National Academies Press: OpenBook

Medical Surge Capacity: Workshop Summary (2010)

Chapter: Appendix B: Agenda

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Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

B
Agenda

June 10, 2009

Keck Center, Room 100

500 Fifth Street, NW

Washington, DC 20001


Background:

The mission of HHS’s Hospital Preparedness Program is to enhance the ability of hospitals and healthcare systems to prepare for and respond to bioterrorism and other public health emergencies. The United States constantly faces the real possibility of catastrophic public health incidents that could involve thousands, or tens of thousands, of patients. Therefore it is critically important for health systems to identify, plan, and prepare for the possibility of a mass-casualty incident. To help address these needs, the Institute of Medicine’s Forum on Medical and Public Health for Catastrophic Events is organizing a workshop around the topic of “medical surge capacity” that will help inform future guidance developed by HHS’s Healthcare Preparedness Program.


Audience:

Policy makers from federal agencies and state and local public health departments. Providers from the healthcare community, including relevant medical disciplines, nursing, emergency medical services (EMS). Healthcare and hospital administrators.

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

Objectives:

The workshop will feature invited presentations and discussions focused on the following topics, including specific discussion of the role of the Hospital Preparedness Programs (HPP) in facilitating each of these efforts, specifically through guidance developed by the HPP.

  • Definitions of medical surge that are applicable to local, state, territorial, tribal governments, and federal government entities;

  • The capability and tools available to local, state, territorial, tribal, and federal government entities to assess the current status of preparedness to conduct medical surge operations;

    • Identify metrics that can be used to improve performance and preparedness for a mass-casualty incident; and

  • Strategies to facilitate public- and private-sector work to improve surge capability for victims and the distressed, including new or modified guidance and legal and funding mechanisms.

For each area, current capabilities, perceived gaps, future opportunities and innovative options should be identified and discussed.


Note: Continental breakfast will be available at 7:30 a.m.

8:00 a.m.

Welcome, Introductions, and Workshop Objectives

 

LEWIS GOLDFRANK, Forum Chair

Professor and Chair

Department of Emergency Medicine

New York University School of Medicine

8:05 a.m.

Charge to Workshop Speakers and Participants

 

GERALD PARKER

Principal Deputy Assistant Secretary

Office of the Assistant Secretary for Preparedness and Response

Department of Health and Human Services

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

8:15 a.m.

ASPR Healthcare Preparedness Programs: Current Objectives and Future Priorities

 

KEVIN YESKEY

Deputy Assistant Secretary

Office of Preparedness and Emergency Operations

Office of the Assistant Secretary for Preparedness and Response

Department of Health and Human Services

8:30 a.m.

Public Health Emergencies: HHS Legal Authorities for Responding to a Mass-Casualty Event

 

SUSAN SHERMAN

Senior Attorney

Office of the General Counsel, HHS

SESSION I:
DEFINITIONS OF MEDICAL AND PUBLIC HEALTH SURGE CAPACITY

Session Objective: Identify and discuss different definitions of medical surge capacity within a construction of an all-hazards approach. Discuss the merits of identifying a commonly accepted terminology. Examine gaps in the currently used definitions.

8:45 a.m.

Session Objectives and Introduction

 

JEFFREY RUNGE, Session Chair

President

Biologue, Inc.

8:55 a.m.

Surge Capacity Continuum: Conventional, Contingency, and Crisis

 

JOHN HICK

Associate Medical Director for EMS and Medical Director of Emergency Preparedness

Hennepin County Medical Center, MN

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

9:10 a.m.

Hospital Surge Capacity for Mass Casualty Events—Israeli Perspective

 

KOBI PELEG

Director

Israeli National Center for Trauma and Emergency Medicine Research

9:25 a.m.

Public Health Perspective on Surge Capacity

 

DANIEL SOSIN

Acting Director

Coordinating Office for Terrorism Preparedness and Emergency Response, CDC

9:40 a.m.

Medical and Public Health Surge Capacity: Emergency Management Perspective

 

ROBERT BASS

Executive Director

Maryland Institute for Emergency Medical Services System

9:55 a.m.

Discussion with attendees

  • What are the advantages of developing a consensus definition of surge capacity?

  • How can a consensus definition of medical surge capacity be established?

  • Is it possible to develop a uniform definition of surge capacity within an all-hazards approach?

