Health care providers will play a crucial role in the event of a pandemic. Planning for pandemic influenza is key. The following checklist is provided to help state and local hospitals prepare for a pandemic.
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Hospital Preparedness Checklist
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Preparedness Subject
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Actions Needed
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1. Structure for planning and decision making
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An internal, multidisciplinary planning committee for influenza preparedness has been created.
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A person has been designated as the influenza preparedness coordinator.
(Insert name)
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Members of the planning committee include the following hospital staff members (insert names)
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Administration
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Legal counsel
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Infection control
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Hospital disaster coordinator
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Risk management
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Facility engineering
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Nursing administration
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Medical staff
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Intensive care
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Emergency Department
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Laboratory services
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Respiratory therapy
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Psychiatry
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Environmental services
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Public relations
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Security
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Materials management
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Staff development
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Occupational health
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Diagnostic imaging
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Pharmacy
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Information technology
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Other members
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Other members
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A state or local health department person has been identified as a committee liaison.
(Insert name)
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A linkage with local or regional emergency preparedness groups has been established
(Planning organization)
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2. Development of a written pandemic influenza plan
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A written plan has been completed or is in progress that includes the elements listed in #3 below.
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The plan specifies the circumstances under which the plan will be activated.
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The plan describes the organization structure that will be used to operationalize the plan.
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Responsibilities of key personnel related to executing the plan have been described.
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A simulation exercise has been developed to test the effectiveness of the plan.
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A simulation exercise has been performed.
(Date performed )
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3. Elements of an influenza pandemic plan
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A surveillance plan has been developed.
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Syndromic surveillance has been established in the emergency room.
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Criteria for distinguishing pandemic influenza is part of the syndromic surveillance plan.
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Responsibility has been assigned for reviewing global, national, regional, and local influenza activity trends and informing the pandemic influenza coordinator of evidence of an emerging problem.
(Name )
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Thresholds for heightened local surveillance for pandemic influenza have been established.
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A system has been created for internal review of pandemic influenza activity in patients presenting to the emergency department.
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A system for monitoring for nosocomial transmission of pandemic has been implemented and tested by monitoring for non-pandemic influenza.
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A communication plan has been developed.
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Responsibility for external communication has been assigned.
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Person responsible for updating public health reporting
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Clinical spokesperson for the facility
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Media spokesperson for the facility
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Key points of contact outside the facility have been identified.
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State health department contact
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Local health department contact
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Newspaper contact(s)
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Radio contact(s)
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Public official(s)
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A list of other healthcare facilities with whom it will be necessary to maintain communication has been established.
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A meeting with local healthcare facilities has been held to discuss a communication strategy.
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A plan for updating key facility personnel on a daily basis has been established.
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The person(s) responsible for providing these updates are:
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A system to track pandemic influenza admissions and discharges has been developed and tested by monitoring non-pandemic influenza admissions and discharges in the community.
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A strategy for regularly updating clinical, ED, and outpatient staff on the status of pandemic influenza, once detected, has been established.
(Responsible person )
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A plan for informing patients and visitors about the level of pandemic influenza activity has been established.
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An education and training plan on pandemic influenza has been developed.
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Language and reading level-appropriate materials for educating all personnel about pandemic influenza and the facility's pandemic influenza plan, have been identified.
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Current and potential sites for long-distance and local education of clinicians on pandemic influenza have been identified.
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Means for accessing state and federal web-based influenza training programs have been identified.
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A system for tracking which personnel have completed pandemic influenza training is in place.
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A plan is in place for rapidly training non-facility staff brought in to provide patient care when the hospital reaches surge capacity.
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The following groups of healthcare personnel have received training on the facility's influenza plan:
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Attending physicians
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House staff
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Nursing staff
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Laboratory staff
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Emergency Department personnel
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Outpatient personnel
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Environmental Services personnel
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Engineering and maintenance personnel
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Security personnel
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Nutrition personnel
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A triage and admission plan has been developed.
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A specific location has been identified for triage of patients with possible pandemic influenza.
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The plan includes use of signage to direct and instruct patients with possible pandemic influenza on the triage process.
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Patients with possible pandemic influenza will be physically separated from other patients seeking medical attention.
