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.
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.
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Definitions of medical surge that are applicable to local, state, territorial, tribal governments, and federal government entities;
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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;
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Identify metrics that can be used to improve performance and preparedness for a mass-casualty incident; and
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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 |
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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 |
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GERALD PARKER Principal Deputy Assistant Secretary Office of the Assistant Secretary for Preparedness and Response Department of Health and Human Services |
8:15 a.m. |
ASPR Healthcare Preparedness Programs: Current Objectives and Future Priorities |
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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 |
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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 |
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JEFFREY RUNGE, Session Chair President Biologue, Inc. |
8:55 a.m. |
Surge Capacity Continuum: Conventional, Contingency, and Crisis |
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JOHN HICK Associate Medical Director for EMS and Medical Director of Emergency Preparedness Hennepin County Medical Center, MN |
9:10 a.m. |
Hospital Surge Capacity for Mass Casualty Events—Israeli Perspective |
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KOBI PELEG Director Israeli National Center for Trauma and Emergency Medicine Research |
9:25 a.m. |
Public Health Perspective on Surge Capacity |
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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 |
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ROBERT BASS Executive Director Maryland Institute for Emergency Medical Services System |
9:55 a.m. |
Discussion with attendees
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10:40 a.m. |
BREAK |
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 |
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DAN HANFLING, Session co-Chair Director Emergency Management and Disaster Medicine Inova Health System |
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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 |
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Leveraging Federal Resources to Bring Together Stakeholder and Develop an Integrated Response |
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RICHARD SERINO Chief Boston EMS |
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Developing a Healthcare Coalition Approach to Coordinating Surge Resources |
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ZACHARY CORRIGAN Executive Director Northern Virginia Hospital Alliance |
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Role of Emergency Health Operations Centers: Managing System Capacity |
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FREDERICK (SKIP) BURKLE Senior Fellow, Harvard Humanitarian Initiative Harvard School of Public Health |
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Role of the 9-1-1 and EMS System |
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LESLEE STEIN-SPENCER Manager of Quality Improvement, Chicago Fire Department Program Advisor, National Association of State EMS Officials |
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Licensing and Interstate Credentialing: Ensuring Staff Availability and Capability |
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JAMES HODGE Executive Director Center for Law and the Public’s Health Johns Hopkins University |
11:45 a.m. |
Discussion with Attendees
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DAN HANFLING, Session co-Chair Director Emergency Management and Disaster Medicine Inova Health System |
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DEBORAH LEVY, Session co-Chair Chief, Healthcare Preparedness Activity Division of Healthcare Quality Promotion, CDC |
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 |
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DAN HANFLING, Session co-Chair Director Emergency Management and Disaster Medicine Inova Health System |
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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 |
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Hospital Surge Capacity for Mass-Casualty Events |
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ARTHUR KELLERMANN Professor of Emergency Medicine and Associate Dean of Health Policy Emory University |
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Utilizing Call Center Capabilities |
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GREGORY BOGDAN Research Director and Medical Toxicology Coordinator Rocky Mountain Poison & Drug Center at Denver Health |
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Alternate Care Capabilities |
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LEWIS RUBINSON Assistant Professor of Medicine Division of Pulmonary and Critical Care Medicine University of Washington |
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Community Mitigation: In-Home Care and Role of the Family |
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LISA KOONIN Senior Advisor Influenza Coordination Unit Centers for Disease Control and Prevention |
2:20 p.m. |
Discussion with Attendees
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DAN HANFLING, Session co-Chair Director Emergency Management and Disaster Medicine Inova Health System |
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DEBORAH LEVY, Session co-Chair Chief, Healthcare Preparedness Activity Division of Healthcare Quality Promotion, CDC |
3:15 p.m. |
BREAK |
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 |
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ERIC TONER, Session Chair Senior Associate Center for Biosecurity, UPMC |
3:40 p.m. |
Panel Discussion: Integrative Strategies and Operational Implications |
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Data Needs for Situational Awareness in a Mass-Casualty Disaster: Optimal and Minimal Data and Technology Requirements |
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PAUL BIDDINGER Chairman Massachusetts Medical Society Committee on Preparedness |
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Harnessing Electronic Health Records for Situational Awareness |
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DAVID GRUBER Assistant Commissioner Division of Health Infrastructure Preparedness and Emergency Response New Jersey Department of Health and Senior Services |
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Developing a System to Improve Situational Awareness |
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CYNTHIA DOLD Healthcare Coalition Program Manager Seattle and King County |
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Information Systems for Just-in-Time Training: How would it work? |
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CARL TAYLOR Assistant Dean University of South Alabama College of Medicine Director Center for Strategic Health Innovation |
