columbia university center for public health preparedness
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Columbia University Center for Public Health Preparedness. Emergency Preparedness Core Competencies for ALL Public Health Workers. - PowerPoint PPT PresentationTRANSCRIPT
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Columbia UniversityCenter for Public Health Preparedness
Emergency Preparedness Core Competencies
for ALL Public Health Workers
The Columbia University Center for Public Health Preparedness is a joint project of the New York City Department of Health and the Mailman School of Public Health, in collaboration with the Center for Health Policy at the
Columbia University School of Nursing. The Center is funded by a Cooperative Agreement between the Centers for Disease Control and
Prevention and the Association of Schools of Public Health, Project # S1544-20/20.
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This presentation has been approved for ( ) contact hours of
continuing education credit through the
(insert the accreditation agency here)
Columbia University Center for Public Health Preparedness
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Thank you for coming today
Before we start….
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ABOUT YOUR FOLDER
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Pre-test Form
Columbia University Center for Public Health Preparedness
(Insert your Pre-Test form here)
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Pre-test Procedures
1. Test sheet & pencil
2. Complete the test
3. Pass completed tests forward
4. Retain your pencil
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Presentation Agenda
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Training Development Team
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Purpose of Training
Provide a basic understanding of the Core Competencies for Emergency Preparedness and Response for the [Public Health Worker]
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The Public Health System Process
• a continuous cycle of gathering information, deciding, acting, evaluating
• Public health is always evaluating the health of the community
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Public Health Preparedness for: Threats and Emergencies
7 Core Capacities
• Workforce
• Information Systems
• Communication
• Epidemiology/surveillance
• Laboratory
• Policy and Evaluation
• Preparedness and Response
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Workforce
The public health system maintains a public health workforce capable of delivering the Essential Public Health Services during routine and emergency operation
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Information Systems
Public Health Systems establish and maintain secure accessible information systems for rapid communication, analysis and interpretation of health data, and public access to health information.
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Communication
Public Health systems maintain communication mechanisms to:
• Routinely translate scientific and health information for communities and policy makers
• Provide timely, accurate public information and advice to policy makers during emergency events
• Coordinate logistical communication within the response community.
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Epidemiology/Surveillance
Public health systems monitor health events to identify changes or patterns and to investigate underlying causes and factors.
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Laboratory
Public health systems maintain the ability to produce timely and accurate laboratory results for diagnostic and investigative public health coverage.
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Policy and Evaluation
Public health systems use community assessment findings to establish priorities and improve the effectiveness of programs and policy decisions.
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Preparedness and Response
Public health systems maintain the ability to effectively detect and respond to public health threats and emergencies.
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In order to respond to any emergency/disaster, ALL public health
workers should be able to:
• IDENTIFY & LOCATE the emergency plan
• DESCRIBE the role of Public Health
• DESCRIBE the Chain of Command
• DESCRIBE & DEMONSTRATE one’s functional role
• RECOGNIZE deviations from the norm
• IDENTIFY limits to own authority
• DESCRIBE communication roles
• DEMONSTRATE use of communication equipment
• APPLY creative problem solving skills
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COMPETENCY
WHAT IS IT?
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COMPETENCY
A complex combination of knowledge, skills and abilities demonstrated by organization members that are critical to the effective and efficient function of the organization
(Center for Public Health Practice, Emory University)
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World Trade Center DisasterSeptember 11, 2001
Scene of Sept. 11, 2001 Plane Crashes into the NYC WTC, Source: CNN
Photo by Michael RiegerFEMA News Photo
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Definitions
• Emergency
• Disaster
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Emergency
“An emergency is a sudden occurrence demanding immediate action that may be due to epidemics, technological catastrophes, or strife [from] natural or man-made causes.”
(W.H.O)
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Disaster“A disaster is any occurrence that causes damage, ecological disruption, loss of human life or deterioration of health and health services on a scale sufficient to warrant an extraordinary response from outside the affected community areas.”