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A system for phone triage of patients for purposes of prioritizing patients who require a medical evaluation has been developed.
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Criteria for determining which patients need a medical evaluation are in place.
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A method for tracking the admission and discharge of patients with pandemic influenza has been developed.
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The tracking method has been tested with non-pandemic influenza patients.
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A facility access plan has been developed.
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Criteria and protocols for closing the facility to new admissions are in place.
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Criteria and protocols for limiting visitors have been established.
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Hospital Security has had input into procedures for enforcing facility access controls.
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An occupational health plan has been developed.
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A system for rapidly delivering vaccine or antiviral prophylaxis to healthcare personnel has been developed.
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The system has been tested during a non-pandemic influenza season.
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A method for prioritizing healthcare personnel for receipt of vaccine or antiviral prophylaxis based on level of patient contact and personal risk for influenza complications has been established.
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A system for detecting symptomatic personnel before they report for duty has been developed.
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This system has been tested during a non-pandemic influenza period.
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A policy for managing healthcare personnel with symptoms of or documented pandemic influenza has been established. The policy considers:
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When personnel may return to work after having pandemic influenza
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When personnel who are symptomatic but well enough to work, will be permitted to continue working
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A method for furloughing or altering the work locations of personnel who are at high risk for influenza complications (e.g., pregnant women, immunocompromised healthcare workers) has been developed.
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Mental health and faith-based resources who will provide counseling to personnel during a pandemic have been identified.
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A strategy for housing healthcare personnel who may be needed on-site for prolonged periods of time is in place.
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A strategy for accommodating and supporting personnel who have child or elder care responsibilities has been developed.
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A vaccine and antiviral use plan has been developed.
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A contact for obtaining influenza vaccine has been identified. (Name)
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A contact for obtaining antiviral prophylaxis has been identified. (Name)
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A priority list (based on HHS guidance for use of vaccines and antivirals in a pandemic when in short supply) and estimated number of patients and healthcare personnel who would be targeted for influenza vaccination or antiviral prophylaxis has been developed.
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Number of first priority personnel
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Number of second priority personnel
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Number of remaining personnel
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Number of first priority patients
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Number of second priority patients
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A system for rapidly distributing vaccine and antivirals to patients has been developed.
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Issues related to surge capacity have been addressed.
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A plan is in place to address unmet staffing needs in the hospital.
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The minimum number and categories of personnel needed to care for a group of patients with pandemic influenza has been determined.
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Responsibility for assessing day-to-day clinical staffing needs during an influenza pandemic has been assigned.
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Persons responsible are: (names and/or titles)
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Legal counsel has reviewed emergency laws for using healthcare personnel with out-of-state licenses.
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Legal counsel has made sure that any insurance and other liability concerns have been resolved.
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Criteria for declaring a “staffing crisis” that would enable the use of emergency staffing alternatives have been defined.
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The plan includes linking to local and regional planning and response groups to collaborate on addressing widespread healthcare staffing shortages during a crisis.
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A priority list for reassignment and recruitment of personnel has been developed.
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A method for rapidly credentialing newly recruited personnel has been developed.
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Mutual AID Agreements (MAAs) and Memoranda of Understanding/Agreement (MOU/As) have been signed with other facilities that have agreed to share their staff, as needed.
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Strategies to increase bed capacity have been identified
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A threshold has been established for canceling elective admissions and surgeries
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MOAs have been signed with facilities that would accept non-influenza patients in order to free-up bed space
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Areas of the facility that could be utilized for expanded bed space have been identified
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The estimated patient capacity for this facility is
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Plans for expanded bed capacity have been discussed with local and regional planning groups
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Anticipated durable and consumable resource needs have been determined
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A primary plan and contingency plan to address supply shortages has been developed
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Plans for obtaining limited resources have been discussed with local and regional planning and response groups.
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A strategy for handling increased numbers of deceased persons has been developed.
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Plans for expanding morgue capacity have been discussed with local and regional planning groups.
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Local morticians have been involved in planning discussions.
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Mortality estimates have been used to estimate the number of body bags and shrouds.
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Supply sources for postmortem materials have been identified.
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<p>Health care providers will play a crucial role in the event of a pandemic. Planning for pandemic influenza is key.</p>