All items with an asterisk (*) are required for submission. * Name: * Position: * Pick facility from list below Other facility, if not listed above: RESOURCES REQUIRED
There should be adequate medical, nursing, and support staff to provide initial triage, and to evaluate and stabilize 300 persons. Which of the above resources, if any, necessitated additional expenditures over those currently planned for your department?
Based on your experience implementing the template, what resources should be added to the "Required Resources" section?
Which of the above resources, if any, caused you the biggest concerns or problems? (Please explain.)
What were the most significant barriers you encountered related to the "Required Resources"?
ACTION STEPS
1. Implement and drill a hospital emergency incident command system. * Indicate your current progress in implementing this action step
Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
2. Instruct clinical staff about the unique aspects of blast-related injuries and care following an attack with a radiation dispersal device (RDD). * Indicate your current progress in implementing this action step Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
How many people were (or will be when the training is completed) involved in the training?
* How long do you estimate it took (or will take) to complete this training for your staff/personnel? * Was/Is the required training readily available? * How did you (will you) provide this training for all of your staff/personnel? * If commercial or publicly provided course, please identify:
** If 'Other,' please specify:
How much do you estimate you have spent (or will spend) on this training?
What types of additional resources were required to complete this training?
3. Establish an institutional lockdown process and drill on a regular basis; include radiation detection and decontamination of arriving patients. * Indicate your current progress in implementing this action step Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
4. Update the institutional call-down list and perform a functional call-down exercise. * Indicate your current progress in implementing this action step
Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
5. Identify surge staffing from employees with clinical training, but not currently tasked with clinical jobs. * Indicate your current progress in implementing this action step Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
6. Identify patient care supplies for a surge situation. * Indicate your current progress in implementing this action step
Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
7. Develop a regional Unified Command Structure that includes local emergency management and area hospitals. * Indicate your current progress in implementing this action step Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
8. Identify non-patient care areas that could be converted to expand bed surge capacity. * Indicate your current progress in implementing this action step Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
9. Establish and drill a procedure for early patient discharge to increase bed capacity. * Indicate your current progress in implementing this action step Please provide any additional comments or explanation that will help to explain your progress.
* How long did it take to implement this step? (If you have not completed this step, estimate how long it will take you to complete implementation.)
Please provide an estimate of the effort — # of people and # of actual person hours — required to complete this action step
Please provide an estimate of the cost of implementing this action step.
What types of additional resources were required to complete this action step?
What would you change about this action step?
What were the most significant barriers you encountered in implementing this action step?
| 
