Preparing for Terrorism Tools for Evaluating the Metropolitan Medical Response System Program (2002) / Chapter Skim
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6 Preparedness Indicators
6 Preparedness Indicators
Pages 91-99
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From page 91... ...
First, there is much to be learned from analysis of the local, state, and federal responses to the terrorist attacks on the World Trade Center and the Pentagon in September 2001; but the committee believes that chemical, biological, or radiological (CBR) terrorism incidents of the scale envisioned by the Office of Emergency Preparedness (OEP)
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From page 92... ...
OEP has dealt with this variation by not attempting to impose a single model or acceptable plan on all its MMRS program cities, instead opting to encourage cities to build their own plans in conjunction with the available structures, resources, and vulnerabilities. This flexible approach results in a substantial reduction in the ability to impose universal performance measures and standards and a corresponding difficulty in devising fair and comparable evaluation tools.
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From page 93... ...
U.S. Department of Transportation, National Highway Transportation Safety Agency, Emergency Medical Services, National Standard Curriculums American College of Emergency Physicians Task Force Recommendations on Objectives, Content, and Competencies for Training of Emergency Medical Technicians, Emergency Physicians, and Emergency Nurses on Caring for Casualties of NBC (Nuclear, Biological, and Chemical)
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From page 94... ...
Most of them also focus on the adequacy of written plans, like the OEP checklist in Appendix D None explicitly addresses CBR terrorism or an emergency of the scale described in the MMRS program contract, and attempts to apply these standards to such scenarios in the past have often proved counterproductive (e.g., misinterpretation of OSHA hazardous waste operations standards has led to expectations that hospital emergency department personnel should have Level A chemical protective suits)
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From page 95... ...
Department of Justice (DOf) , the Federal Bureau of Investigation, and CDC to evaluate vulnerability, threat, and public health system performance combined with assessments of required and current capabilities in the realms of fire services, hazmat services, emergency medical services, law enforcement, public works, public health, and emergency management A 100-page "Tool Kit" provided for use by the state and local personnel assigned to fill out the forms, but it could be the basis of peer interviews State assessment designed to be a compilation of local assessments, so it is really a local instrument Public Health Assessment Instrument for Public Health Emergency Preparedness (CDC)
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From page 96... ...
Like the existing standards described in the previous section, most of these instruments also focus on the adequacy of written plans, like the OEP checklist in Appendix D In sum, the committee views them as providing too little additional assurance for the substantial effort involved.
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From page 97... ...
PERFORMANCE MEASURES VERSUS PREPAREDNESS INDICATORS The MMRS contract deliverables are all written plans, and although written plans are certainly necessary elements of preparedness, they are in most cases only the beginning of a continuing process. Some elements of these plans can be carried out only during or after an actual incident or a very realistic exercise, but many require advance preparations, such as the purchase of equipment, hiring or training of personnel, or even changes in the way in which everyday business is conducted (for example, citywide electronic surveillance of emergency department visits or 911
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From page 98... ...
. In each table in Appendix E the far left column, labeled "Plan Elements," lists the required elements of the deliverable, numbered in accord with the checklist supplied to FY 2000 MMRS program cities by OEP under the title "2000 MMRS Contract Deliverable Evaluation Instrument," a copy of which is provided as Appendix D The remaining three columns of the tables present the committee's suggested preparedness indicators for each plan element.
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From page 99... ...
In this circumstance evidence for preparedness might be sought among inputs and processes. All three types of indicators are, however, merely surrogate or proxy measures of MMRS effectiveness that are based on the judgment of knowledgeable students of the field but that have never been truly validated (and that cannot be, short of an actual mass-casualty CBR terrorism incident)
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