  • What components of a definition are necessary to allow for “surge capacity” to be measured?

  • How can the HPP assist in the development of a commonly accepted definition of surge capacity?

10:40 a.m.

BREAK

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

SESSION II:
LOCAL STRATEGIES: CREATING AN INTEGRATED APPROACH TO AN ALTERNATE CARE SYSTEM

Session Objective: Recognizing that urban and rural communities would utilize resources and assets in different ways, discuss some common guiding principles that will guide the use of resources and assets. Identify and discuss strategies to leverage and integrate local and community resources to develop an effective alternate care system.

10:55 a.m.

Session Objectives and Introduction

 

DAN HANFLING, Session co-Chair

Director

Emergency Management and Disaster Medicine

Inova Health System

 

DEBORAH LEVY, Session co-Chair

Chief, Healthcare Preparedness Activity

Division of Healthcare Quality Promotion, CDC

11:05 a.m.

Panel Discussion: Opportunities to Leverage Local Components: Strategies and Guiding Principles

 

Leveraging Federal Resources to Bring Together Stakeholder and Develop an Integrated Response

 

RICHARD SERINO

Chief

Boston EMS

 

Developing a Healthcare Coalition Approach to Coordinating Surge Resources

 

ZACHARY CORRIGAN

Executive Director

Northern Virginia Hospital Alliance

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

 

Role of Emergency Health Operations Centers: Managing System Capacity

 

FREDERICK (SKIP) BURKLE

Senior Fellow, Harvard Humanitarian Initiative

Harvard School of Public Health

 

Role of the 9-1-1 and EMS System

 

LESLEE STEIN-SPENCER

Manager of Quality Improvement, Chicago Fire Department

Program Advisor, National Association of State EMS Officials

 

Licensing and Interstate Credentialing: Ensuring Staff Availability and Capability

 

JAMES HODGE

Executive Director

Center for Law and the Public’s Health

Johns Hopkins University

11:45 a.m.

Discussion with Attendees

  • What are some common guiding principles that will guide the use of resources and assets?

  • How can local components of the healthcare and public health sector resources be better leveraged, e.g., private providers, EMS, call centers, urgent care facilities?

 

DAN HANFLING, Session co-Chair

Director

Emergency Management and Disaster Medicine

Inova Health System

 

DEBORAH LEVY, Session co-Chair

Chief, Healthcare Preparedness Activity

Division of Healthcare Quality Promotion, CDC

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

12:45 p.m.

LUNCH

SESSION III:
ALTERNATE CARE SYSTEM: STRATIFICATION OF CARE

Session Objective: Discuss benefits of establishing effective alternate care facilities. How can alternate care sites be effectively used? How should alternate care sites be established so that they meet the goal of saving as many lives as possible given the limited resources? How to ensure coordination with the entire healthcare system? How should alternate care facilities be integrated into the emergency medical services system?

1:30 p.m.

Session Objectives and Introduction

 

DAN HANFLING, Session co-Chair

Director

Emergency Management and Disaster Medicine

Inova Health System

 

DEBORAH LEVY, Session co-Chair

Chief, Healthcare Preparedness Activity

Division of Healthcare Quality Promotion, CDC

1:40 p.m.

Panel Discussion: Effective Alternate Care Facilities: Opportunities to Integrate into Current Plans

 

Hospital Surge Capacity for Mass-Casualty Events

 

ARTHUR KELLERMANN

Professor of Emergency Medicine and Associate Dean of Health Policy

Emory University

 

Utilizing Call Center Capabilities

 

GREGORY BOGDAN

Research Director and Medical Toxicology Coordinator

Rocky Mountain Poison & Drug Center at Denver Health

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

 

Alternate Care Capabilities

 

LEWIS RUBINSON

Assistant Professor of Medicine

Division of Pulmonary and Critical Care Medicine

University of Washington

 

Community Mitigation: In-Home Care and Role of the Family

 

LISA KOONIN

Senior Advisor

Influenza Coordination Unit

Centers for Disease Control and Prevention

2:20 p.m.

Discussion with Attendees

  • What are the characteristics of an appropriate alternate care site?

  • What are the most appropriate uses of alternate care sites?

  • How can alternate care facilities be established to ensure they meet the goal of saving as many lives as possible given the limited resources?