(W.H.O)
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Definitions: Disasters/Emergencies
• Man-Made (Human-Made)
• Natural
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Man-Made Disasters/Emergencies
“Situation which man clearly causes such as: wars, armed conflicts or civil strife…[including] technological disasters.” (Guha-Sapir, 2000)
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Examples of a RANGE of:
Man-Made (Human-Made) Disasters/Emergencies that have Public Health Implications
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Potential Emergencies/Disasters
Transportation Accidents
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Potential Emergencies/Disasters
Aviation
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Potential Emergencies/Disasters
Fire
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Potential Emergencies/Disasters
Hazardous Material Incident
Baltimore train carrying hazardous materialscatches fire July 17, 2001
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Potential Emergencies/Disasters
Biological and Chemical Terrorism
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Potential Emergencies/Disasters Outbreak
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Common Features of Large Scale Disasters/Emergencies
• Pose a threat to public health & safety
• May disrupt social and economic infrastructure
• May require large scale mobilization of local resources to manage consequences
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Natural Emergencies/Disasters
Results of …ecological disruptions exceeding the adjustment capacity of the affected community. They are generally of sudden onset and imply unforeseen, serious and immediate threats to public health.
(W.H.O.)
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Examples of a RANGE of Natural Disasters/Emergencies
with Public Health Implications
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Potential Emergencies/DisastersWinter Storms (Snow Emergency)
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Potential Emergencies/Disasters
A HEAT WAVE SIZZLES: THE NEIGHBORHOOD; Blackout Stops Trains and Electricity for 200,000
Source: The New York Times, 7/7/99
Utility DisruptionsHeat Emergency
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Potential Emergencies/Disasters Hurricane
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Potential Emergencies/Disasters
Nor’easter Coastal Flooding
Canal Street, November 1950
Fulton Fish Market, November 1950
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EMERGENCY PREPAREDNESS COMPETENCY
IDENTIFY and LOCATE your agency emergency response plan (or the pertinent portion of the plan)
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Do You Know Where the Emergency/Disaster Plan is for Your
Agency?
The plan should be:
• In an accessible location at work
• Reviewed by each employee on a regular basis
• Updated at least annually
• Practiced regularly
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First Steps to Emergency Preparedness
In order to be ready to respond to public emergencies you must develop, practice and maintain your own
1. Public Health Agency Emergency/Disaster Plan2. Personal Emergency/Disaster Plan3. Family Emergency/Disaster Plan
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EMERGENCY PREPAREDNESS COMPETENCY
DESCRIBE the public health role in emergency response in a range of emergencies that might arise.
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Core Functions of Public Health in America
• Prevent epidemics and spread of disease
• Protect against environmental hazards
• Prevent injuries
• Promote and encourage health behaviors
• Assure the quality and accessibility of health services
• Respond to disasters and assist communities in recovery
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The Role of the Local Public Health Agency in Emergency Response
• Collaborate with other agencies in policy decisions and actions
• Surveillance
• Investigation
• Public information
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The Role of the Local Public Health Agency in Emergency Response (cont’d)
• Medical provider information
• Reference laboratory support
• Public health interventions (e.g. mass vaccinations)
• Establish and staff shelters and assure the safety of the displaced
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Which Public Health Employees are Needed During Emergency or
Disaster Response?
• Some emergencies and disasters could require the mobilization of MOST or ALL public health employees.
• Therefore, ALL public health workers need to learn what their roles may be in these situations.
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Role of the State or Local Office of Emergency Management
(OEM)
Plans, monitors and coordinates all inter-agency activities for potential or actual emergency situations.
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Example of a Common Multi-level Scheme for Disaster Communication and Coordination
PRESIDENT FEMA
GOVERNOR’S OFFICE
Police
STATE OEM (or equivalent)
STATE DOH
HHSCDC
Office of LocalElected Official
LOCAL OEM(if applicable)
LOCAL DOH(if applicable)
Fire OtherState
Federal
City
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Example: NYCFederal, State and Local Coordination in DISASTERS
HHC
Voluntary Agencies(ARC, etc.)
NYPD
FEMA
STATE EMERGENCY MANAGEMENT OFFICE
State
Federal
City
FDNY-EMSVoluntary
Health Sector
MAYOR’SOFFICE
PRESIDENT HHS/CDC/VA etc.
