enhance the Protocol during a CRSE

    • Develop a mechanism for revising the Protocol during a CRSE

    • Determine when the Protocol will be activated

    • Determine how and when you will move between tiers of the Protocol

    • Determine when the Protocol will be terminated


Protocol development cont

Protocol Development cont.

  • Identify essential documentation

  • Coordinate with other Protocols

  • Memorialize Protocol in writing

  • Conduct training


Which is the appropriate planning unit3

Which is the appropriate Planning Unit?

Region

Community

Health System

Hospital


Who should be on the crag3

Who should be on the CRAG?


Expectations4

Expectations

  • There will be [#] meetings for this CRAG.

  • The meetings will be held [dates] at [place].

  • [Name] will facilitate each meeting.

  • [$] will be budgeted to this group for expenses incurred.

  • Each member will be compensated [$].


Ad hoc protocols

Ad Hoc Protocols

  • 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


Which is the appropriate planning unit4

Which is the appropriate Planning Unit?

Region

Community

Health System

Hospital


Who should be on the crag4

Who should be on the CRAG?


Expectations5

Expectations

  • There will be [#] meetings for this CRAG.

  • The meetings will be held [dates] at [place].

  • [Name] will facilitate each meeting.

  • [$] will be budgeted to this group for expenses incurred.

  • Each member will be compensated [$].


Coordination with hmdos

Coordination with HMDOs

  • Identify HMDOs for coordination

  • Create a communication strategy with other HMDOs

  • Understand how HMDOs’ responses to the CRSE will impact other HMDOs

  • Engage in discussions regarding changes to scope of services

    • Expansion of scope

    • Reduction of scope

  • Discuss cooperative initiatives with other HMDOs

  • Establish parameters regarding “essential documentation”


Which is the appropriate planning unit5

Which is the appropriate Planning Unit?

Region

Community

Health System

Hospital


Who should be on the crag5

Who should be on the CRAG?


Expectations6

Expectations

  • There will be [#] meetings for this CRAG.

  • The meetings will be held [dates] at [place].

  • [Name] will facilitate each meeting.

  • [$] will be budgeted to this group for expenses incurred.

  • Each member will be compensated [$].


Evaluation and maintenance

Evaluation and Maintenance


Which is the appropriate planning unit6

Which is the appropriate Planning Unit?

Region

Community

Health System

Hospital


Who should be on the crag6

Who should be on the CRAG?


Expectations7

Expectations

  • There will be [#] meetings for this CRAG.

  • The meetings will be held [dates] at [place].

  • [Name] will facilitate each meeting.

  • [$] will be budgeted to this group for expenses incurred.

  • Each member will be compensated [$].


Approval and integration

Approval and Integration


Which is the appropriate planning unit7

Which is the appropriate Planning Unit?

Region

Community

Health System

Hospital


Who should be on the crag7

Who should be on the CRAG?


Expectations8

Expectations

  • There will be [#] meetings for this CRAG.

  • The meetings will be held [dates] at [place].

  • [Name] will facilitate each meeting.

  • [$] will be budgeted to this group for expenses incurred.

  • Each member will be compensated [$].


Communication plans

Communication Plans

  • Develop a communication strategy tailored to providers

  • Develop a communication strategy tailored to patients

  • Develop a communication strategy tailored to partners of the hospital(s) in the Planning Unit

  • Develop a communication strategy tailored to the public

  • Develop a communication strategy tailored to the press

  • Develop a communication strategy tailored to politicians


Which is the appropriate planning unit8

Which is the appropriate Planning Unit?

Region

Community

Health System

Hospital


Who should be on the crag8

Who should be on the CRAG?


Expectations9

Expectations

  • There will be [#] meetings for this CRAG.

  • The meetings will be held [dates] at [place].

  • [Name] will facilitate each meeting.

  • [$] will be budgeted to this group for expenses incurred.

  • Each member will be compensated [$].


Questions

Questions?


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