  • How can the HPP and other federal programs facilitate the increased capacity of the emergency medical services and healthcare system

 

DAN HANFLING, Session co-Chair

Director

Emergency Management and Disaster Medicine

Inova Health System

 

DEBORAH LEVY, Session co-Chair

Chief, Healthcare Preparedness Activity

Division of Healthcare Quality Promotion, CDC

3:15 p.m.

BREAK

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

SESSION IV:
CREATING SITUATIONAL AWARENESS: A SYSTEMS APPROACH

Session Objective: Examine strategies to establish an integrated systems approach for improving situational awareness for medical surge capacity. Identify current capabilities, perceived gaps, future opportunities and innovative options that could improve coordination between sectors with in a community. Identify reporting mechanisms that could be developed to ensure a community is adequately prepared.

3:30 p.m.

Session Objectives and Introduction

 

ERIC TONER, Session Chair

Senior Associate

Center for Biosecurity, UPMC

3:40 p.m.

Panel Discussion: Integrative Strategies and Operational Implications

 

Data Needs for Situational Awareness in a Mass-Casualty Disaster: Optimal and Minimal Data and Technology Requirements

 

PAUL BIDDINGER

Chairman

Massachusetts Medical Society Committee on Preparedness

 

Harnessing Electronic Health Records for Situational Awareness

 

DAVID GRUBER

Assistant Commissioner

Division of Health Infrastructure Preparedness and Emergency Response

New Jersey Department of Health and Senior Services

 

Developing a System to Improve Situational Awareness

 

CYNTHIA DOLD

Healthcare Coalition Program Manager

Seattle and King County

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

 

Information Systems for Just-in-Time Training: How would it work?

 

CARL TAYLOR

Assistant Dean

University of South Alabama College of Medicine

Director

Center for Strategic Health Innovation

4:20 p.m.

Discussion with Attendees

  • What is the optimal set of data needed for situational awareness in a mass-casualty disaster?

    • What is the optimal technology needed to enable it?

    • What is the minimal set of data and technology needed?

  • How can electronic health records be harnessed for situational awareness?

  • What role would syndromic surveillance systems play in situational awareness in mass-casualty disasters?

  • Information systems for just-in-time training—how would it work?

 

ERIC TONER, Session Chair

Senior Associate

Center for Biosecurity, UPMC

SESSION V:
OPPORTUNITIES TO MOVE FORWARD

Session Objective: Review the discussions that took place during the day and identify promising avenues by which the HPP and other federal programs can improve the surge capacity of our nation’s healthcare system.

5:00 p.m.

Panel Discussion: Recap of Promising Ideas from Day 1

 

GAMUNU WIJETUNGE

NHTSA/Office of Emergency Medical Services

U.S. DOT

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

 

DAVID MARCOZZI

Homeland Security Council

The White House

 

MARGARET VANAMRINGE

Vice President

Public Policy and Government Relations

The Joint Commission

 

LEWIS GOLDFRANK

Professor and Chair

Department of Emergency Medicine

New York University School of Medicine

 

JACK HERRMANN

Senior Advisor

Public Health Preparedness

NACCHO

5:20 p.m.

Discussion with Attendees

  • What new ideas have surfaced in this workshop that should be explored further?

  • What action steps are required to integrate these strategies into the current guidance and funding opportunities, including the HPP program?

  • What resources and further infrastructure investments will be necessary in the short- and long-term?

6:00 p.m.

ADJOURN

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

June 11, 2009


Keck Center, Room 100

500 Fifth Street, NW

Washington, DC 20001


Note: Continental breakfast will be available at 8:00 a.m.

8:30 a.m.

Welcome

 

LEWIS GOLDFRANK, Forum Chair

Professor and Chair

Department of Emergency Medicine

New York University School of Medicine

SESSION VI:
VULNERABLE POPULATIONS: BEHAVIORAL HEALTH EFFECTS AND MEDICAL NEEDS FOR AT-RISK POPULATIONS

Session Objective: Discuss current capabilities, perceived gaps, future opportunities and innovative options to ensure appropriate care can be provided to individuals with medical needs. Identify strategies that could be modeled and tested to improve care to individuals with medical needs.

8:35 a.m.

Session Objectives and Introduction

 

ARTHUR COOPER, Session Chair

Professor of Surgery

Columbia University Medical Center

8:45 a.m.