NYC-DOH
NYS-DOHGOVERNOR’S
OFFICE
NYC OFFICE OF EMERGENCY MANAGEMENT
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Federal, State and Local Disaster Coordination for: (insert state or local community name here)
[Insert the appropriate coordination tree here]
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EMERGENCY PREPAREDNESS COMPETENCY
DESCRIBE the (YOUR AGENCY’S) chain of command in emergency response.
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Incident Command System
Incident Commander
Finance/Admin.Section
Information Officer
LogisticsSection
OperationsSection
PlanningSection
Safety Officer
Liaison Officer
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EXAMPLE: NYCDOH Disaster Command and Control
Health Commissioner Or Designee
City of New YorkMayor & OEM
Director
Incident-Specific Expert(s)
Division of HealthDeputy Commissioner
Public/Govt./LegalAffairs
Director or Designee
EOC
EOC LiaisonAdministrative Mgr.
Mayor’s Office of Emergency Management
EOC Coordinator
Senior ManagementManager
Chair or Desig.Sheltering
Chair or Desig.Epi/Surveillance
Chair or Desig.Operations
Chair or Desig.Med/Clinical
Chair or Desig.MIS
Chair or Desig.Environmental
Chair or Desig.Laboratory
New York City Department of Health Emergency Operations Center
Sen
ior-
Lev
el A
dvi
sors
/Co
nsu
ltan
ts, a
s n
eed
ed
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EXAMPLE: Epidemiology/SurveillanceRoles and Responsibilities in Emergency
Response
• Provide background info on emergency surveillance data
• Conduct field epidemiological investigations (prn)
• Monitor existing surveillance systems
• Establish new surveillance system- Assemble field teams - Establish databases
- Develop questionnaires/forms - Enter data
- Liaison with hospital/field personnel - Analyze data
- Collect data
- Develop recommendations for policy
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• Provide resources to facilitate others’ activities
EXAMPLE: OperationsRoles and Responsibilities in
Emergency Response
• Transportation
• Communication
• Facilities
• Security
• Personnel
• Printing
• Coordinate hotlines for public & providers
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• Prepare recommendations on clinical aspects of emergency-Public safety issues -Training of community MDs
-Occupational safety issues -Disinfection/decon issues
-Develop prevention & treatment message
• Establish and staff prophylaxis/treatment distribution centers
• Staff DOH clinics involved in emergency
• Liaison with OCME regarding mortuary issues
• Supplement clinical backup to school health program sheltering
activities
EXAMPLE:Medical/ClinicalRoles and Responsibilities in
Emergency Response
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Facilitate computing issues during emergencies
-Field to Headquarters data transmission
-Database management
-Mapping/GIS
EXAMPLE: Medical Information Systems (MIS)
Roles and Responsibilities in Emergency Response
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• Research specific topic
• Provide background information
• Prepare recommendations re:-Public health threat
-Sample collection
-Evacuation/reoccupation
• Collect samples
• Collaboration w/ FDNY Hazmat
EXAMPLE: EnvironmentalRoles and Responsibilities in
Emergency Response
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• Provide recommendations for specimen types and
handling
• Accept specimens for testing
• Ensure rapid transports to reference labs
• Perform testing
• Coordinate with epi/surveillance re: data entry
• Liaison with outside labs re: testing and data reporting
EXAMPLE: LaboratoriesRoles and Responsibilities in
Emergency Response
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“To work in cooperation with the ARC to ensure the staffing of shelter sites in response to OEM’s determination of a potential for an adverse weather event which may necessitate the activation of the shelter protocol”
School Health Program Shelter Protocol
EXAMPLE: ShelteringRoles and Responsibilities in
Emergency Response
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Incident Command Structure of: (insert YOUR state or local agency name here)
(Insert YOUR LOCAL Incident Command tree and specific department roles during emergency/response here)
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EMERGENCY PREPAREDNESS COMPETENCY
DESCRIBE your functional role(s) in emergency response
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Functional Roles of Public Health Workers in an Emergency/Disaster
• Your role may be the same or similar to what you do every day
or• Your role may be different from what
you usually do.
