All items with an asterisk (*) are required for submission.
* Name:
* Position:
* Pick facility from list below
Other facility, if not listed above:
RESOURCES REQUIRED
The general public’s and health care communities’ education and acceptance of the concept and need for altered standards of care during a large-scale disaster response.
Adequate staffing to support response efforts (physicians, nurses, technicians, support staff, supplies, and equipment).
Mechanism to implement an altered standard of care. This should include ways to rapidly "step down" suitable patients (e.g., from ICU to floor and from floor to elsewhere)
Mechanism within hospitals that place hospitalists into "real-time" roles that enable them to allocate and ration resources and to serve as advisors to and outreach arms of Incident Command.
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. Develop and disseminate an alternate standard-of-care policy for use during a disaster situation. Include in-hospital triage for alternate levels of care, early transfer to lower levels of care, and early discharge.
* 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. Convene ethics panel as necessary.
* 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?
3. Educate appropriate staff about the alternate standard of care policy.
* 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?
4. Ensure that hospitalists are incorporated into the disaster response of each hospital to address issues related to effective preparedness and response.
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?