Panel Discussion: Enhancing the Health Care System’s Capacity to Care for those with Special Medical Needs

 

H1N1: Special Considerations for Children and Youth

 

RICHARD HATCHETT

Homeland Security Council

The White House

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

 

Developing Care Strategies and Capacity for the Psychologically Impacted and the Distressed

 

ROBERT URSANO

Professor of Psychiatry and Neuroscience

Chairman of the Department of Psychiatry

Uniformed Services University of the Health Sciences

 

Enhancing the Health Care System’s Capacity for the Young

 

JOSEPH WRIGHT

Professor of Pediatrics (Vice Chair), Emergency

Medicine and Health Policy

George Washington University/Children’s National Medical Center

Washington, DC

 

Enhancing the Health Care System’s Capacity for the Elderly

 

CHARLOTTE YEH

Chief Medical Officer

AARP Services Incorporated

Washington, DC

 

Enhancing the Health Care System’s Capacity for the Chronically Ill

 

RAY SWIENTON

Associate Professor, Division of Emergency Medicine

University of Texas Southwestern Medical Center

9:25 a.m.

Discussion with Attendees

  • What are the current capabilities and perceived gaps in providing care to individuals with medical needs?

  • What future opportunities and innovative options could ensure appropriate care can be provided to individuals with medical needs?

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

 

  • What strategies that could be modeled and tested to improve care to individuals with medical needs?

 

ARTHUR COOPER, Session Chair

Professor of Surgery

Columbia University Medical Center

10:05 a.m.

BREAK

SESSION VII:
FATALITY MANAGEMENT STRATEGIES

Session Objective: Examine potential fatality management strategies. Identify the goals of managing fatalities during a mass-casualty incident. Discuss the resources necessary for ensuring adequate fatality management.

10:15 a.m.

Session Objectives and Introduction

 

JACK HERRMANN, Session co-chair

Senior Advisor

Public Health Preparedness

National Association of County and City Health Officials

 

LISA LADUE, Session co-chair

Deputy Director

National Mass Fatalities Institute

Cedar Rapids, Iowa

10:25 a.m.

Panel Discussion: Mass Fatality Strategies: Gaps and Opportunities

 

Domestic Mass Fatality Response: Lessons from the DoD

 

MICHAEL LUKE

Joint Mortuary Affairs Officer

United States NORTHCOM

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

 

Family Assistance Centers

 

VIRGINIA MEWBORN

Assistant Commissioner of Training and Exercises

Office of Emergency Management, New York City

 

Responding to Mass Casualty Incidents: Medical Examiners

 

FRANK DEPAOLO

Director of Special Operations Division

Office of Chief Medical Examiner

New York City

 

Private Sector Opportunities and Challenges

 

JOHN FITCH

Senior Vice President, Advocacy

National Funeral Directors Association

11:10 a.m.

Discussion with Attendees

  • What strategies can be used to ensure appropriate planning for fatality management during a mass-casualty incident?

  • What are the resources necessary for ensuring adequate fatality management?

 

JACK HERRMANN, Session co-chair

Senior Advisor

Public Health Preparedness

National Association of County and City Health Officials

 

LISA LADUE, Session co-chair

Deputy Director

National Mass Fatalities Institute

Cedar Rapids, Iowa

11:45 a.m.

LUNCH

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

SESSION VIII:
RAMPING DOWN: WHEN IS IT APPROPRIATE AND HOW CAN ONE BEST TRANSITION AFTER A MASS-CASUALTY INCIDENT?

Session Objective: Discuss what are realistic assumptions about care in the short-term (not immediately following) following a mass-casualty incident. Based on these assumptions, discuss potential criteria and guidelines that may be used to assist stakeholders in transitioning from a surge environment back to a “new normal” level of “steady state” care.

12:30 p.m.

Session Objectives and Introduction

 

ROSLYNE SCHULMAN, Session Chair

Senior Associate Director

American Hospital Association

12:40 p.m.

Panel Discussion: Ensuring Operational Sustainability

 

Demobilization and Return to Former Operations

 

MARK ROBITAILLE

President and CEO

Martin Memorial Medical Center, Florida

 

Reassessment of Needs

 

KAREN SEXTON

Interim Executive Vice President and Chief Executive Officer

University of Texas Medical Branch Health System

 

Rebuilding of the Health Care System

 

JOHN MATESSINO

President and CEO

Louisiana Hospital Association

 

Repatriation

 

DAVID LAKEY

Commissioner

Texas Department of State Health Services

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

1:20 p.m.