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Potential Functional Roles for thePublic Health
LEADER / ADMINISTRATOR
I. Agency Director: serve as Incident Commander; direct provision of a specific service
II. Division or Section Head: Communicate with the Liaison Officer; direct departmental operations; communicate with the Logistics Section Chief for procurement of supplies
III. Clinic Administrator: Coordinate departmental operations; monitor use of, need for and availability of resources.
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Potential Functional Roles for the Public Health (PH) PROFESSIONAL
I. PH Physician: communicate with medical providers; provide clinical expertise and consultation regarding bio-threats; develop clinical protocols
II. PH Nurse: administer immunizations and medications, staff shelters
III. Health Education Specialists: staff hotlines; develop special public information messages
IV. Environmentalists: monitor/test environment
V. Epidemiologist: coordinate local lab with CDC; conduct special investigations
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Potential Functional Roles for the Public Health
TECHNICAL AND CLERICAL SUPPORT STAFF
• Lab Technician: gather samples, staff the lab
• Environmental Worker: participate in cleanup or recovery
• Secretary: communicate with the field; maintain action logs
• Driver: deliver specimens or supplies
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EMERGENCY PREPAREDNESS COMPETENCY
RECOGNIZE deviations from the norm that might indicate an emergency, and…
DESCRIBE appropriate action (e.g. communicate clearly within the chain of command).
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Example:NYC West Nile Virus Outbreak
New York City Statistics
September 1999• 45 cases• 4 deaths Summer 2000• 14 cases • 1 death
August 2001• 2 cases
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Example: Recognize Deviations From The Norm
[Insert local examples here]
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EMERGENCY PREPAREDNESS COMPETENCY
• IDENTIFY limits to own knowledge/skills/authority and..
• IDENTIFY key system resources for referring matters that exceed these limits
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Some Examples
LIMITS TO OWN SKILLS OR AUTHORITY
• Communication with media
• Legal authority
• Supervision of others
• Allocation of resources
• Clinical skills or decision making
• Policy decision
KEY SYSTEM RESOURCES
• Agency chain of command
• Web resources
• Logistics Officer
• Policy and procedure manual
• Disaster plan / protocols
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Some Examples for a Public Health Nurse in the Shelter Setting:
Limits• Treatment of the
seriously ill
• Providing information to the media
• Re-assigning roles of other shelter staff
Resources• Local Emergency Room
• DOH Public Relations (or Public Affairs Dept.)
• Shelter manager
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EMERGENCY PREPAREDNESS COMPETENCY
DESCRIBE communication role(s) in emergency response:
• Within agency• Media• General public• Personal (family, neighbors)
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Communication Within the Agency
Communication through the Chain of Command will insure that your information and requests for support get to the correct individual.
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Communication with theMedia
• In emergency situations, there are many media inquiries, and they are made to everybody.
• Know you agency’s media plan
• Usually, all press inquiries are to be referred to the Commissioners Office.
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Communication with the General Public
• As a public health employee, you always represent PUBLIC HEALTH to the community in your day to day lives.
• You may be required to answer queries and take information through hotlines or disseminate public health messages.
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Communication with Your Family
Your family may be concerned, involved and/or have their routines changed.