4:20 p.m. |
Discussion with Attendees
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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 |
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GAMUNU WIJETUNGE NHTSA/Office of Emergency Medical Services U.S. DOT |
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DAVID MARCOZZI Homeland Security Council The White House |
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MARGARET VANAMRINGE Vice President Public Policy and Government Relations The Joint Commission |
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LEWIS GOLDFRANK Professor and Chair Department of Emergency Medicine New York University School of Medicine |
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JACK HERRMANN Senior Advisor Public Health Preparedness NACCHO |
5:20 p.m. |
Discussion with Attendees
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6:00 p.m. |
ADJOURN |
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 |
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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 |
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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 |
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H1N1: Special Considerations for Children and Youth |
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RICHARD HATCHETT Homeland Security Council The White House |
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Developing Care Strategies and Capacity for the Psychologically Impacted and the Distressed |
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ROBERT URSANO Professor of Psychiatry and Neuroscience Chairman of the Department of Psychiatry Uniformed Services University of the Health Sciences |
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Enhancing the Health Care System’s Capacity for the Young |
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JOSEPH WRIGHT Professor of Pediatrics (Vice Chair), Emergency Medicine and Health Policy George Washington University/Children’s National Medical Center Washington, DC |
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Enhancing the Health Care System’s Capacity for the Elderly |
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CHARLOTTE YEH Chief Medical Officer AARP Services Incorporated Washington, DC |
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Enhancing the Health Care System’s Capacity for the Chronically Ill |
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RAY SWIENTON Associate Professor, Division of Emergency Medicine University of Texas Southwestern Medical Center |
9:25 a.m. |
Discussion with Attendees
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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 |
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JACK HERRMANN, Session co-chair Senior Advisor Public Health Preparedness National Association of County and City Health Officials |
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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 |
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Domestic Mass Fatality Response: Lessons from the DoD |
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MICHAEL LUKE Joint Mortuary Affairs Officer United States NORTHCOM |
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Family Assistance Centers |
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VIRGINIA MEWBORN Assistant Commissioner of Training and Exercises Office of Emergency Management, New York City |
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Responding to Mass Casualty Incidents: Medical Examiners |
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FRANK DEPAOLO Director of Special Operations Division Office of Chief Medical Examiner New York City |
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Private Sector Opportunities and Challenges |
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JOHN FITCH Senior Vice President, Advocacy National Funeral Directors Association |
11:10 a.m. |
Discussion with Attendees
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JACK HERRMANN, Session co-chair Senior Advisor Public Health Preparedness National Association of County and City Health Officials |
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LISA LADUE, Session co-chair Deputy Director National Mass Fatalities Institute Cedar Rapids, Iowa |
11:45 a.m. |
LUNCH |
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 |
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ROSLYNE SCHULMAN, Session Chair Senior Associate Director American Hospital Association |
12:40 p.m. |
Panel Discussion: Ensuring Operational Sustainability |
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Demobilization and Return to Former Operations |
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MARK ROBITAILLE President and CEO Martin Memorial Medical Center, Florida |
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Reassessment of Needs |
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KAREN SEXTON Interim Executive Vice President and Chief Executive Officer University of Texas Medical Branch Health System |
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Rebuilding of the Health Care System |
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JOHN MATESSINO President and CEO Louisiana Hospital Association |
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Repatriation |
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DAVID LAKEY Commissioner Texas Department of State Health Services |
1:20 p.m. |
Discussion with Attendees
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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 |
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WILLIAM SMITH, Session Chair Senior Director Emergency Preparedness University of Pittsburgh Medical Center |
2:20 p.m. |
Panel discussion |
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MARC HARTSTEIN Deputy Director Hospital and Ambulatory Policy Group Center for Medicare Management Centers for Medicare and Medicaid Services |
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KURT KRUMPERMAN Clinical Assistant Professor Emergency Health Services Department University of Maryland, Baltimore County |
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DIANA DENNETT Counsel AHIP |
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JEFFREY RUNGE President Biologue, Inc. |
3:20 p.m. |
Discussion with Attendees
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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.
4:00 p.m. |
Panel Discussion: Synopsis of Workshop Discussions |
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DAN HANFLING Director Emergency Management and Disaster Medicine Inova Health System |
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ERIC TONER Senior Associate Center for Biosecurity, UPMC |
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MARGARET MCMAHON Senior Clinical Editor—Journal of Emergency Nursing Emergency Nurses Association |
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DAVID LAKEY Commissioner Texas Department of State Health Services |
4:20 p.m. |
Discussion with Attendees
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4:45 p.m. |
Closing Remarks: The Path Forward |
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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 |