Discussion with Attendees

  • When is it appropriate to begin to transition back to “steady state” care?

    • What are the triggers and how can they be recognized?

  • What tools and guidelines are necessary for stakeholders?

  • What should stakeholders be doing now to plan for rebuilding their healthcare system following a large-scale incident?

  • How should a reassessment of need be accomplished?

 

ROSLYNE SCHULMAN, Session Chair

Senior Associate Director

American Hospital Association

SESSION IX:
FINANCING SURGE CAPACITY AND PREPAREDNESS

Session Objective: Based on workshop discussions, identify funding mechanisms that could be utilized to ensure effective and efficient medical surge capacity preparedness and response. Identify barriers for establishing preparedness and response. Examine potential changes in reimbursement policy to assist the healthcare system during and immediately following a catastrophic event.

2:10 p.m.

Session Objectives and Introduction

 

WILLIAM SMITH, Session Chair

Senior Director

Emergency Preparedness

University of Pittsburgh Medical Center

2:20 p.m.

Panel discussion

 

MARC HARTSTEIN

Deputy Director

Hospital and Ambulatory Policy Group

Center for Medicare Management

Centers for Medicare and Medicaid Services

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

 

KURT KRUMPERMAN

Clinical Assistant Professor

Emergency Health Services Department

University of Maryland, Baltimore County

 

DIANA DENNETT

Counsel

AHIP

 

JEFFREY RUNGE

President

Biologue, Inc.

3:20 p.m.

Discussion with Attendees

  • What resources are required to implement the changes necessary to ensure that the most efficient and effective frameworks are in place?

  • What economic barriers are preventing effective preparedness and response for a mass-casualty incident?

  • How should federal resources be integrated into local and state planning?

  • What changes can be made to the current reimbursement mechanisms to improve the stability of effected healthcare systems, e.g., modified filing deadlines and interim payments, recognizing alternate care sites, flexibility in coding, etc.?

 

WILLIAM SMITH, Session Chair

Senior Director

Emergency Preparedness

University of Pittsburgh Medical Center

SESSION X:
GENERAL DISCUSSION WITH WORKSHOP PARTICIPANTS AND ATTENDEES

Session Objective: Discuss what opportunities and constraints exist to improve medical surge capacity to a mass- casualty incident. Review opportunities and challenges identified during the workshop. Identify and discuss the most promising near-term opportunities for improving standards-of-care protocols at local, state, and regional jurisdictions.

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
×

4:00 p.m.

Panel Discussion: Synopsis of Workshop Discussions

 

DAN HANFLING

Director

Emergency Management and Disaster Medicine

Inova Health System

 

ERIC TONER

Senior Associate

Center for Biosecurity, UPMC

 

MARGARET MCMAHON

Senior Clinical Editor—Journal of Emergency Nursing

Emergency Nurses Association

 

DAVID LAKEY

Commissioner

Texas Department of State Health Services

4:20 p.m.

Discussion with Attendees

  • What new ideas have surfaced in this workshop that should be explored further?

  • What action steps are required to integrate these strategies into the current public health system?

  • What resources and further infrastructure investments will be necessary in the short- and long-term?

4:45 p.m.

Closing Remarks: The Path Forward

 

GERALD PARKER

Principal Deputy Assistant Secretary

Office of the Assistant Secretary for Preparedness and Response

Department of Health and Human Services

5:00 p.m.

ADJOURN

Suggested Citation:"Appendix B: Agenda." Institute of Medicine. 2010. Medical Surge Capacity: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12798.
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During natural disasters, disease pandemics, terrorist attacks, and other public health emergencies, the health system must be prepared to accommodate a surge in the number of individuals seeking medical help. For the health community, a primary concern is how to provide care to individuals during such high demand, when the health system's resources are exhausted and there are more patients than the system can accommodate.

The IOM's Forum on Medical and Public Health Preparedness for Catastrophic Events held a workshop June 10-11, 2009, to assess the capability of and tools available to federal, state, and local governments to respond to a medical surge. In addition, participants discussed strategies for the public and private sectors to improve preparedness for such a surge. The workshop brought together leaders in the medical and public health preparedness fields, including policy makers from federal agencies and state and local public health departments; providers from the health care community; and health care and hospital administrators. This document summarizes the workshop.

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