Do you have a:• Family Disaster Plan
• Personal Emergency Plan
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Family Disaster Plan Materials
Source: FEMA: www.fema.gov/library/epc.pdf and www.fema.gov/library/yfdp.pdf
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NEW YORK CITY DEPARTMENT OF HEALTH SCHOOL HEALTH PROGRAM
PERSONAL EMERGENCY PLAN
In the event that I am called upon to respond to an emergency as a Department of Health
employee I, _____________________________________, have made the following
arrangements to ensure that my family and pets are cared for while I am on duty:
My child(ren) will be cared for by: ___________________________________(Name)
__________________________________(Phone
#)
________________________________________________________________(Address
)
My pet(s) will be cared for by: ___________________________________(Name)
__________________________________(Phone
#)
________________________________________________________________(Address)
My parent(s) will be cared for by: ___________________________________(Name)
__________________________________(Phone
#)
________________________________________________________________(Address)
Personal Emergency Plans For:
NEW YORK CITY DEPARTMENT OF HEALTH SCHOOL HEALTH PROGRAM
PERSONAL EMERGENCY PLAN
In the event that I am called upon to respond to an emergency as a Department of Health
employee I, _____________________________________, have made the following
arrangements to ensure that my family and pets are cared for while I am on duty:
My child(ren) will be cared for by: ___________________________________(Name)
__________________________________(Phone
#)
________________________________________________________________(Address
)
My pet(s) will be cared for by: ___________________________________(Name)
__________________________________(Phone
#)
________________________________________________________________(Address)
My parent(s) will be cared for by: ___________________________________(Name)
__________________________________(Phone
#)
________________________________________________________________(Address)
NYC-DOH School Health Program Draft, August 2001
During Working Hours After Working Hours
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Remember……
Make provisions for:•Child(ren) •Spouse/Partner•Parents•Pets•Others
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EMERGENCY PREPAREDNESS COMPETENCY
DEMONSTRATE correct use of all communication equipment used for emergency communication (phone, fax, radio, etc.).
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Communication Equipment Frequently Used in a Disaster/Emergency
• Telephone: know how to transfer a call
• Fax: know how to operate the copier or group fax functions
• Walkie-talkie
• Bullhorn
• Paper and pencil • Use of “runners” (staff to deliver messages)
• Intercom system
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Communication Equipment Used by: (insert Agency name here)
(Insert the types of communication equipment likely to be used during an emergency/disaster operation here)
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EMERGENCY PREPAREDNESS COMPETENCY
APPLY creative problem solving and flexible thinking to unusual challenges within functional roles and responsibilities and
EVALUATE the effectiveness of all actions taken.
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CREATIVE PROBLEM SOLVING
What situations requiring creative problem solving and flexible thinking can you imagine occurring?
• Telephone system fails?
• Expected supplies are not delivered?
• Agency facility is inaccessible?
• Other types of problems???
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CREATIVE PROBLEM SOLVING
What situations requiring creative problem solving and flexible thinking can you imagine occurring?
[Insert local examples here]
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Evaluation of All Actions
How would you evaluate the effectiveness of all actions you took?
• Were the issues you referred to others acted upon?
• Was the issue that you addressed resolved?
• After the situation, evaluate the effectiveness of the plan.
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Examples of Evaluations of Actions Taken
[Insert local examples here]
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Core Public Health Worker Competencies for Emergency Preparedness and Response
Effective public health emergency preparedness and response depends upon the coordinated efforts of multiple people from many different agencies, working in concert.
Mastery of the Core Public Health Worker Emergency Preparedness and Response Competencies is the first step for the public health team.
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In order to respond to any emergency/disaster, ALL public health
workers should be able to:
• IDENTIFY & LOCATE the emergency plan
• DESCRIBE the role of Public Health
• DESCRIBE the Chain of Command
• DESCRIBE & DEMONSTRATE one’s functional role
• RECOGNIZE deviations from the norm
• IDENTIFY limits to own authority
• DESCRIBE communication roles
• DEMONSTRATE use of communication equipment
• APPLY creative problem solving skills
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National Network of Academic Centers for Public Health Preparedness
• Columbia University Center for Public Health Preparedness (Columbia University)
• Heartland Center for Public Health Preparedness (St. Louis University)
• Illinois Public Health Preparedness Center (University of Illinois)
• Iowa Center for Public Health Preparedness (University of Iowa)
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National Network of Academic Centers for Public Health Preparedness (cont’d)
• University of North Carolina (Chapel Hill) Center for Public Health Preparedness
• University of South Florida Center for Public Health Preparedness
• Northwest Center for Public Health Preparedness
(University of Washington)
http://www.phppo.cdc.gov/owpp/centersforPHP.asp
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THANK YOU!
QUESTIONS?
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Post-test Procedure
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Post-test Form
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Post-test Procedures
1. Test sheet & pencil
2. Complete the test
3. Pass the test to the center aisle
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Columbia UniversityCenter for Public Health Preparedness
Website:http://cpmcnet.columbia.edu/dept/sph/CPHP/index.html